Intercultural Pediatrics Unit (UPI)

Access of Recent Muslim Immigrant Families to Perinatal Health Services: Conciliation of Knowledge and Healthcare Practices

The main objective of this study is to document how, within the context of the birth of a child, Muslim parents and healthcare practitioners conciliate family and professional healthcare practices. By adopting the hypothesis that clinical visits lead to a negotiation or conciliation of the respective positions of the social actors, we postulate that: (a) each of the actors (i.e., healthcare professionals, mother and father, local/transnational family network) provides knowledge, healthcare standards and practices that is not always shared; (b) knowledge, healthcare standards and practices are dynamic and permeable; (c) the migration path, settlement experiences, sociability links and family structure are all contexts that influence the migrant and the place he/she holds in clinical visits. With an interest in the entire perinatal period, we intend: (1) to paint a picture of the pathways used to obtain the help resources preferred by Muslim parents during the perinatal period; (2) to see how parents conciliate the logical arguments proposed by the family and healthcare network; (3) to examine how healthcare professionals take into consideration family practices related to perinatality; (4) to document issues related to knowledge transfer (and transmission mechanisms) and health practices related to pregnancy and birth adopted by this religious minority within a context of migration.

Along with a more diversified source of immigration and the significant Muslim populations that make up these countries (Morocco, Algeria, Lebanon, India, Pakistan), the presence of Muslims in Montreal has more than doubled over the period 1991 (41,000) to 2001 (100,185). For these populations, most often young families, healthcare services associated with perinatality represent an area of regular, even pivotal, contact with Quebec society. In this way, for the parents, their child’s birth triggers a succession of contacts with a number of professionals, at various moments during the perinatal period (pregnancy monitoring, childbirth, postnatal monitoring). The arrival of a child constitutes a privileged moment to prevent the appearance of healthcare issues and to promote the adoption of healthy lifestyle habits. It is, therefore, crucial that accessible perinatal healthcare services be ensured for these populations that have a double minority status because of their ethnicity and religion. It is all the more important to welcome a child into life and at the same time integrate it into a new society. These two requirements may exacerbate certain vulnerabilities. The possible gap between the family and healthcare professionals’ practices and knowledge may represent an important obstacle when it comes to their accessibility to the services. In the case of maternity and healthcare systems, the conceptions that surround them vary widely at the cultural level. Early screening strategies, healthcare standards, associated notions of viability and risk are part of a given conception of health and the best interest of the mother, fetus and child. The relation with life (and death in the case of fetal anomalies or complex pathologies in newborns, for example) and more widely the health practices proposed by the healthcare professionals may differ from those that come from the original culture of the immigrant parents and conveyed by their close relations. The latter generally represent an important source of information and support for the new parents. This diversity of perspectives also permeates the biomedical staff both in hospital settings and in providing primary care. For this reason, the clinical space is not only a biomedical space, but also a social, relational space where norms and values as well as professional, social and cultural models come together.

The study population is made up of two groups: (1) Muslim parents; (2) healthcare professionals (physicians, nurses and other professionals associated with perinatal care services/units in a hospital and a health and social service center (CSSS) context. The adopted research methodology is anthropologically-based (observations, interviews, case studies) and qualitative with the addition of quantitative methods in the treatment of certain data. The expected results mainly include the improvement of perinatal services for minority populations and the identification of conditions for the emergence of a pluralistic clinical practice that may inspire physicians (obstetricians, neonatologists and pediatricians), nurses and other healthcare professionals from the hospital setting as well as primary caregivers.

  • Principal Investigator at the CHU Sainte-Justine: Sylvie Fortin
  • Principal Co-investigator: Josiane LeGall (CSSS de la Montagne)
  • Co-investigators: Antoine Payot, François Audibert (CHU Sainte-Justine), Gilles Bibeau (University of Montreal), Franco Carnevale (McGIll University)
  • Granting Agency: Canadian Institutes of Health Research CIHR
  • Project Period: 2007-2011

 

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Updated on 10/14/2014
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