Healthcare providers' perceptions of the challenges and opportunities to engage Chinese migrant women in contraceptive counselling: a qualitative interview study

Abstract

Background In Australia, there are many culturally and linguistically diverse communities and Chinese migrants make up one of the largest. Yet, little is known about healthcare providers’ (HCPs) unique experiences in providing contraceptive care for Chinese migrant women. There is minimal research into the HCPs’ perceptions of challenges or opportunities in engaging Chinese migrant women in informed and shared decision-making processes during contraceptive counselling. The aim of this study is to explore HCPs’ experiences of providing contraceptive care for Chinese migrant women, their perceptions of women’s care needs when choosing contraceptive methods, as well as their own needs in supporting women’s decision-making. Methods: Semi-structured interviews were conducted with 20 HCPs in Sydney, Australia who had substantial experience in providing contraceptive services to Chinese women who were recent migrants. Transcribed audio-recorded data were analysed using thematic analysis. Results: Four main themes were identified, including: ‘Are you using contraception?’: the case for being proactive and opportunistic; ‘Getting the message across’: barriers to communication; ‘Hormones are unnatural?’: women favouring non-hormonal methods; and ‘Word of mouth’: social influence on contraceptive method choice. Conclusions: In order to facilitate informed choice and shared decision-making with Chinese migrant women during contraceptive counselling, broader health system and community-level strategies are needed. Such strategies could include improving HCPs’ cultural competency in assessing and communicating women’s contraceptive needs; providing professional interpreting services and translated materials; and improving women’s health literacy, including their contraceptive knowledge and health system awareness.

Long-acting reversible contraception and satisfaction with structured contraceptive counselling among non-migrant, foreign-born migrant and second-generation migrant women: evidence from a cluster randomised controlled trial (the LOWE trial) in Sweden

“…An additional strength of this trial is the use of multimodal tools in the intervention material. Although many of the foreign-born migrants had been residing in Sweden for a long time and the majority spoke Swedish, multimodal materials can be an important complement in shared decision-making,7 especially when one is not receiving information in one’s native language. Hence, translated materials are important.…”

“…Lower contraceptive use and higher abortion rates have been reported among migrants from low- and middle- income countries who reside in high-income countries in Europe, including Sweden 2–5. The lower use of contraception among migrants has been explained by language and knowledge barriers and limited access to healthcare as well as by values related to contraceptive use or the use of certain contraceptive methods 6 7. Since 2005, immigration to Sweden has increased,8 and a lower contraceptive use is still seen among migrants compared with non-migrants 9…”

“…There are conflicting data on how to provide contraceptive counselling to migrants. Some data show that healthcare providers proactively take opportunities to discuss contraception with migrants while other data indicate that contraception is less often discussed with migrants compared with non-migrants 7 10. Providing contraceptive counselling to migrants may increase the demands on healthcare providers, such as handling time constraints and knowledge and language barriers,11 as well as having to acquire knowledge and awareness of cultural and religious factors 12…”