Yonder: Ethnic minority maternity experiences, colorectal resection, foreign medical aid and weight stigma

Ahmed Rashid is a GP and Professor of medical education at UCL medical school, He is on X: @Dr_A_Rashid

Existing evidence has shown that ethnic minority women feel neglected and are not receiving optimum quality of maternity care, which affects both maternal and newborn health outcomes. Given this, a research team from Singapore recently sought to consolidate the available evidence around ethnic minority women’s experiences and needs when accessing maternity care¹. Synthesising results from 22 studies, they found that negative experiences with maternity care were attributed to barriers including ineffective communication, cultural and religious insensitivity, inattentiveness and disregard for women’s needs, and isolation-related impact due to the COVID pandemic. The authors conclude that there is a ‘big gap’ between the expectations of these women and the maternity care they receive. They argue that maternity care policies need to recognise the experiences of ethnic minority women but also highlight that further context-specific research is needed given important geographical differences between world regions.

Surgical resection, which encompasses invasive and high-risk procedures with significant complication rates, remains an important part of the management of colorectal cancer, which is an extremely common cancer across Europe. In order to support improved shared decision making, a research team from the Netherlands sought to explore the impact of resection for colorectal cancer on patients’ daily life². They found that patients face several challenges in the long term, including stoma issues, poor bowel function, chemotherapy-induced neuropathy, fear of tumour recurrence and sexual dysfunction. Notably, though, these challenges and health deficits lead to only minor interference with daily life, leading the authors to suggest that coping mechanisms are likely to be effective for these patients.

For those of us working in high-income countries, it can be easy to ignore that reliance on medical missions is a reality in many healthcare systems globally. Short-term medical missions (STMMs) are a healthcare delivery model where services are provided for a limited period (days, weeks) to a community with unmet healthcare needs. There is, though, growing concern about the sustainability and long-term impact of this model, prompting a recent study in Honduras³. It found that although Honduran healthcare providers largely framed foreign medical teams as being assets, most respondents emphasised a need for culturally- and linguistically-tailored medical care and health education interventions. Participants also recommended strengthening local partnerships to mitigate the risk of dependence, including on-going training and support of community health workers to promote sustainable change.

The detrimental impact of experiencing weight stigma on mental and physical health outcomes has emerged as an area of concern. In a recent study from Boston, the research team interviewed individuals with type 2 diabetes or prediabetes who completed a specialized binge eating disorder treatment program to understand their lived experience in healthcare settings and in a ‘weight-neutral’ eating disorder treatment program⁴. Participants reported that helpful elements included consistency in the eating pattern, sufficient and specific education, and comprehensive support. Reported impacts included decreased binge episodes, experiencing less shame, and increased resiliency following treatment. This was in stark contrast to the embarrassment, blame, and failure that they had become used to and led the authors to suggest that decreasing weight stigma should be an important priority going forwards.

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References

1. Toh RK, Shorey S. Experiences and needs of women from ethnic minorities in maternity healthcare: A qualitative systematic review and meta-aggregation. Women and Birth. 2023 Feb 1;36(1):30-8.
2. van Kooten RT, Schutte BA, van Staalduinen DJ, et al. Patient perspectives on consequences of resection for colorectal cancer: A qualitative study. Colorectal Disease. 2023 Jun 17.
3. Faktor KL, Payán DD, Ramirez AJ, May FP. Impact and Sustainability of Foreign Medical Aid: A Qualitative Study with Honduran Healthcare Providers. Annals of Global Health. 2023;89(1).
4. Salvia MG, Ritholz MD, Craigen KL, Quatromoni PA. Women’s perceptions of weight stigma and experiences of weight-neutral treatment for binge eating disorder: A qualitative study. EClinicalMedicine. 2023 Feb 1;56.

Featured Photo by Himesh Kumar Behera on Unsplash