Health system responsiveness to maternity care expectations: The case of African-born women residing in Melbourne, Australia

Abstract Background Migrants come to host countries with different health needs, requiring access to new and complex health systems. Health system responsiveness is an important consideration in the delivery of both clinical and non-clinical care to migrant communities. Migration of women of childbearing age from African countries is increasing in Australia, however, the responsiveness of the health system to their maternity care needs has not been well studied. This study aimed to assess the health system responsiveness to maternity care expectations of African-born women living in Melbourne, Australia. Methods A cross-sectional survey was conducted from August to December 2023 among African-born women residing in metropolitan Melbourne, Australia. A standardised tool was used for data collection and a total of 248 complete responses were received. The data were analysed using descriptive and inferential statistics in STATA 18 software. Results Most respondents, 205 (82.7%), rated the Australian health system responsiveness as ‘acceptable’. The quality of basic amenities domain received the highest scores, while the choice for service providers obtained the lowest score. Health system responsiveness was more likely to be considered ‘unacceptable’ among women aged 26–35 years old compared to women younger than 25 years old (AOR: 4.71, 95% CI: (1.17–19.02) and migrant women as compared to humanitarian entrants (AOR: 2.51, 95% CI: (1.29–7.67). However, women who worked in non-professional jobs were less likely to report ‘unacceptable’ health system responsiveness as compared to women working in professional jobs (AOR: 0.54, 95% CI: (0.23–0.93). Conclusions This study suggested that the Australian health system was mostly responsive to the maternity care needs of African-born women. The domains that were rated with low scores, such as, choice for service providers, communication, autonomy, and prompt attention, could be addressed by improving African-born women’s health literacy using tailored strategies to support informed decision making.