Knowledge Hub

Background

• South Asian population in Hong Kong: Increased from 65K+ (2011) to 101K+ (2021) 
• Previous studies showed that ethnic minority and migrant women face health disparities, which can lead to adverse maternal and neonatal outcomes.

Method

• One-on-one in-depth interviews 
• Participants: 20 South Asian women who used maternity care services in the past 5 years 

Key findings

1) Maternal care services: Hong Kong VS home country 

• All participants preferred Hong Kong’s services over those in their country of origin. 
• They predominantly chose public services due to cost-effectiveness and reported overall satisfaction

2) Navigating Hong Kong’s maternal care system

• Public-private partnerships in Hong Kong presents a challenge for maintaining continuity of healthcare. 
• Recommendations 

1. 1. Ensure South Asian women are followed up by the same healthcare providers or translator, at least in the public sector
   2. Introduce the local healthcare system during antenatal visits or migration procedures
   3. Organize sharing sessions led by trained migrant women 

3) Perception of optimum care

• South Asian women have different perceptions of optimal care compared to local healthcare staff. The gap between expectations and actual care can lead to negative perceptions and feelings of discrimination. 
• Recommendations: Improve staff attitudes and understanding through cross-cultural training to provide culturally sensitive, woman-centred care.

4) Language & communication 

• Linguistic politeness and cultural differences in communication can hinder women's perception of staff attitude and services provided. 
• Recommendations: 

1. 1. Healthcare workers should explore women's preferences and provide options accordingly to avoid sounding coercive 
   2. Reserve specifically trained personnel and longer follow-up duration for culturally competent care 
   3. Provide additional visiting times for women to ask questions or give feedback 
   4. Ensure trained translators are available to facilitate communication 

5) Impact of COVID-19 

• Pandemic restrictions, including the cancellation of translation services and limiting of visitors, adversely affected maternity care experiences.  
• Recommendations: Ensure support through virtual translator services and facilitating food transport to mitigate these challenges in future pandemics 

Full article

Nagesh N, Ip CHL, Leung ETY, Wong JY, Fong DY, Lok KYW. South Asian women's views on and experiences of maternity care services in Hong Kong: A qualitative study. Women Birth. 2024 Aug 27;37(6):101806. doi: 10.1016/j.wombi.2024.101806. Epub ahead of print. PMID: 39197386. 

Background

In July 2020, Hong Kong increased statutory paid maternity leave from 10 to 14 weeks. 

Findings

1. Extended leave is associated with a 22% decrease in postnatal depression symptoms and a 33% decrease in emotional well-being interference in new mothers.
2. Even a modest increase in paid maternity leave was associated with significant benefits for mental health.
3. Post-policy mothers were significantly more likely to return to work than to quit or become stay-at-home mums.

Recommendations

1. Policy makers should consider extending paid maternity leave to international norms to improve working mums’ mental health and to support female workforce retention.  
2. Despite the positive impact of leave extension, maternal mental health concerns in Hong Kong remain pervasive and require further intervention. 

HKU Press Release

Full article

Andres EB, Du X, Pang SSL, Liang JN, Ye J, Lee MH, Tarrant M, Yung SS, Johnston JM, Lok KYW, Quan J. Extended Paid Maternity Leave Associated With Improved Maternal Mental Health In Hong Kong. Health Aff (Millwood). 2024 May;43(5):707-716. doi: 10.1377/hlthaff.2023.00742. PMID: 38709965. 

Full article

Lok KYW, Choi MSL, Ko RWT, Chau PPH, Lam CCO, Chang YS, Bick D. Effectiveness of a home-based peer support programme for Chinese mothers with low breastfeeding self-efficacy to increase the exclusivity and duration of breastfeeding: study protocol of a randomised control trial. BMJ Open. 2024 Jul 23;14(7):e081897. doi: 10.1136/bmjopen-2023-081897. PMID: 39043588; PMCID: PMC11268066.

Full article

Li J, Ip HL, Fan Y, Kwok JY, Fong DY, Lok KYW. Unveiling the voices: Exploring perspectives and experiences of women, donors, recipient mothers and healthcare professionals in human milk donation: A systematic review of qualitative studies. Women Birth. 2024 Jul 9;37(5):101644. doi: 10.1016/j.wombi.2024.101644. Epub ahead of print. PMID: 38986194.

Goal of the BFCI program

Promote breastfeeding and optimize its practices 

1. For expecting/breastfeeding mums: Offer comprehensive support and care during the perinatal period and post-hospital discharge
2. For the community: Improve breastfeeding knowledge, foster positive attitudes, and help community members create a supportive environment for breastfeeding mums

Breastfeeding education

1. Online Mother Workshop (1-2 hours) 

• • Participants: 2,340 expecting/breastfeeding mums
  • Aim: Address common breastfeeding challenges, improve knowledge, confidence and self-efficacy
  • Outcome: Mean score increase in breastfeeding self-efficacy by 6.6 and attitude by 3.3. 

2. Staff Training Course (2 hours)

• • Participants: 1,339 staff members from shopping malls, public premises and restaurants
  • Aim: Promote breastfeeding friendliness, enhance knowledge
  • Outcome: Mean score increase in breastfeeding knowledge by 5.8 and attitude by 6.1. 

Key finding

BFCI effectively improved knowledge, nurtured positive attitudes and promoted breastfeeding. 

Success criteria

1. Active community participation: Engage diverse stakeholders (healthcare providers, policymakers, business owners and community members) to create a supportive environment for breastfeeding mums
2. Accreditation and award system 
3. Culturally sensitive breastfeeding education: Consider the community’s socio-economic status for effective knowledge dissemination and sustainability

Recommendations

1. Broaden the target audience for breastfeeding education to include various community stakeholders beyond families
2. Scale up the BFCI model globally to promote optimal infant health 

Full article

Lok KYW, Fan HSL, Ip HL, Leung ETY, Lau KW, Wong JYH, Choi E, Lam CCO, Tarrant M, Ngan HYS, Ip P, Lin CC. Building a baby-friendly community: Development, strategy, implementation and evaluation of a BFCI program. J Adv Nurs. 2024 Jun 14. doi: 10.1111/jan.16267. Epub ahead of print. PMID: 38877670.