Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Community & Public Health Team (ESPIC), Centre for International Health and Infectious Diseases, Drassanes-Vall d'Hebron, Carrer de Sant Oleguer, 17, Barcelona, 08001, Spain.
Int J Equity Health. 2024 Oct 9;23(1):206. doi: 10.1186/s12939-024-02290-5.
Immigrant populations, especially women, continue facing challenges in accessing quality healthcare, particularly sexual and reproductive health services (SRH). Poor cultural competent health systems contribute to communication challenges between immigrant women and healthcare providers perpetuating health disparities. This exploratory study describes these communication barriers from the perspective of Moroccan and Pakistani immigrant women and healthcare providers within the Catalan health system and its implications to ensure an equitable provision of SRH services.
An exploratory-descriptive qualitative study was conducted in various municipalities of Barcelona with high concentration of immigrants. Eight focus groups (N = 51) and semi-structured interviews (N = 22) with Moroccan and Pakistani immigrant women were combined with key informant interviews (N = 13) with healthcare professionals. Thematic analysis and data triangulation were performed primarily using an inductive approach.
Language barriers and cultural differences in health needs, expectations, care-seeking behaviours and understanding of quality healthcare provision hindered the ability of immigrant women and providers to interact effectively. Limited availability of intercultural mediators and inadequate cultural competence training opportunities for health staff were also identified. Findings suggest a lack of minority representation in the Catalan health workforce and leadership roles.
This study reinforces the evidence of persistent inequities in accessing healthcare among immigrant populations by focusing on the cultural competence barriers of the Catalan health system in the provision and access to SRH services. The regularization of adequately trained intercultural mediators, quality training in cultural competence for health staff and a commitment to increase workforce diversity would contribute to improve intercultural communication between immigrant patients and providers. An urgent call to action in this direction is needed to ensure an equitable access to SRH services among immigrant women.
移民群体，尤其是女性，在获得高质量医疗保健方面仍然面临挑战，尤其是性健康和生殖健康服务（SRH）。文化能力不足的医疗体系导致移民妇女与医疗服务提供者之间的沟通障碍持续存在，从而加剧了健康差距。本探索性研究从摩洛哥和巴基斯坦移民妇女以及加泰罗尼亚医疗体系中的医疗服务提供者的角度描述了这些沟通障碍，并探讨了其对确保公平提供 SRH 服务的影响。
在巴塞罗那的多个移民聚居的市镇进行了一项探索性描述性定性研究。结合对摩洛哥和巴基斯坦移民妇女（N=51）和医疗保健专业人员（N=13）的关键人物访谈，共进行了 8 次焦点小组（N=51）和半结构化访谈（N=22）。主要采用归纳法进行主题分析和数据三角剖分。
语言障碍和健康需求、期望、寻求医疗服务行为以及对优质医疗服务提供的理解方面的文化差异，阻碍了移民妇女和提供者之间有效互动的能力。还发现跨文化调解员的有限可用性以及卫生工作人员的文化能力培训机会不足。研究结果表明，加泰罗尼亚医疗保健劳动力中少数民族代表人数不足，领导角色也不足。
本研究通过关注加泰罗尼亚医疗体系在提供和获取 SRH 服务方面的文化能力障碍，强调了移民人群在获得医疗保健方面持续存在的不平等现象。通过规范培训有文化能力的跨文化调解员、为卫生工作人员提供文化能力培训以及承诺增加劳动力多样性，可以促进移民患者和提供者之间的跨文化交流。需要紧急采取行动，以确保移民妇女公平获得 SRH 服务。
