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South Asian individuals experiences on the NHS low-calorie diet programme: a qualitative study in community settings in England

Por: Dhir · P. · Maynard · M. · Drew · K. J. · Homer · C. V. · Bakhai · C. · Ells · L. J.
Background

Existing literature examines barriers to the provision of ethnically diverse dietary advice, however, is not specific to total diet replacement (TDR). There is a lack of literature from the UK, limiting the potential applicability of existing findings and themes to the UK context. This study addresses this gap in research by interviewing participants of South Asian ethnicity who have undertaken the National Health Service (NHS) low-calorie diet programme (LCD) for people with type 2 diabetes living with overweight or obesity. This study explores factors that may affect the uptake and acceptability of its TDR, food reintroduction and weight maintenance stages. This aims to provide rich data that can inform effective tailoring of future programmes with South Asian participants.

Objective

To explore the perspectives of individuals of South Asian ethnicity on an NHS programme using TDR approaches for the management of type 2 diabetes (T2D).

Design

Qualitative study.

Setting

Individuals in the community undertaking the NHS LCD programme.

Participants

Twelve one-to-one interviews were conducted with individuals from a South Asian ethnicity participating in the NHS LCD.

Main outcome measures

Qualitative semistructured interviews conducted through different stages of the programme. Reflexive thematic analysis was used to analyse the transcripts.

Results

Key themes highlighted positive and negative experiences of the programme: (1) more work is needed in the programme for person centeredness; (2) it is not the same taste; (3) needing motivation to make changes and feel better; (4) a mixed relationship with the coach; (5) social experiences; (6) culture-related experiences.

Conclusion

This study provides important experience-based evidence of the need for culturally tailored T2D programmes. Action to address these findings and improve the tailoring of the NHS LCD may improve experience, retention and outcomes on the programme for people of South Asian ethnicity and thereby reduce inequalities.

Intrapartum care measures and indicators for monitoring the implementation of WHO recommendations for a positive childbirth experience: a scoping review

Por: Vallely · L. H. · Shalit · A. · Nguyen · R. · Althabe · F. · Pingray · V. · Bonet · M. · Armari · E. · Bohren · M. · Homer · C. · Vogel · J. P.
Objective

We aimed to identify all available studies describing measures or indicators used to monitor 41 intrapartum care practices described in the 2018 WHO intrapartum care recommendations, with a view to informing development of standardised measurement of implementing these recommendations.

Design

Systematic scoping review.

Methods

We conducted a scoping review to identify studies reporting measures of intrapartum care published between 1 January 2000 and 28 June 2021. Primary and secondary outcome measures included study characteristics (publication year, journal, country and World Bank classification) and intrapartum care measure characteristics (definition, numerator, denominator, measurement level and measurement approach). We searched MEDLINE, EMBASE, CINAHL, Cochrane Library, the Maternity and Infant Care Database, Global Index Medicus and grey literature using structured search terms related to included recommendations, focusing on respectful and supportive care, and clinical practices performed throughout labour and birth. The measures identified were classified by the WHO recommendation and their characteristics reported.

Results

We identified 150 studies which described 1331 intrapartum care measures. These measures corresponded to 35 of the 41 included WHO recommendations, and represented all domains of the WHO recommendations (care throughout labour and birth, first stage of labour, second stage of labour, third stage of labour). A total of 40.1% (534 of 1331 measures) of measures were related to respectful maternity care. Most studies used a questionnaire or survey measurement approach (522 of 1331 measures, 39.2%).

Conclusion

This scoping review presents a database of existing intrapartum care measures used to monitor the quality of intrapartum care globally. There is no clear consensus on a core set of measures for evaluating the practice of the WHO’s intrapartum care recommendations. This review provides a foundation to support the development of a core set of internationally standardised intrapartum care measures for the WHO intrapartum care recommendations, highlighting key areas requiring consensus and validation, and measure development.

The provision of midwife-led care in low-and middle-income countries: An integrative review

Addressing preventable maternal and newborn mortality and morbidity are major issues globally with low- and lower middle-income countries (LMICS) having the highest rates (Graham et al. 2016; UNFPA, WHO & ICM 2014; WHO, UNICEF & UNFPA 2014). Each day, approximately 830 women die from preventable causes related to pregnancy and childbirth (Alkema et al. 2016). In addition, approximately 2.5 million newborn babies die each year (UN 2018) and a further 2.6 million are stillborn (Lawn et al. 2011). Most deaths are from LMICS which account for 95% of maternal and 90% of all child deaths globally (Boerma et al.
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