Sara Torres, PhD Candidate Institute of Population Health University of Ottawa CPHA Edmonton, June 12, 2012

Transcription

1 Sara Torres, PhD Candidate Institute of Population Health University of Ottawa CPHA Edmonton, June 12, 2012

2 To discuss how Multicultural Health Broker programs can improve access to health services by immigrant and refugee women in Canada.

3 The case The Multicultural Health Brokers Coop (MCHB Co-op) in Edmonton The phenomenon under study The Multicultural Health Brokers practice The embedded mini-cases The Perinatal Outreach program Health for Two program

4 Research strategies Face-to-face in-depth interviews (40 participants) Participant and Direct observation activities ( 87 entries) Documents review, archival records and artifacts

5 Women living in low socio-economic status (SES) neighbourhoods in the AHS Edmonton Zone have a higher rate of low birth weight babies and a higher rate of preterm births than women living in high SES neighbourhoods (Predy et al., 2008)

6 Many of the newly-arrived pregnant refugee women are said to suffer from physical health problems like malnutrition and psychological problems due to the impact of warrape and other traumas (MCHB Co-op report )

7 The increase in the number of immigrant and refugee clients of multicultural health brokers grew from 1105 families, recorded in the 2005 report, to 2340 families, documented in the 2010 report (MCHB Co-op report )

8 Many immigrant and refugee families are struggling with inadequate income, poor housing, mental health, family problems or intergenerational conflict

9 The MCHB Co-op and the multicultural health brokers do not just work on one presenting problem, (e.g., pregnant women at risk of having low birth babies), but they attempt to tackle several problems impacting women (e.g., lack of housing, food insecurity and isolation) together to maximize the long range chances for pregnant women and families health and wellbeing

10 1. Personal care (one-on-one support); 2. Small group development (parents and families); 3. Community organization (community mobilization); 4. Advocacy (providers and institutional level); and 5. Policy and practice (advocacy at the system level) (Labonté 1993)

11 Income/Social Status (child tax credit, maternity leave benefits, subsidized housing) Social Support Networks (parenting groups, coalition building) Education & Literacy (ESL classes, system navigation, advocacy) Employment/Working Conditions (immigration paperwork) Personal Health Practices & Coping Skills (balancing cultures) Healthy Child Development (children s services, child protection) Health Services (remove barriers to perinatal & other health services) Gender (prevention of violence against women) Culture (pre-migration- cultural competency) 11

12 Health inequalities among Edmonton neighbourhoods cannot be resolved merely through the provision of more advanced health care or better access to existing health or community services. They are insufficient. Improving population health in Edmonton by reducing inter-neighbourhood health inequalities will require multi-sectoral long-term commitment, common vision, and consistent collaboration at all levels of government and across all sectors (Predy et al., 2008b, p.28)

13 Alberta Health Services needs to work with other sectors and ministries in order to achieve collaboration among stakeholders to address health equity for immigrants and refugees Consistent collaboration at all levels of government and across all sectors is crucial in order to address the health inequities experienced by immigrant and refugee communities.

14 The multicultural health broker program bridges practice, policy and research by providing perinatal health education to immigrant and refugee women within a broader socio-cultural approach The program needs support from different ministries

15 Research sites: The Multicultural Health Brokers Co-operative and Alberta Health Services Edmonton Zone Public Health Doctoral Awards: CIHR- Institute of Gender and Health, PHIRN - Population Health Improvement Research Network Thesis Supervisor/Committee: Dr. Denise Spitzer, Dr. Caroline Andrew, Dr. Carol Amaratunga and Dr. Ronald Labonté

16 Questions?