TY - JOUR
T1 - An ethnographic investigation of the maternity healthcare experience of immigrants in rural and urban Alberta, Canada
AU - Higginbottom, Gina M.
AU - Safipour, Jalal
AU - Yohani, Sophie
AU - O'Brien, Beverly
AU - Mumtaz, Zubia
AU - Paton, Patricia
AU - Chiu, Yvonne
AU - Barolia, Rubina
N1 - Funding Information:
The authors thank Shireen Bell and Dr. Rebecca Malhi (Faculty of Nursing, University of Alberta) for their assistance with data collection and/or analysis, Tracey Kaczanowski (Alberta Health Services, Rural Town) for her great assistance with initiating the study and disseminating the findings in the study community, and Barbara Osswald (Faculty of Nursing, University of Alberta) for editing the manuscript. They would also like to thank Killa Ibraham Maragang of the Multicultural Health Brokers Co-operative (Urban Town) for her assistance with participant recruitment, organizing and translating during the focus groups, and for commenting on the manuscript draft. This study was funded by an emerging team grant from the Faculty of Medicine and Dentistry (University of Alberta), Alberta Health Services, and the Women and Children’s Health Research Institute (Urban Town, Alberta). The funders had no role in the study design, or in the collection, analysis, and interpretation of data, nor did they assist or influence the writing of the manuscript or partake in the decision to submit the manuscript for publication. This work was funded in part by GH’s Canada Research Chair ( http:// www.chairs-chaires.gc.ca10.1186/s12884-015-0773--chaires.gc.ca/).
Publisher Copyright:
© 2016 Higginbottom et al.
PY - 2016/1/27
Y1 - 2016/1/27
N2 - Background: Canada is among the top immigrant-receiving nations in the world. Immigrant populations may face structural and individual barriers in the access to and navigation of healthcare services in a new country. The aims of the study were to (1) generate new understanding of the processes that perpetuate immigrant disadvantages in maternity healthcare, and (2) devise potential interventions that might improve maternity experiences and outcomes for immigrant women in Canada. Methods: The study utilized a qualitative research approach that focused on ethnographic research design and data analysis contextualized within theories of organizational behaviour and critical realism. Data were collected over 2.5 years using focus groups and in-depth semistructured interviews with immigrant women (n = 34), healthcare providers (n = 29), and social service providers (n = 23) in a Canadian province. Purposive samples of each subgroup were generated, and recruitment and data collection - including interpretation and verification of translations - were facilitated through the hiring of community researchers and collaborations with key informants. Results: The findings indicate that (a) communication difficulties, (b) lack of information, (c) lack of social support (isolation), (d) cultural beliefs, e) inadequate healthcare services, and (f) cost of medicine/services represent potential barriers to the access to and navigation of maternity services by immigrant women in Canada. Having successfully accessed and navigated services, immigrant women often face additional challenges that influence their level of satisfaction and quality of care, such as lack of understanding of the informed consent process, lack of regard by professionals for confidential patient information, short consultation times, short hospital stays, perceived discrimination/stereotyping, and culture shock. Conclusions: Although health service organizations and policies strive for universality and equality in service provision, personal and organizational barriers can limit care access, adequacy, and acceptability for immigrant women. A holistic healthcare approach must include health informational packages available in different languages/media. Health care professionals who care for diverse populations must be provided with training in cultural competence, and monitoring and evaluation programs to ameliorate personal and systemic discrimination.
AB - Background: Canada is among the top immigrant-receiving nations in the world. Immigrant populations may face structural and individual barriers in the access to and navigation of healthcare services in a new country. The aims of the study were to (1) generate new understanding of the processes that perpetuate immigrant disadvantages in maternity healthcare, and (2) devise potential interventions that might improve maternity experiences and outcomes for immigrant women in Canada. Methods: The study utilized a qualitative research approach that focused on ethnographic research design and data analysis contextualized within theories of organizational behaviour and critical realism. Data were collected over 2.5 years using focus groups and in-depth semistructured interviews with immigrant women (n = 34), healthcare providers (n = 29), and social service providers (n = 23) in a Canadian province. Purposive samples of each subgroup were generated, and recruitment and data collection - including interpretation and verification of translations - were facilitated through the hiring of community researchers and collaborations with key informants. Results: The findings indicate that (a) communication difficulties, (b) lack of information, (c) lack of social support (isolation), (d) cultural beliefs, e) inadequate healthcare services, and (f) cost of medicine/services represent potential barriers to the access to and navigation of maternity services by immigrant women in Canada. Having successfully accessed and navigated services, immigrant women often face additional challenges that influence their level of satisfaction and quality of care, such as lack of understanding of the informed consent process, lack of regard by professionals for confidential patient information, short consultation times, short hospital stays, perceived discrimination/stereotyping, and culture shock. Conclusions: Although health service organizations and policies strive for universality and equality in service provision, personal and organizational barriers can limit care access, adequacy, and acceptability for immigrant women. A holistic healthcare approach must include health informational packages available in different languages/media. Health care professionals who care for diverse populations must be provided with training in cultural competence, and monitoring and evaluation programs to ameliorate personal and systemic discrimination.
KW - Canada
KW - Diversity
KW - Ethnographic study
KW - Healthcare access
KW - Immigrant woman
KW - Maternity care
UR - http://www.scopus.com/inward/record.url?scp=84956686662&partnerID=8YFLogxK
U2 - 10.1186/s12884-015-0773-z
DO - 10.1186/s12884-015-0773-z
M3 - Article
C2 - 26818961
AN - SCOPUS:84956686662
SN - 1471-2393
VL - 16
JO - BMC Pregnancy and Childbirth
JF - BMC Pregnancy and Childbirth
IS - 1
M1 - 20
ER -