Uncovering the Role of Community Health Worker/Lay Health Worker Programs in Addressing Health Equity for Immigrant and Refugee Women in Canada: An Instrumental and Embedded Qualitative Case Study
“Why do immigrants and refugees need community health workers/lay health workers (CHWs) if Canada already has a universal health care system?” Abundant evidence demonstrates that despite the universality of our health care system marginalized populations, including immigrants and refugees, experienc...
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Université d'Ottawa / University of Ottawa
2013
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Online Access: | http://hdl.handle.net/10393/23753 http://dx.doi.org/10.20381/ruor-6425 |
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Canada Case Study Inequity Immigrants Refugees Community Capacity Building Alberta Health Services Multicultural Health Brokers Health Human Resources Workforce Health Brokers Lay Health Promoters Lay Health Workers Authoritative Knowledge Experiential Knowledge Feminist Families Qualitative Research Child Welfare Cultural Brokering Community Health Workers Models Multicultural Health Brokers Co-operative Co-operatives Women Women's Urban Citizenship Empowerment Embedded Case Study Research Social Determinants of Health Social Change Social Work Urban Citizenship Universal Programs Unregulated Health Care Workers Theory Typology Perinatal Health Racialized Gender Race Class Discrimination Diversity Health Worker Co-operatives Policy Makers Urban Citizenship Universal Programs Access to Health Services Equity Access to Social Services Cultural Competence Racism Canada Prenatal Nutrition Program Public Health Primary Care Health Promotion Violence Prevention Immigrant Health Care Workers Immigrant Community Health Workers |
spellingShingle |
Canada Case Study Inequity Immigrants Refugees Community Capacity Building Alberta Health Services Multicultural Health Brokers Health Human Resources Workforce Health Brokers Lay Health Promoters Lay Health Workers Authoritative Knowledge Experiential Knowledge Feminist Families Qualitative Research Child Welfare Cultural Brokering Community Health Workers Models Multicultural Health Brokers Co-operative Co-operatives Women Women's Urban Citizenship Empowerment Embedded Case Study Research Social Determinants of Health Social Change Social Work Urban Citizenship Universal Programs Unregulated Health Care Workers Theory Typology Perinatal Health Racialized Gender Race Class Discrimination Diversity Health Worker Co-operatives Policy Makers Urban Citizenship Universal Programs Access to Health Services Equity Access to Social Services Cultural Competence Racism Canada Prenatal Nutrition Program Public Health Primary Care Health Promotion Violence Prevention Immigrant Health Care Workers Immigrant Community Health Workers Torres Ospina, Sara Uncovering the Role of Community Health Worker/Lay Health Worker Programs in Addressing Health Equity for Immigrant and Refugee Women in Canada: An Instrumental and Embedded Qualitative Case Study |
description |
“Why do immigrants and refugees need community health workers/lay health workers (CHWs) if Canada already has a universal health care system?” Abundant evidence demonstrates that despite the universality of our health care system marginalized populations, including immigrants and refugees, experience barriers to accessing the health system. Evidence on the role of CHWs facilitating access is both lacking and urgently needed. This dissertation contributes to this evidence by providing a thick description and thorough analytical exploration of a CHW model, in Edmonton, Canada. Specifically, I examine the activities of the Multicultural Health Brokers Co-operative (MCHB Co-op) and its Multicultural Health Brokers from 1992 to 2011 as well as the relationship they have with Alberta Health Services (AHS) Edmonton Zone Public Health. The research for this study is based on an instrumental and embedded qualitative case study design. The case is the MCHB Co-op, an independently-run multicultural health worker co-operative, which contracts with health and social services providers in Edmonton to offer linguistically- and culturally-appropriate services to marginalized immigrant and refugee women and their families. The two embedded mini-cases are two programs of the MCHB Co-op: Perinatal Outreach and Health for Two, which are the raison d’être for a sustained partnership between the MCHB Co-op and AHS. The phenomenon under study is the Multicultural Health Brokers’ practice.
I triangulate multiple methods (research strategies and data sources), including 46 days of participant and direct observation, 44 in-depth interviews (with Multicultural Health Brokers, mentors, women using the programs, health professionals and outsiders who knew of the work of the MCHB Co-op and Multicultural Health Brokers), and document review and analysis of policy documents, yearly reports, training manuals, educational materials as well as quantitative analysis of the Health Brokers’ 3,442 client caseload database. In addition, data include my field notes of both descriptive and analytical reflections taken throughout the onsite research. I also triangulate various theoretical frameworks to explore how historically specific social structures, economic relationships, and ideological assumptions serve to create and reinforce the conditions that give rise to the need for CHWs, and the factors that aid or hinder their ability to facilitate marginalized populations’ access to health and social services.
