Midwives’ views on factors that contribute to health care inequalities among immigrants in Sweden: a qualitative study

Akhavan

Description

Ethnic and socioeconomic inequalities in the Swedish health care system have increased. Most indicators suggest that immigrants have significantly poorer health than native Swedes. The purpose of this study was to explore the views of midwives on the factors that contribute to health care inequality among immigrants. Methods Data were collected via semi-structured interviews with ten midwives. These were transcribed and related categories identified through content analysis. Results The interview data were divided into three main categories and seven subcategories. The category “Communication” was divided into subcategories “The meeting”, “Cultural diversity and language barriers” and “Trust and confidence”. The category “Potential barriers to the use of health care services” contained two subcategories, “Seeking health care” and “Receiving equal treatment”. Finally, the category “Transcultural health care” had subcategories “Education on transcultural health care” and “The concept”. Conclusions This study suggests that midwives believe that health care inequality among immigrants can be the result of miscommunication which may arise due to a shortage of meeting time, language barriers, different systems of cultural beliefs and practices and limited patient-caregiver trust. Midwives emphasized that education level, country of origin and length of stay in Sweden play a role when an immigrant seeks health care. Immigrants face more difficulties when seeking health care and in receiving adequate levels of care. However, different views among the midwives were also observed. Some midwives were sensitive to individual and intra-group differences, while some others viewed immigrants as a group of “others”. Midwives’ beliefs about subgroup-specific health services vs. integrating immigrants’ health care into mainstream health care services should be investigated further. Patients’ perspective should also be considered.

Sujets

• Immigration
• Midwifery
• Communication
• Inequality

Informations

• Publié par: biomed
• Publié le: 01 janvier 2012
• Nombre de lectures: 20
• Langue: English

Extrait

AkhavanInternational Journal for Equity in Health2012,11:47 http://www.equityhealthj.com/content/11/1/47

R E S E A R C H

Open Access

Midwives’views on factors that contribute to health care inequalities among immigrants in Sweden: a qualitative study * Sharareh Akhavan

Abstract Introduction:Ethnic and socioeconomic inequalities in the Swedish health care system have increased. Most indicators suggest that immigrants have significantly poorer health than native Swedes. The purpose of this study was to explore the views of midwives on the factors that contribute to health care inequality among immigrants. Methods:Data were collected via semistructured interviews with ten midwives. These were transcribed and related categories identified through content analysis. Results:The interview data were divided into three main categories and seven subcategories. The category “Communication”was divided into subcategories“The meeting”,“Cultural diversity and language barriers”and “Trust and confidence”. The category“Potential barriers to the use of health care services”contained two subcategories,“Seeking health care”and“Receiving equal treatment”. Finally, the category“Transcultural health care”had subcategories“Education on transcultural health care”and“The concept”. Conclusions:This study suggests that midwives believe that health care inequality among immigrants can be the result of miscommunication which may arise due to a shortage of meeting time, language barriers, different systems of cultural beliefs and practices and limited patientcaregiver trust. Midwives emphasized that education level, country of origin and length of stay in Sweden play a role when an immigrant seeks health care. Immigrants face more difficulties when seeking health care and in receiving adequate levels of care. However, different views among the midwives were also observed. Some midwives were sensitive to individual and intragroup differences, while some others viewed immigrants as a group of“others”. Midwives’beliefs about subgroupspecific health services vs. integrating immigrants’health care into mainstream health care services should be investigated further. Patients’perspective should also be considered. Keywords:Immigrants, Midwives, Communication, Inequality, Transcultural health care

Introduction The practice of health care in Sweden has encountered new challenges in recent decades as the immigrant popu lation has increased. The goal of the Swedish health care system is to provide good care on equal terms to all people and in so doing, contribute to a more equitable spread of health [1]. Health care in Sweden is a public responsibility, financed primarily through taxes that are levied by county councils and municipalities. The Swedish health care sys tem is structured on three levels: national, represented by

Correspondence: [e-mail] Department of Public Health  University of Skövde & School of Health, Care and Social Welfare, University of Mälardalen, Mälardalen, Sweden

central government, regional, i.e., the municipalities and local, represented by the county councils. The county councils plan the development and organization of health care according to the needs of their residents, among others immigrants. However, asylum seekers and undocu mented immigrants in Sweden have very restricted access to state subsidized health care [2,3]. Reports show that inequalities in the Swedish health care system have increased since the beginning of the 1990s. Most indicators suggest that immigrants have sig nificantly poorer health than native Swedes [4,5]. Al though the increasing disparity may have different causes, one may be due to the fact that immigrants do

© 2012 Akhavan; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.