Health Inequalities in Maternal Care for Black, Asian & Minority Ethnic Women in UK

Examining factors contributing to these inequalities, their impact on health and social care experiences, and the government policies and interventions aimed at reducing these disparities and improving maternal health outcomes for BAME communities

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Introduction of Health & Social Care Inequalities Assignment

Health inequalities are considered to be the differences in the health status as well as changes in the distribution within the health resources that are arising at different groups among the chosen population. There are numerous ways in which the term health inequalities that can is used. This clearly indicates or depicts that when one is talking about health inequality, it is useful to measures the inequality that being distributed and between which sectors of people it is being considered (Campos-Matos et al. 2021). Health inequalities are considered to be “unfair and avoidable differences” within the health across the population that is being chosen in between different groups within the same society. This also includes how people are likely to live within the society, the health condition they are experiencing within the community and the level of intense care that is available to them. Health inequalities usually arises from that point from which an individual is born, the cultural values that they are administering as well as the health status across the population and between the different sectors present within the same society. These are considered to be the major determinants of health. People dwelling in the UK community and those are Black Asian has created a direct link with the people considering the minor groups as well as between other groups of the same minority. Therefore, this essay is inclined towards inequality in access to maternal healthcare among the Black Asian and minority ethnic population living in the major area of the UK (Hosseinpoor et al. 2018). The issue chosen here is the maternal health care among Black Asian and minority ethnic population those who are leaving in major parts of UK and it is going to provide an explanation on how this inequalities exist and how it affect the health and social care setting of the chosen group as well as it will provide an exploration of the facts that the government policies and intervention can be introduced in order to reduce the inequality as well as improve health and social care outcomes.

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Maternal Health Inequalities and Ethnicity in BAME

Maternal as well as “infant mortality and morbidity rate” have observed a sharp declination in the recent decade within the entire world and there has been much improvement in the maternal care in the UK. As per the recent research, disparities are present within the ethnic groups. “Black Asian and minority ethnic (BAME)” women has observed certain limitations in access to maternity service within the UK population as well as experiencing poor health outcomes as compared to that of British women. The health inequalities among the BAME population is considered to be a major area of concern among the UK community and it had raised the interest within the media sources as well. Women from the Black, Asian and minority ethnicities reported care are determined to be much more functional as well supportive as compared to that of the mother maternity service groups and most of the time they usually failed to treat them as the person. This inequality has drastically affected their culture and increases the complexities within their lives as well as impose a serious threat to the minority groups within the chosen population (Khan, 2021). Moreover, on the other hand, the UK maternity service faced a number of challenges due to the significant alteration in the chosen population as they tries to meet the needs and the requirements of the maternal population. According to that “2011 UK census”, it has been evident that “14% of the UK population” has identified as BAME and ethnically diverse populations were predominantly connected or associated with the lives belonging to the cities (ethnicity-facts-figures.service, 2022). It is also evident that the ethnic group of people are among the disadvantageous position among the major population of UK and the same time they are facing as strong social determination from the health including those of the poverty as well as unemployment rate. Moreover, on the other hand, it is also evident that the Covid 19 has also shown inequalities and has a disproportionate impact on the people from the Black and the corresponding minority of the ethic group of people.

Maternal service as well as system is regarded as organizational as well as a kind of logical structures that are contributing to the inequalities that are being faced by BAME women. As per the views of Ajayi (2021), the concern of all maternal health stakeholders has the motive to improve maternal health as well as reduce maternal death to the barest minimum. In order to understand the health equalities that the black and the group of minorities are constantly experiencing, it is evident that the NHS established in England are facing certain inequalities that are leading to forces as well as the structural racism and discrimination within the chosen society.

Inequalities affecting the health and social care experience of the BAME group

“Black, Asian and minority ethnic groups (BAME)” have significantly high “morbidity as well as mortality rate” in the UK as well as poor experience of care. As per the opinion of Ajayi (2021), underlying socio-economic factors including education employment poverty that are considered to be the clear factors that are contributing much more to the inequalities within the health condition. However, it is also depicted that the structural racism are leading people towards the ethnic minority background that are having poor or health outcomes. Ethnic differences in health may vary with the generation likely, in some BAME groups rates of ill health are considered to be worse among those who are born in the UK then in the first generation migrants (Beetham et al. 2021). As per the recent research it has been depicted that the inequalities within the maternal healthcare among the BAME people, it has an effect on the communication, the midwife women relationship, and has a strong effect on the maternity services as well as on the systems (Paton et al. 2020). An equal effect on the culture, social needs and in many other ethical activities as well could be administered by means of this. This is important for managing the healthcare situation of the people selected here and this is a major public health concern to look after.

