Interventions that improve maternity care for immigrant women in the UK: protocol for a narrative synthesis systematic review

Introduction A quarter of all births in the UK are to mothers born outside the UK. There is also evidence that immigrant women have higher maternal and infant death rates and of inequalities in the provision and uptake of maternity services/birth centres. The topic is of great significance to the National Health Service because of directives that address inequalities and the changing patterns of migration to the UK. Our main question for the systematic review is ‘what interventions exist that are specifically focused on improving maternity care for immigrant women in the UK?’ The primary objective of this synthesis is to generate new interpretations of research evidence. Second, the synthesis will provide substantive base to guide developments and implementation of maternity services/birth centres which are acceptable and effective for immigrant women in the UK. Methods and analysis We are using a narrative synthesis (NS) approach to identify, assess scientific quality and rigour, and synthesise empirical data focused on access and interventions that enhance quality of maternity care/ birth centres for the UK immigrant women. The inclusion criteria include: publication date 1990 to present, English language, empirical research and findings are focused on women who live in the UK, participants of the study are immigrant women, is related to maternity care/ birth centres access or interventions or experiences of maternity. In order to ensure the robustness of the NS, the methodological quality of key evidence will be appraised using the Center for Evidence-Based Management tools and review confidence with CERQual (Confidence in the Evidence from Reviews of Qualitative Research). Two reviewers will independently screen studies and extract relevant evidence. We will synthesise evidence studying relationships between included studies using a range of tools. Dissemination Dissemination plan includes: an e-workshop for policymakers, collaborative practitioner workshops, YouTube video and APP, scientific papers and conference presentations. IntroductIon The UK is in a period of superdiversity with more diverse populations accessing maternity care. Superdiversity ‘is distinguished by a dynamic interplay of variables among an increased number of new, small and scattered, multiple-origin, transnationally connected, socio-economically differentiated and legally stratified immigrants’ (p 1024) who started arriving in the UK after 1990. It has been argued that current level of superdiversity in the UK has resulted in a huge challenge for understanding and meeting individualised healthcare needs. Offering relevant and effective maternity healthcare to immigrant women in the UK is crucial for achieving maximum health and well-being potentials. 3 6–8 Absence of culturally relevant and safe healthcare can result in negative outcomes ranging from inadequate communication to life-risking events with serious consequences in maternity. Interventions that improve maternity care for immigrant women in the UK: protocol for a narrative synthesis systematic review Gina Marie Awoko Higginbottom, Catrin Evans, Myfanwy Morgan, Kuldip Kaur Bharj, Jeanette Eldridge, Basharat Hussain to cite: Higginbottom GMA, Evans C, Morgan M, et al. Interventions that improve maternity care for immigrant women in the UK: protocol for a narrative synthesis systematic review. BMJ Open 2017;7:e016988. doi:10.1136/