faces of truth perspectives on health care for female muslim allochtonen in amsterdam emily sands...
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Faces of Truth Perspectives on Health Care for
Female Muslim Allochtonen in Amsterdam
Emily Sands and Lauren SterlingUniversity of Washington
University of Amsterdam Summer Institute
Allochtonen
In the Netherlands, refers to immigrants and their children in the sense that they are outsiders. One is an allochtoon if one or both parents
were not born in the Netherlands.
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Amsterdam Demographics
Native Dutch
Western Alloctonen
Non-Muslim Non-Western Allochtonen
Muslim Non-WesternAllochtonen
55%
13%
19%
13%
Background:Health Care in the Netherlands
Focus on primary care Patient’s main contact is General Practitioner
(GP) Universal, mandatory, private health insurance
as of 2006 The government is responsible for the
accessibility and quality of the healthcare.
Research Question
What are the greatest barriers to health care for female Muslim allochtonen? What are the differences in beliefs about
those barriers between patients and their providers?
Literature Review
Immigrant women have higher fertility and child/maternal mortality than native Dutch (Nordbeckk 1985, nigz.nl)
Migrant health educators improved quality of health care (Johnston 2004)
Older Moroccan and Turkish females report more serious communication problems (GG&GD 2001)
Conceptual Framework
Cultural Diversity: Culture is beliefs, values and traditions which form the basis for shared social action and which are transmitted and reinforced within a group.
Cultural Competence: refers to an ability to interact effectively with people of different cultures.
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Research Methods
Surveys of professionals (n=5) Surveys of women (n=4) Interviews (n=3) Site visits Library/Online Research
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Map of Locations
Two faces
Of a doctor: “What do you think is the most important issue that prevents Muslim women from receiving the best health care possible?”
“Primarily, their spouses, and secondly, the language barrier.”
Survey of Women: Question and Response
“Have you ever chosen to not attend an appointment?” “Yes. I made an appointment because my back hurts.
When I heard that a male doctor would examine me I didn’t go.”
“What do you think is the most important issue that prevents you from receiving the best health care possible?” “Sometimes I have problems explaining where it hurts
in Dutch. The doctor gets frustrated about that.”
Results:Interviews
Male Muslim Student Organizer: “The child cannot come.” Segregation (re-pillarization) of communities Trust issues
Female Native-Dutch Citizen: “Problem is not being “non-native,’ problem is
that doctors blame the problem on the ‘non-native-ness.’”
Female Non-Dutch Health Care Provider: Cultural understanding/specialization important
Discussion:Differences in Perspectives
Don’t want to see male doctors
Spouses interfere with care
Cultural differences
Drs. Impatient, language hard
Understaffing, other issues
Not enough time to explain
Turkish, Arabic, etc.
DutchLanguage
Women’s Perspective
Doctor’s PerspectiveBarriers to Care
Conclusion:
The purpose of our research was too: Illuminate barriers Show differing viewpoints
Recommendations Increase Cultural Competency
Training for doctors Specialized migrant health workers
Increase Dialogue
Future Questions/ Continuing Research
Questions Desegregation of schools? Language vs. Cultural barriers?
Research More data Cultural competency educators Spouse issues Comparative Studies