Transnationalism and care of migrant families during pregnancy, postpartum and early-childhood: an integrative review

Abstract

Background: Migrant families' transnational ties (i.e., connections to their countries of origin) may contribute to their hardships and/or may be a source of resiliency. A care approach that addresses these transnational ties may foster a positive identity and give coherence to experiences. We conducted an integrative review to determine what is known about transnational ties and the care of migrant families during pregnancy, postpartum and early childhood. Methods: We searched 15 databases to identify literature reporting on a health or social program, service, or care experience of migrant families during pregnancy up to age five in a Western country (i.e., Canada, US, Australia, New Zealand or a European country). Information regarding if and how the service/program/care considered transnational ties, and care-providers' perceptions of transnational ties, was extracted, analyzed and synthesized according to transnational 'ways of belonging' and 'ways of being'. Results: Over 34,000 records were screened; 69 articles were included. Care, programs and services examined included prenatal interventions (a mhealth app, courses, videos, and specialized antenatal care), doula support, maternity care, support groups, primary healthcare and psycho-social early intervention and early childhood programs. The results show that transnational ties in terms of 'ways of belonging' (cultural, religious and linguistic identity) are acknowledged and addressed in care, although important gaps remain. Regarding 'ways of being', including emotional, social, and economic ties with children and other family members, receipt of advice and support from family, and use of health services abroad, there is very little evidence that these are acknowledged and addressed by care-providers. Perceptions of 'ways of belonging' appear to be mixed, with some care-providers being open to and willing to adapt care to accommodate religious, cultural and linguistic differences, while others are not. How care-providers perceive the social, emotional and economic ties and/or the use of services back home, remains relatively unknown. Conclusion: Significant knowledge gaps remain regarding care-providers' perceptions of transnational 'ways of being' and whether and how they take them into account, which may affect their relationships with migrant families and/or the effectiveness of their interventions. Continued efforts are needed to ensure care is culturally safe for migrants.

Barriers to and Recommendations for Equitable Access to Healthcare for Migrants and Refugees in Aotearoa, New Zealand: An Integrative Review

“…This is not a counter to integration, but to allow migrants and refugees to maintain their transnational identity, and preserve, honour and respect their cultural, religious, and linguistic ties, Salahshour [ 73 ] proposes increased policies and initiative encouraging better intercultural understanding of other minority groups while maintaining the attention given to Māori and Pacific people as being mutually exclusive. Allowing migrants and refugees to maintain their transnational identity and among other identities may provide an alternate and viable avenue to cultivate a sense of belonging, contribute to social and economic capital, and result in the health benefits for migrant and refugee communities as seen elsewhere [ 74 , 75 ].…”

Healthcare Professionals’ Perceptions of Promoting Healthy Lifestyle Behaviors in Pregnant Migrant Women and the Potential of a Digital Support Tool—A Qualitative Study

“…We also identified resources needed in maternity care to promote health behaviors, including need of cultural awareness. Increased cultural competence has previously been identified as a need in the healthcare meeting for healthcare professionals working with pregnant migrant women and migrant families with young children [ 27 ]. Additionally, we found that resources, such as satisfying communication, time, and trust are essential in the health-promoting meeting.…”

How to Support Child Healthcare Nurses in Sweden to Promote Healthy Lifestyle Behaviors from the Start of Life

“…A study by Laws et al also reported how maternal and child health nurses expressed a desire to know more about how to tailor interactions and recommendations to different cultures [15]. Furthermore, a recent integrative review looking at migrant family experiences also highlighted "the need of culturally safe interventions and care environments", as migrant families reported that the care provided within maternal-and child-healthcare were not always culturally appropriate [26]. Thus, it is important to find working methods that can be adapted to different cultures.…”