It is being suggested that BAME groups are experiencing worse health than the overall population in the UK which has been also attributed to the social economic deprivation. As per the opinion of Igbineweka et al. (2021), higher rates of unemployment, poor housing as well as higher rates of poverty the differences are being evaluated. Communication is considered to one of the factor that has created barriers and are often considered oversimplified as well as misunderstand. As per the opinion of Igbineweka et al. (2021), there is ample evidence that proves that there are a number of factors that are mainly responsible for causing inequalities in the health of the individuals dwelling from the groups of BAME women within the UK community. The social factors that play an indistinct role in the UK community are the educational qualification, employment status, source of income as well as ethinity and equality. Moreover, in addition to that, midwives are not well aware of the verbal communication and they relies on their experience among the BAME population according to listening skill by means of healthcare professionals, which also resulted in women feeling dismissed as well as unsaved (Codjoe et al. 2019). As per opinion of Codjoe et al. (2019), the women who were taken under consideration from the UK population recognize that any difficult in having a relationship between them could results in major pregnancy outcome however midwives as well as the women are having different expectation among they are relationship with wives that are tended to take a holistic approach as well. While on the other hand the women they care for prefer professional as well as task oriented relationship. As per the opinion of Arday et al. (2022), it has been predominantly found that women found difficulty in establishing a deep relationship with the conditioning and massive altitudes of midwives because of negative previous experiences with midwives. It had led to the feelings of isolation as well and it had made possible lack of care within the same society. Those who had previously been encountered with the midwives and more likely to have a positive pregnancy as well as labour experience of “genuine interest in the women's emotional” wellbeing had often late to meet midwives workload result in distressed woman also fail stereotype that if they had diagnosis with maternal health problem and fail that they were being observe for science or failure with generated feelings of vulnerability as well (Haque et al. 2020). It is also evident from the recent research that Covid 19 has taken the lives of a large number of individuals from the minority groups as they cannot adjust with the white British resulting in the distinction of the different individuals from the same community. The policies and the healthcare advancement is necessary in order to address the needs of the common mass and especially to the BAME individuals who are the resident of the UK community.

Past research has predicted that patients who were belonging from this ethnic minority background has faced inequality while accessing their healthcare services even they faces problem in language as and they cannot communicate with the healthcare professionals (Feltner et al. 2018). They also face problem in population diversity as well as in the institutional altitudes as well. The current reality that is being considered for the ethnic minority patient with the health care system is considered to be one of the most standard issue that is being rising in the UK community. New policies and processes were also introduced in order to track these issues as well as to explore for the solutions as well as to monitor the expected outcome. Since, they cannot communicated with the healthcare professionals, they had faced certain issues in getting the required cared that is needed both in case of maternal services as well as during the other healthcare needs.

BAME women had a minimum level of engagement with the maternity services in comparison to the white woman that is from British society (Haque et al. 2020). It has also been reported that nonattendance appointments had often been misinterpreted as the midwives are avoiding the care and showing no concern for taking the care from the public settings. The women presenting from this minor groups are considered to be very much detrimental in avoiding the care from the healthcare professions as they feel abandoned within the society for interacting with the people from the other cultural sectors of women (Fallon et al. 2019). Some midwives had also acknowledged or found out that there are certain groups of women who were not willing to understand the verbal as well as written information about their appointment that are considered to be exacerbated by poor interpretation services as well. As per the opinion of Haque et al. (2020), it is also evident that Covid 19 has a havoc impact and the disease is disproportionately impacting the Black Asian and minority ethnic community. In UK it was very striking that the first 11 doctors who died due to Covid 19 were of the BAME background. As per the opinion of Haque et al. (2020), women are thinking of advertising on the open public as well as to present their orientation to the local general public in order to have a good access of the healthcare concern in case of the minor groups of women. Differences within the UK maternity service as compared to a woman that is from a native country could have contributed to a poor engagement as well and it has caused delayed in the service booking.

As per the opinion of FRSPH et al. (2022), Moreover it was also determined that the women who were belonging to this cultural community have since comparison or contradiction that has highly impacted the mental condition of the chosen community The BAME women were neglected from the society and they also differ in their cultural values as well. The factor that plays a key role within this context is that they were lacking a proper education, and was undergoing a long term poverty that has resulted in the enhancement of the workload or the burden among themselves (Novignon et al. 2019). Stereotyping and a lack of culture by means of healthcare professionals had a major contribution towards the late bookings and it had also created a sense of feelings isolated among some members who are from the similar community as that of the white British (Naz et al. 2019). “Childcare abundances” is considered to be one of the major challenges or issue that had been identified by the women for not attending the cultural community.

