Disproportional morbidity and mortality experienced by ethnic minorities in the UK have been highlighted by the COVID-19 pandemic. The ‘Black Lives Matter’ movement has exposed structural racism’s contribution to these health inequities. ‘Cultural Safety’, an antiracist, decolonising and educational innovation originating in New Zealand, has been adopted in Australia. Cultural Safety aims to dismantle barriers faced by colonised Indigenous peoples in mainstream healthcare by addressing systemic racism.This paper explores what it means to be ‘culturally safe’. The ways in which New Zealand and Australia are incorporating Cultural Safety into educating healthcare professionals and in day-to-day practice in medicine are highlighted. We consider the ‘nuts and bolts’ of translating Cultural Safety into the UK to reduce racism within healthcare. Listening to the voices of black, Asian and minority ethnic National Health Service (NHS) consumers, education in reflexivity, both personal and organisational within the NHS are key. By listening to Indigenous colonised peoples, the ex-Empire may find solutions to health inequity. A decolonising feedback loop is required; however, we should take care not to culturally appropriate this valuable reverse innovation.
Background: Pregnant women/people globally are increasingly using digital technology such as texting, emailing, instant messaging, pregnancy applications, social media and the internet to access information about their pregnancy. There is little information, however, on how the technology is used to enable midwives and pregnant women/people to communicate with each other and what effect this may have on the quality of maternal and newborn health within Aotearoa New Zealand. Aim: To explore the literature on how communication technology has been used to enable midwives and pregnant women/people to connect with each another. Method: An integrative literature review of peer reviewed studies between 2010 and 2021 was undertaken to explore how communication technology was used to enable midwives and pregnant women/people to connect with each another. The initial search elicited 450 articles, of which five met the inclusion criteria. These were then assessed using the Critical Appraisals Skills Programme checklist. Results: The five relevant studies were summarised using an evidence table to enable comparison of themes or relationships between the studies. Four main themes were identified: (1) connecting, (2) access to healthcare, (3) privacy and confidentiality, and (4) lack of skills and knowledge. Using communication technology appeared to provide a safe space for information sharing within which pregnant women/people and midwives could connect. A feeling of connection was important, in supporting the pregnant woman/person in their access to maternity services. This emotional connection was enabled regardless of whether the pregnant person and midwife were known to each other. However, concerns were identified relating to issues of privacy, and the skills pregnant women/people and midwives needed to access and use the technology. Conclusion: Gaps in the published literature were highlighted through undertaking this integrative literature review. The first was in the understanding of how midwives and pregnant women/people use communication technology when communicating with one another, and the second was in how communication technology is used within a midwifery continuity of care model.
There is growing use of communication technology in Aotearoa New Zealand. How it is used between midwives and pregnant people is unknown. Surveys are ideal for gathering information when there is little known of a phenomenon. Aligning questions to a midwifery informed framework provides an innovate approach to explore this issue. To assess reliability and validity of questions for two online surveys using a tool created for an expert advisory group of midwives with experience in survey design and midwifery practice. An innovative approach is taken to validate questions for two online surveys using an expert advisory group of seven midwifery academic researchers with experience in both quantitative and qualitative research designs, and midwifery practice. The group were asked to rate items using a 4-point rating scale ranging from strongly agree to strongly disagree. Analysis of the scoring was undertaken using Content Validity Index, Cronbach’s alpha coefficient and review of comments by the group. Quantitative scoring of both survey instruments were valid and reliable. The overall Content Validity Index score was 0.92 (midwives) and 0.93 (pregnant people). The overall Cronbach’s alpha coefficient score was .78 (midwives) and .83 (pregnant people). Qualitative comments reinforced the validity and reliability of survey questions. An innovative approach was taken in assessing the reliability and validity of two online surveys using a midwifery expert advisory group and a midwifery framework to situate the surveys within a midwifery body of expertise and knowledge. The comments made by midwifery experts provided an extra layer in the validation of survey instruments using Content Validity Index and Cronbach’s alpha coefficient scoring. Creating a tool for validating questions developed by midwives for an expert group of midwives recognises the potential patriarchal roots of knowledge production and dissemination and enables marginalised voices to be heard.
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