Project Description


The project “ORAMMA: Operational Refugee And Migrant Maternal Approach” has a vision to develop an operational and strategic approach in order to promote safe motherhood, to improve access and delivery of maternal healthcare for refugee and migrant women and to improve maternal health equality within European Union. Moreover the project will increase awareness, commitment and action towards improving maternal health of refugees in EU. There is an increasing need for a prompt, coordinated, and effective response for all migrant and refugee pregnant and lactating women with newborn babies. Migrant and refugee women face specific health risks and challenges during perinatal period that need to be dealt by well-trained multidisciplinary teams of health professional experts since they are characterized by a complex physical, psychological and mental state of health.

The majority of the refugee pregnant women, their families and their communities are not empowered to be healthy, do not always have adequate capacities to provide appropriate care during pregnancy or when the new baby has arrived, neither are they able to make healthy decisions and act upon those decisions, including the decision to seek care when needed. There is a lack of empower manifest in a number of levels while additionally gender constraints may prevent some refugee women from expressing the need for and obtaining care during perinatal period.

The ORAMMA project will develop, pilot implement and evaluate by comparative analysis an integrated and cost-effective approach on safe motherhood provision for migrant and refugee women, taking into consideration (a) best practices, (b) the special risks and characteristics of the target group and (c) the transferability of the model in different healthcare systems across EU: from camps sites in Greece, to National Health Services in the UK and to community-based model in Netherlands.The project “ORAMMA: Operational Refugee And Migrant Maternal Approach” has a vision to develop an operational and strategic approach in order to promote safe motherhood, to improve access and delivery of maternal healthcare for refugee and migrant women and to improve maternal health equality within European Union. Moreover the project will increase awareness, commitment and action towards improving maternal health of refugees in EU.


Safe journey to motherhood

The ORAMMA project develops an integrated, mother and woman centered, culturally oriented and evidence based approach for all phases of the migrant and refugee women perinatal healthcare, including detection of pregnancy, care during pregnancy and birth, as well as support after birth. This approach implemented by multidisciplinary teams of experts, namely midwives, social workers and general practitioners, with the active participation of women from migrants and refugee communities, ensures a safe journey to motherhood.
a) Guidelines for perinatal care for migrant and refugee women

The guidelines will be addressed to health providers, individual health professionals working with the target group and other community-based services that the target group visits. The aim of the Guidelines is to be used both as a practice tool for health professionals but also as an informative and educational tool for all stakeholders involved in health assessment of migrant and refugee women and other related services.

b) ORAMMA approach development

This approach includes all the characteristics of the approach, description and role of the multidisciplinary team, description of phases and specifications on each phase, decision trees and/or algorithms for the implementation of the model.

c) Perinatal Personal operational plan

The Perinatal Personal Operational Plan (general health, psychosocial, perinatal assessment and plan) will be the basic tool of the perinatal healthcare provision for migrant and refugee women. It will provide all the necessary information both for the woman and the team treating her such as personal information, medical history related to pregnancy and childbirth,  the perinatal care plan, the assessment of the professionals of the team, as well as useful information for the women, such as the benefits and impact of the PPOP for her and her family.

d) Pilot and recommendations.

The ORAMMA approach and tools will be pilot tested and assessed in different European settings (UK, the Netherlands and Greece), in order to provide recommendations on the perinatal healthcare of migrant and refugee women and feedback on its effectiveness and efficacy.

e) Mapping of perinatal healthcare for migrants and refugee women in Europe.

The ORAMMA project gathers information on the present situation and the current size of the migrant and refugee  population, the needs of the target groups and the needs of health professionals, the existing practices, social services and operational structures of healthcare provision, as well as special issues as legislation or other country specific issues to be taken into consideration. As a result, a summative Report on EU and national context on perinatal healthcare for migrant and refugee women will be used for the development of the model, the pilot implementation and the design of the training course.

Cultural awareness across the borders

Involvement of women from the target population and their training in order to assist and act as advocates for pregnant women during the whole perinatal and antenatal period as intercultural mediators is a key aspect of the ORAMMA project. A highly innovative concept enabling these women to have more encompassing role not only as an interpreter but truly mediate, actively assist and provide support to migrant and refugee pregnant women. Through developing an education/package this will facilitate two-way knowledge transfer and learning between health professionals and community increasing cultural awareness.