The factors on which they were showing comparison with the British women of the society is in the religious or cultural views The beam women are the individuals belonging to these community where also resulting in the lack of individualised Kiya from the healthcare professionals as they were more focused on the British women. In a study by Vahdaninia et al. (2020), most midwives were frustrated simply because women were led to “negative stereotypes” by midwives providing complex social services such as referrals to tax offices and residential purposes. Immigration status has also been linked to late appointments, and submission to maternity services is seen as a warning to authorities and deportation is imminent. Therefore it can be examined that inequalities within the healthcare sectors that are experienced by the BAME women in maternity service are considered to be one of the complex needs and of themselves each of the ethical groups of women had identified some overlapping position with the other (Singh, 2020).

It has also be seen that wave women very usually nucleated and they are even lacking a proper education that has created barrier among themselves within the society (Rehman, 2020). It subsequently impacted the care setting that is considered to be negative on the way the women usually interact with their community. On the other hand, the women were also at high risk of feeling isolated as well irrespective of their barrier in language difficulties and in the midwives ability to provide holistic care as well need time to mitigate or bridge the gap that is being created in between the language as well as communication need of women to provide effective care (Rehman, 2020). Moreover, difficulty in understanding the heterogeneous social cultural context of fostering stereotypical views had led to service expectation being women as well respecting women cultures as well as circumstances that can lead to greater engagement with service as well.

Government policies and interventions used

Reducing health inequalities between different countries is an ethical, social as well as economical way and it has a minor goal of the health system worldwide. Health equity is one of the major health concern when the “World health organization Ottawa charter” is being published for health promotion. The health and social care Act of 2012 has introduced a new system for health that has protected and improved the nation's health and wellbeing and reduced the health inequalities. They reduce health inequality by driving a “fair share of income power and wealth through legislation, policies, regulations and taxation” (Haynes, 2020). The maternity disparities task force was introduced in the year 2022 by the government of UK in order to support the women as well as the other ethnic minorities in order to provide support in their healthcare needs as well as to provide them the safest place to give birth to their child irrespective of their religions. It is evident that nearly £6.8 million is going to help the local health systems in order to reduce the overall health inequalities that is being experienced by pregnant women as well as their new born babies, and to bring significant improvement in the race equality (Crear-Perry et al. 2021). Ensuring fair and equitable access to good quality housing education as well as health and other public service is considered to be effective in order to mitigate or breach the gap that is being created among the beam. Sharing all public services and delivering the service in proportion to mitigate the need of the common people dwelling within the community is one of the major concern taken by the government. Initiatives that were taken by the government were to improve the living condition, urban planning as well as revival of rural infrastructures and the means of livelihood as well as to improve the educational qualification (Haynes, 2020). Nutrition and early child development as well as “security measures” and “food security measures” are considered to be the other effective means that is considered to be effective in order to mitigate the health inequality among the BAME people.

Conclusion

From each and every aspect of the study it can be determined that BAME women had encountered an area of 5 inequality that have a huge impact on their experiences as well as their healthcare services. The essay had clearly identified that “maternity services” act as a central or core theme that can be modified through effective policy or making certain amendments within the policies launched by the government as well as service implementation. All the five themes that are being encountered in the overall study of potential explanation to know differences within the Mortality as well as morbidity rate of “BAME women within the UK sector” compared to the white woman through detailed analysis in order to understand its casualty. Lastly, the entire study offers renowned understanding of the experience and health inequality from the BAME women as well as certain number of policies were being explored and the social health care Act that is considered to be effective in order to mitigate or bridge the gap between the equalities among the BAME women within the society are also being discussed.

References

Ajayi, O., 2021. A perspective on health inequalities in BamE communities and how to improve access to primary care. Future healthcare journal, 8(1), p.36.

Arday, J., Branchu, C. and Boliver, V., 2022. What do we know about Black and minority ethnic (BAME) participation in UK higher education?. Social Policy and Society, 21(1), pp.12-25.

Beetham, H., Hurt, L. and Copeland, L., 2021. P13 How have UK maternal health services change in response to the COVID-19 pandemic?–A systematic review. J Epidemiol Community Health, 75(Suppl 1), pp.A49-A49.

