BMC Pregnancy and Childbirth
Volume 16, Issue 1, 2016

An ethnographic investigation of the maternity healthcare experience of immigrants in rural and urban Alberta, Canada (Article) (Open Access)

Higginbottom G.M.* , Safipour J. , Yohani S. , O'Brien B. , Mumtaz Z. , Paton P. , Chiu Y. , Barolia R.
  • a University of Nottingham, Mary Seacole Professor of Ethnicity and Community Health School of Health Sciences, South Block Link Queen's Medical Centre, Rm 1976, A Floor, Nottingham, NG7 2HA, United Kingdom
  • b University of AlbertaAB, Canada, Linnaeus University, Department of Health and Caring Sciences, Building: K2244, Vaxj Linnaeus, 35195, Sweden
  • c University of Alberta, Department of Educational Psychology, 6-107D Education North, Edmonton, Canada
  • d University of Alberta, Faculty of Nursing, Edmonton Clinic Health Academy, 3rd Floor 11405 87th Avenue, Edmonton, T6G 1C9, Canada
  • e University of Alberta, School of Publin Health, Edmonton Clinic Health Academy, 3rd Floor 11405 87th AvenueAB T6G 1C9, Canada
  • f College and Association of Registered Nurses of Alberta, Alberta Health Services, 11620 168 Street, Edmonton, T5M 4A6, Canada
  • g Multicultural Health Brokers Coop, 301, 9955-114 Street, Edmonton, T5K 1P7, Canada
  • h University of AlbertaAB, Canada, Aga Khan University, School of Nursing and Midwifery, stadium Road, Karachi, 74800, Pakistan

Abstract

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. © 2016 Higginbottom et al.

Author Keywords

Immigrant woman Diversity Ethnographic study Maternity care healthcare access Canada

Index Keywords

information processing Health Personnel urban population doctor patient relation communication barrier ethnographic research Communication Barriers publication immigrant scientist hospitalization patient information health care personnel Stereotyping human cultural anthropology rural population Social Workers organization social support language social worker Social Work cultural competence qualitative research informed consent Humans migrant psychology consultation Canada Emigrants and Immigrants semi structured interview female purposive sample Alberta pregnancy clinical article Health Knowledge, Attitudes, Practice adult data analysis Health Services Accessibility Anthropology, Cultural monitoring maternal health service Maternal Health Services attitude to health satisfaction Focus Groups Culture health care delivery
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84956686662&doi=10.1186%2fs12884-015-0773-z&partnerID=40&md5=74962682dec4cfdc11ed4f49ee2a76fb
DOI: 10.1186/s12884-015-0773-z
ISSN: 14712393
Cited by: 12
Original Language: English