Working together for a better community

The implementation of the ORAMMA approach refers to communities with migrant and refugee populations. Selected key members or active players from these communities will propagate and diffuse the perinatal approach into the communities and motivate them to actively participate. The project combines close cooperation of health professionals and migrant and refugee communities. In this framework training activities on both target groups will be implemented as well as raise awareness of migrant and refugee women on a rights-based knowledge.  

Health care with compassion

The ORAMMA project develops an integrated, mother centered, culturally oriented and evidence based approach for all phases of the migrant and refugee women perinatal healthcare. The ORAMMA approach supports a compassionate holistic treatment of these vulnerable groups focusing on their needs, addressing in a compassionate way the challenges migrant and refugee women face.

Work package’s

Work Package 1

Coordination of the project by lead TEI-A

Start month:1 – End month: 24

The coordination WP runs throughout the duration of the project and seeks to support and define the relationships among the partners; the co-operation; and co-ordination processes, in order to ensure smooth progress of the project activities, efficient handling of any problems that may appear and risk management.
In addition, a detailed planning for the project management has been developed, which might readjust according to the needs of the project. Apart from defining the level of responsibility and authority of each person /institution involved and describing the governance structure of the project management, clear and appropriate reporting mechanisms are included. Thus, defined roles, functions, scopes of authority and systems that will help all members of the partnership to ensure effective management and monitoring of the project, will be in place.

Work Package 2

Dissemination of the project by lead EMA

Start month:1 – End month: 24

The partnership will create lists containing medical associations, potentially interested organizations and experts on the field, in each participating country. During the project they will be informed on a regular basis about the project’s progress and results (e.g. development of the model and perinatal personal operation plan, piloting implementation, health professionals trained etc). Moreover, partners plan to participate to annual health related conferences in national and European level address informative letters to scientific communities and health professionals of different target groups (midwives, social workers and GPs etc.), organize consultation meetings and presentation of the results in a conference conducted by project’s coordinator and finally scientific papers with the results arising from pilot sessions.

Work Package 3

Evaluation by lead CMT PROOPTIKI

Start month:1 – End month: 24

The partnership will develop an evaluation and quality assurance plan at the early stages of the project. This plan will specify the procedures and standards for implementation, monitoring and evaluation of the project. Moreover, the partnership will develop a relevant evaluation tool (evaluation questionnaire). The overall evaluation of the project will be performed in two phases: a) in the middle of the project and b) at the end of the project, leading to an interim and final evaluation report, respectively. An external evaluator will be subcontracted, providing an additional and independent evaluation of project’s results and outcomes.

Specifically, this WP includes the following tasks for the internal evaluation of the project:

State of the art & ORAMMA approach development by lead TEI-A

Start month:1 – End month: 11

State of the art activities: The overall aim of the State of the art activities is to gain a holistic knowledge of (a) the current settings & situation in Europe on addressing migrants’/refugees’ women health needs, (b) the best practices in perinatal healthcare for migrant & refugee women and (c) the emerging needs in healthcare provision & in healthcare capacity building for the healthcare professionals. In order for the partnership to identify and assess the recent progress in the field of perinatal healthcare for refugee and migrant women the following tasks will be undertaken:

Work Package 5

Community capacity building, propagating key members and empowering migrant and refugee women by lead SHU

Start month:8 – End month: 24

The process of implementing a community-based health care model, especially for migrant and refugee populations, requires a process of empowering the communities through partnerships, collaborative planning, community actions and overall community capacity building. This work package will organise and implement activities with the overall aim to prepare and empower the communities that the developed approach will be implemented. Including the community itself into the healthcare approach will facilitate the implementation, enhance the participation and increased the health benefits for the target group. The activities to be undertaken are:

Work Package 6

Pilot implementation and assessment by lead TEI-A

Start month:12 – End month: 24

The pilot implementation of the proposed model will be conducted in three different European settings: in camps/hotspots in Greece, through the NHS in the UK and in municipality-based services in Netherlands. The purpose of the three settings has been made in order pilot test the model in the much different health systems throughout Europe.

The tasks to be undertaken for the pilot implementation are: