Providing health information to immigrant families during pregnancy and childbirth poses particular challenges. A study from Melbourne, Australia, involving 16 mothers, 14 fathers and 34 health professionals, has identified a number of particular needs. Half of the parents interviewed had not completed secondary school and five were not literate in their spoken language.

All those interviewed reported that they consulted substantially with family members and friends.

“I always discuss it with my husband and my family in Pakistan…..My husband is the first point of contact, then my family in Pakistan, then community member….but I cannot discuss my family matters with community members because I cannot trust them and I am afraid of being a topic of gossip in the community.” (A mother)

Nurses and doctors were also reported as main sources of information.

“Yes, she would explain things…she would tell us things like how to feed the baby and how much to feed the baby. She also gave us some numbers to call if we needed any help, and she also came to our house three times.” (A father)

A number of key challenges were identified in the interviews.

• Where health literacy is very low – lack of understanding of both health issues and the health system – communication is considerably limited. Several nurses reported that some Afghan women had insufficient knowledge even to understand diagrams.
• Drawing pictures is a possibility, but some midwives doubt their drawing abilities!
• Translated material is of limited use if the woman or man is illiterate in their spoken language.
• Interpreters, when used, sometimes used a different dialect from the woman/man.
• Often the man is used as the interpreter, which can work, but has limitations – his own language abilities may not be adequate and there is the possibility of him selecting which information to pass on.
• Antenatal classes don’t work well. Problems include lack of transport, language barriers (lack of interpreters and classes are not language specific so multiple interpreters would be required), cost and care responsibilities for older children.
• On-line information (almost all in English) is rarely tailored to minorities.

The researchers make three recommendations:

1. Ensure health professionals have access to alternatives to written information – diagrams/images.
2. Ensure access to interpreters, including those proficient in particular dialects.
3. Health professions need to build trust, explaining their role and how the health system works, and understanding the person’s past experiences.

Riggs E, Yelland J, Szwarc J, Duell-Piening P, Wahidi S, Fouladi F, Casey S, Chesters D & Brown S (2020), Afghan families and health professionals’ access to health information during and after pregnancy, Women and Birth 33

Header photo: Asim Bharwani. Creative Commons.