The law ensures access to health care for all citizens regardless of their legal status, however, in practice, several obstacles are identified (language and cultural miscommunication, lack of information, lack of cultural competence of health professionals, administrative resistance). Looking at health and access implies the consideration of the interplay between culture, social inequalities and social exclusion. Lack of economic resources, poor housing and precarious working conditions are associated with poorer health due to insufficient and inadequate nutrition, overcrowded and inadequately housing, risky working conditions, and unhealthy behaviors such as smoking, alcohol consumption and poor exercise.

 

These risk factors in pregnant women could have a negative impact not only on themselves but also on their children’s development and health. The project looks at the experience of pregnant migrant (and national women) with maternal health services, focusing on the impact of culture & social inequalities on health output, involving all interested actors: pregnant women and health/social support professional, and community organizations, enlarging its potential. The target population is two-folded:

 

1) pregnant immigrant women from the most significant countries of origin (PALOP´s, Brazil and Ukraine), together with Portuguese pregnant women as control and comparison group; and

 

2) health professionals/staff, as key actors in the provision of maternal health care.

 

The geographical contexts is metropolitan area of Porto. Other important aspects are the empowerment of immigrant women and the promotion of cultural competence, emphasizing the interconnection between theory & practice and paying attention to 'good practices' in the field of maternal health care, and developing a multi-method needs assessment to identify and tackle existing health needs.