Multicultural Health Care:

Experiences from a New Town

Discovering opportunities for the interculturalisation of health care

Auke Vlonk, research by Renske Voorn

Istanbul, 10-09-2013

Outline

• Planning a New Town

• Current (health) status of De Bijlmermeer

• Health system

• Objective & Research Question

• Conceptual model

• Methodology

• Results

• Conclusions

Planning a New Town: De Bijlmer• 1965, Nassuth• Aimed at the working middle class• High rise buildings with large green areas (unsafety)• Segregation of facilities

However…• The actual population of De Bijlmer/Amsterdam South

East (wijkscan.com):• Low incomes• Influx of ethnic minorities (Suriname, Ghana, Antilles• Little relocations, though relatively young population

• The role of (urban) planning in relation to health care?

Health system in De Bijlmer• Insufficient services, not considered as a problem• High unemployment, low education level, unsafety, low

incomes, ethnic minorities• High burden of disease?

Multicultural Health Services

• Cultural barrier, literacy

• Not familiar with the system• Gatekeeping

• Interculturalisation• Cultural sensitivity• Cultural diversity

Supply or demand driven?

Objective & Research Question

ObjectiveThe objective of this research is to make recommendations on how a health system could connect with a society with high cultural diversity by investigating the health system and determine its best and worst practices in the Bijlmermeer, the Netherlands.

Research questionWhat are the best and worst practices concerning the health system in the Bijlmermeer the Netherlands and how can this knowledge be used to make recommendations for health systems within a society with high cultural diversity?

Conceptual Model

Methodology

• Embedded case study• Qualitative data

• 9 semi-structured interviews• Health care providers• Health policy makers

• Content analysis

Results

• Stewardship• The role of the city council

• Creating resources• Difficult to get educated personnel• 2 out of 36 GP with other ethnic background • Cultural sensitivity vs diversity

• Service delivery• Historically good cooperation within and between formal

institutions• Linking formal vs informal care• Institutions are too white

• Finance• Relatively inexpensive area• The Law of the handicap of a head start

ConclusionsAlthough the population of the area differs from what was expected:

• Good cooperation between health care providers, city council and insurance company

• Awareness of cultural differences (cultural sensitivity)• Demand driven: flexibility to cope with (un)expected changes

Room for improvement to achieve more interculturalisation?

• Cultural diversity (workforce), interculturalisation• No culturally specific care providing (although not considered as a

problem)• The role of informal care• Structural governmental changes needed?

Questions?

a.vlonk@jvei.nl | http://www.jvei.nlhttp://www.newtowninstitute.org | http://www.efpc.nl/