title: Migrant women's perceptions of healthcare during pregnancy and early motherhood: addressing the social determinants of health.
abstract: Recent guidelines from the World Health Organization emphasize the need to monitor the social determinants of health, with particular focus on the most vulnerable groups. With this in mind, we evaluated the access, use and perceived quality of care received by migrant women during pregnancy and early motherhood, in a large urban area in northern Portugal. We performed semi-structured interviews in 25 recent mothers, contacted through welfare institutions, who had immigrated from Eastern European countries, Brazil, or Portuguese-speaking African countries. Six native-Portuguese women of equal economic status were also interviewed for comparison. Misinformation about legal rights and inadequate clarification during medical appointments frequently interacted with social determinants, such as low social-economic status, unemployment, and poor living conditions, to result in lower perceived quality of healthcare. Special attention needs to be given to the most vulnerable populations in order to improve healthcare. Challenges reside not only in assuring access, but also in promoting equity in the quality of care.
authors.affiliation: Institute of Public Health, Faculty of Medicine, University of Porto (ISPUP/FMUP), Rua das Taipas no 135, 4050-600, Porto, Portugal, ligia_almeida@fpce.up.pt.
authors.forename: Lígia Moreira
authors.initials: LM
authors.lastname: Almeida
authors.forename: Catarina
authors.initials: C
authors.lastname: Casanova
authors.forename: José
authors.initials: J
authors.lastname: Caldas
authors.forename: Diogo
authors.initials: D
authors.lastname: Ayres-de-Campos
authors.forename: Sónia
authors.initials: S
authors.lastname: Dias
mesh_terms: D000328:Adult; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011174:Portugal; D011247:Pregnancy; D011787:Quality of Health Care; D064890:Social Determinants of Health; D014171:Transients and Migrants; D035862:Vulnerable Populations