Findings reveal that Multicultural Health Brokers facilitate access to health and social services as well as foster community capacity building in order to address settlement, adaptation, and integration of immigrant and refugee women and their families into Canadian society. Findings also demonstrate that the Multicultural Health Broker model is an example of collaboration between community-based organizations and local systems in targeting health equity for marginalized populations; in particular, in perinatal health and violence against women. A major problem these workers face is they provide important services as part of Canada’s health human resources workforce, but their contributions are often not recognized as such. The triangulation of methods and theory provides empirical and theoretical understanding of the Multicultural Health Brokers’ contribution to immigrant and refugee women and their families’ feminist urban citizenship. |
author2 |
Spitzer, Denise |
author_facet |
Spitzer, Denise Torres Ospina, Sara |
author |
Torres Ospina, Sara |
author_sort |
Torres Ospina, Sara |
title |
Uncovering the Role of Community Health Worker/Lay Health Worker Programs in Addressing Health Equity for Immigrant and Refugee Women in Canada: An Instrumental and Embedded Qualitative Case Study |
title_short |
Uncovering the Role of Community Health Worker/Lay Health Worker Programs in Addressing Health Equity for Immigrant and Refugee Women in Canada: An Instrumental and Embedded Qualitative Case Study |
title_full |
Uncovering the Role of Community Health Worker/Lay Health Worker Programs in Addressing Health Equity for Immigrant and Refugee Women in Canada: An Instrumental and Embedded Qualitative Case Study |
title_fullStr |
Uncovering the Role of Community Health Worker/Lay Health Worker Programs in Addressing Health Equity for Immigrant and Refugee Women in Canada: An Instrumental and Embedded Qualitative Case Study |
title_full_unstemmed |
Uncovering the Role of Community Health Worker/Lay Health Worker Programs in Addressing Health Equity for Immigrant and Refugee Women in Canada: An Instrumental and Embedded Qualitative Case Study |
title_sort |
uncovering the role of community health worker/lay health worker programs in addressing health equity for immigrant and refugee women in canada: an instrumental and embedded qualitative case study |
publisher |
Université d'Ottawa / University of Ottawa |
publishDate |
2013 |
url |
http://hdl.handle.net/10393/23753 http://dx.doi.org/10.20381/ruor-6425 |
work_keys_str_mv |
AT torresospinasara uncoveringtheroleofcommunityhealthworkerlayhealthworkerprogramsinaddressinghealthequityforimmigrantandrefugeewomenincanadaaninstrumentalandembeddedqualitativecasestudy |
_version_ |
1719415711791579136 |
spelling |
ndltd-uottawa.ca-oai-ruor.uottawa.ca-10393-237532021-07-06T05:22:33Z Uncovering the Role of Community Health Worker/Lay Health Worker Programs in Addressing Health Equity for Immigrant and Refugee Women in Canada: An Instrumental and Embedded Qualitative Case Study Torres Ospina, Sara Spitzer, Denise Canada Case Study Inequity Immigrants Refugees Community Capacity Building Alberta Health Services Multicultural Health Brokers Health Human Resources Workforce Health Brokers Lay Health Promoters Lay Health Workers Authoritative Knowledge Experiential Knowledge Feminist Families Qualitative Research Child Welfare Cultural Brokering Community Health Workers Models Multicultural Health Brokers Co-operative Co-operatives Women Women's Urban Citizenship Empowerment Embedded Case Study Research Social Determinants of Health Social Change Social Work Urban Citizenship Universal Programs Unregulated Health Care Workers Theory Typology Perinatal Health Racialized Gender Race Class Discrimination Diversity Health Worker Co-operatives Policy Makers Urban Citizenship Universal Programs Access to Health Services Equity Access to Social Services Cultural Competence Racism Canada Prenatal Nutrition Program Public Health Primary Care Health Promotion Violence Prevention Immigrant Health Care Workers Immigrant Community Health Workers “Why do immigrants and refugees need community health workers/lay health workers (CHWs) if Canada already has a universal health care system?” Abundant evidence demonstrates that despite the universality of our health care system marginalized populations, including immigrants and refugees, experience barriers to accessing the health system. Evidence on the role of CHWs facilitating access is both lacking and urgently needed. This dissertation contributes to this evidence by providing a thick description and thorough analytical exploration of a CHW model, in Edmonton, Canada. Specifically, I examine the activities of the Multicultural Health Brokers Co-operative (MCHB Co-op) and its Multicultural Health Brokers from 1992 to 2011 as well as the relationship they have with Alberta Health Services (AHS) Edmonton Zone Public Health. The research for this study is based on an instrumental and embedded qualitative case study design. The case is the MCHB Co-op, an independently-run multicultural health worker co-operative, which contracts with health and social services providers in Edmonton to offer linguistically- and culturally-appropriate services to marginalized immigrant and refugee women and their families. The two embedded mini-cases are two programs of the MCHB Co-op: Perinatal Outreach and Health for Two, which are the raison d’être for a sustained partnership between the MCHB Co-op and AHS. The phenomenon under study is the Multicultural Health Brokers’ practice. I triangulate multiple methods (research strategies and data sources), including 46 days of participant and direct observation, 44 in-depth interviews (with Multicultural Health Brokers, mentors, women using the programs, health professionals and outsiders who knew of the work of the MCHB Co-op and Multicultural Health Brokers), and document review and analysis of policy documents, yearly reports, training manuals, educational materials as well as quantitative analysis of the Health Brokers’ 3,442 client caseload database. In addition, data include my field notes of both descriptive and analytical reflections taken throughout the onsite research. I also triangulate various theoretical frameworks to explore how historically specific social structures, economic relationships, and ideological assumptions serve to create and reinforce the conditions that give rise to the need for CHWs, and the factors that aid or hinder their ability to facilitate marginalized populations’ access to health and social services. Findings reveal that Multicultural Health Brokers facilitate access to health and social services as well as foster community capacity building in order to address settlement, adaptation, and integration of immigrant and refugee women and their families into Canadian society. Findings also demonstrate that the Multicultural Health Broker model is an example of collaboration between community-based organizations and local systems in targeting health equity for marginalized populations; in particular, in perinatal health and violence against women. A major problem these workers face is they provide important services as part of Canada’s health human resources workforce, but their contributions are often not recognized as such. The triangulation of methods and theory provides empirical and theoretical understanding of the Multicultural Health Brokers’ contribution to immigrant and refugee women and their families’ feminist urban citizenship. 2013-01-29T14:42:50Z 2013-01-29T14:42:50Z 2013 2013 Thesis http://hdl.handle.net/10393/23753 http://dx.doi.org/10.20381/ruor-6425 en application/pdf Université d'Ottawa / University of Ottawa |