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.

http://lh3.ggpht.com/_Tbarytmj7CA/R6JJ9K1o_oI/AAAAAAAACnY/OQHzdpVjqwA/2008-01-

25T145733Z_01_FSA05_RTRMDNP_3_TURKEY-HEADSCARF-PRESIDENT.jpg

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.

http://blogs.reuters.com/faithworld/files/2008/02/turkish-headscarf-wearers.jpg

Research Methods

Surveys of professionals (n=5) Surveys of women (n=4) Interviews (n=3) Site visits Library/Online Research

http://www.miller.k12.ga.us/images/MPj03995750000%5B1%5D.jpg

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