title: Development of the Migrant Friendly Maternity Care Questionnaire (MFMCQ) for migrants to Western societies: an international Delphi consensus process.
abstract: BACKGROUND
  Through the World Health Assembly Resolution, 'Health of Migrants', the international community has identified migrant health as a priority. Recommendations for general hospital care for international migrants in receiving-countries have been put forward by the Migrant Friendly Hospital Initiative; adaptations of these recommendations specific to maternity care have yet to be elucidated and validated. We aimed to develop a questionnaire measuring migrant-friendly maternity care (MFMC) which could be used in a range of maternity care settings and countries.
  
  
  METHODS
  This study was conducted in four stages. First, questions related to migrant friendly maternity care were identified from existing questionnaires including the Migrant Friendliness Quality Questionnaire, developed in Europe to capture recommended general hospital care for migrants, and the Mothers In a New Country (MINC) Questionnaire, developed in Australia and revised for use in Canada to capture the maternity care experiences of migrant women, and combined to create an initial MFMC questionnaire. Second, a Delphi consensus process in three rounds with a panel of 89 experts in perinatal health and migration from 17 countries was undertaken to identify priority themes and questions as well as to clarify wording and format. Third, the draft questionnaire was translated from English to French and Spanish and back-translated and subsequently culturally validated (assessed for cultural appropriateness) by migrant women. Fourth, the questionnaire was piloted with migrant women who had recently given birth in Montreal, Canada.
  
  
  RESULTS
  A 112-item questionnaire on maternity care from pregnancy, through labour and birth, to postpartum care, and including items on maternal socio-demographic, migration and obstetrical characteristics, and perceptions of care, has been created--the Migrant Friendly Maternity Care Questionnaire (MFMCQ)--in three languages (English, French and Spanish). It is completed in 45 minutes via interview administration several months post-birth.
  
  
  CONCLUSIONS
  A 4-stage process of questionnaire development with international experts in migrant reproductive health and research resulted in the MFMCQ, a questionnaire measuring key aspects of migrant-sensitive maternity care. The MFMCQ is available for further translation and use to examine and compare care and perceptions of care within and across countries, and by key socio-demographic, migration, and obstetrical characteristics of migrant women.
authors.affiliation: Ingram School of Nursing and Department of Obstetrics and Gynaecology, McGill University, 3506 University St,, Room 207, Montreal, Quebec H3A 2A7, Canada. anita.gagnon@mcgill.ca.
authors.forename: Anita J
authors.initials: AJ
authors.lastname: Gagnon
authors.forename: Rebecca
authors.initials: R
authors.lastname: DeBruyn
authors.forename: Birgitta
authors.initials: B
authors.lastname: Essén
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.forename: Maureen
authors.initials: M
authors.lastname: Heaman
authors.forename: Zeinab
authors.initials: Z
authors.lastname: Jeambey
authors.forename: Dineke
authors.initials: D
authors.lastname: Korfker
authors.forename: Christine
authors.initials: C
authors.lastname: McCourt
authors.forename: Carolyn
authors.initials: C
authors.lastname: Roth
authors.forename: Jennifer
authors.initials: J
authors.lastname: Zeitlin
authors.forename: Rhonda
authors.initials: R
authors.lastname: Small
mesh_terms: D032921:Consensus; D003245:Consensus Statements as Topic; D065246:Culturally Competent Care; D003697:Delphi Technique; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000592:standards*; D017060:Patient Satisfaction; D011247:Pregnancy; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D014171:Transients and Migrants; D014175:Translating