Campos-Matos, I., Mandal, S., Yates, J., Ramsay, M., Wilson, J. and Lim, W.S., 2021. Maximising benefit, reducing inequalities and ensuring deliverability: Prioritisation of COVID-19 vaccination in the UK. The Lancet Regional Health–Europe, 2.

Codjoe, L., Barber, S. and Thornicroft, G., 2019. Tackling inequalities: a partnership between mental health services and black faith communities. Journal of mental health, 28(3), pp.225-228.

Coronini-Cronberg, S., Maile, E.J. and Majeed, A., 2020. Health inequalities: the hidden cost of COVID-19 in NHS hospital trusts?. Journal of the Royal Society of Medicine, 113(5), pp.179-184.

Crear-Perry, J., Correa-de-Araujo, R., Lewis Johnson, T., McLemore, M.R., Neilson, E. and Wallace, M., 2021. Social and structural determinants of health inequities in maternal health. Journal of women's health, 30(2), pp.230-235.

Fallon, V.M., Harrold, J.A. and Chisholm, A., 2019. The impact of the UK Baby Friendly Initiative on maternal and infant health outcomes: A mixed?methods systematic review. Maternal & Child Nutrition, 15(3), p.e12778.

Feltner, C., Weber, R.P., Stuebe, A., Grodensky, C.A., Orr, C. and Viswanathan, M., 2018. Breastfeeding programs and policies, breastfeeding uptake, and maternal health outcomes in developed countries.

FRSPH, M.J.M., MacGregor, F., Salman, M., Breckon, J., Kunonga, E., Tolchard, B. and Nnyanzi, L., 2022. Exploring the barriers and facilitators to making healthy physical activity lifestyle choices among UK BAME adults during covid-19 pandemic: A study protocol. International Journal of Physical Activity and Health, 1(3), p.1.

Haque, E.U., Choudry, B. and George, R.E., 2020. How Can We Improve Health and Healthcare Experiences of Black, Asian and Minority Ethnic (BAME) Communities?. In Tackling Causes and Consequences of Health Inequalities (pp. 233-244). CRC Press.

Haynes, K., 2020. Structural inequalities exposed by COVID-19 in the UK: the need for an accounting for care. Journal of Accounting & Organizational Change.

Hosseinpoor, A.R., Bergen, N., Schlotheuber, A. and Grove, J., 2018. Measuring health inequalities in the context of sustainable development goals. Bulletin of the World Health Organization, 96(9), p.654.

Igbineweka, N.E., Tshuma, N. and Roy, N., 2021. Medical science must address health disparities amongst different ethnic groups. Nature Human Behaviour, 5(12), pp.1595-1597.

Khan, Z., 2021. Ethnic health inequalities in the UK's maternity services: a systematic literature review. British Journal of Midwifery, 29(2), pp.100-107.

Naz, S., Gregory, R. and Bahu, M., 2019. Addressing issues of race, ethnicity and culture in CBT to support therapists and service managers to deliver culturally competent therapy and reduce inequalities in mental health provision for BAME service users. The Cognitive Behaviour Therapist, 12.

Novignon, J., Ofori, B., Tabiri, K.G. and Pulok, M.H., 2019. Socioeconomic inequalities in maternal health care utilization in Ghana. International journal for equity in health, 18(1), pp.1-11.

Paton, A., Fooks, G., Maestri, G. and Lowe, P., 2020. Submission of evidence on the disproportionate impact of COVID 19, and the UK government response, on ethnic minorities and women in the UK.

Rehman, Z., 2020. A mixed-method study exploring the mental health problems of a diverse LGB community in the UK: a focus on the experiences of BAME LGB individuals.

Shaaban, A.N., Peleteiro, B. and Martins, M.R.O., 2020. The Writing's on the Wall: On Health Inequalities, Migrants, and Coronavirus. Frontiers in public health, 8, p.505.

Singh, C., 2020. PHE and BAME inequalities: too little, too late?. British Journal of General Practice, 70(699), pp.498-498.

Vahdaninia, M., Simkhada, B., van Teijlingen, E., Blunt, H. and Mercel-Sanca, A., 2020. Mental health services designed for Black, Asian and Minority Ethnics (BAME) in the UK: a scoping review of case studies. Mental Health and Social Inclusion.

ethnicity-facts-figures.service.gov.uk, Overview of the article, Available at: https://www.ethnicity-facts-figures.service.gov.uk/uk-population-by-ethnicity

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