Community-based doulas for migrant and refugee women: A mixed-method systematic review and narrative synthesis

Sarah Min Lee Khaw, Rana Islamiah Zahroh, Kerryn O'Rourke, Ruth Elizabeth Dearnley, Caroline Homer, Meghan A. Bohren

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    Abstract

    Background Community-based doulas share the same cultural, linguistic, ethnic backgrounds or social experiences as the women they support. Community-based doulas may be able to bridge gaps for migrant and refugee women in maternity settings in high-income countries (HICs). The aim of this review was to explore key stakeholders’ perceptions and experiences of community-based doula programmes for migrant and refugee women during labour and birth in HICs, and identify factors affecting implementation and sustainability of such programmes.

    Methods We conducted a mixed-method systematic review, searching MEDLINE, CINAHL, Web of Science, Embase and grey literature databases from inception to 20th January 2022. Primary qualitative, quantitative and mixed-methods studies focusing on stakeholders’ perspectives and experiences of community-based doula support during labour and birth in any HIC and any type of health facility were eligible for inclusion. We used a narrative synthesis approach to analysis and GRADE-CERQual approach to assess confidence in qualitative findings.

    Results Twelve included studies were from four countries (USA, Sweden, England and Australia). There were 26 findings categorised under three domains: (1) community-based doulas’ role in increasing capacity of existing maternity services; (2) impact on migrant and refugee women’s experiences and health; and (3) factors associated with implementing and sustaining a community-based doula programme.

    Conclusion Community-based doula programmes can provide culturally-responsive care to migrant and refugee women in HICs. These findings can inform community-based doula organisations, maternity healthcare services and policymakers. Further exploration of the factors that impact programme implementation, sustainability, strategic partnership potential and possible wider-reaching benefits is needed.
    Original languageEnglish
    Article numbere009098
    Pages (from-to)1-16
    Number of pages16
    JournalBMJ Global Health
    Volume7
    Issue number7
    DOIs
    Publication statusPublished - 28 Jul 2022

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