Health Equity and Universal Provision in Norway: A Case Study

  • Lydia Mehrara Department of Social Studies, Faculty of Social Sciences, University of Stavanger
  • Susan Young Social Policy Practice and Research Consortium, Faculty of Health and Medical Science, The University of Western Australia
Keywords: Maternal Health, Migrant Women, Migrant Health, Social Policy, Social Work, Norway, WPR Framework

Abstract

This article reports on a qualitative study undertaken to explore the policy-practice nexus of health policy in Norway in relation to the provision and delivery of maternal health services to migrant women.  The research used a case study approach focusing on a particular programme which provided maternal health services to migrant women and collected data through review and analysis of policy documentation, observation of this programme, and discussions with people responsible for implementing health policy.  While Norway is well known for its universal policy principles, which in the main enable good access to services, the case study indicated that there are some limitations in policy and practice.  We use the principle of proportionate universalism to comment on and make recommendations for policy makers and practitioners in this area, to better attend to the principle of equity in service access and usage.  The article provides an overview of the Norwegian health policy systems, structures and provisions; describes the service provision from a specific programme providing maternal health services to migrant women in Stavanger, Norway; and concludes with some recommendations which emerge from the findings.

References

Bacchi, C. (2009). Analysing Policy: What's the problem represented to be? (1 ed.). Pearson Australia: Pearson Higher Education AU.

Bacchi, C. (2012). Why study problematizations? Making politics visible. Open Journal of Political Science, 2(01), 1-8. https://doi.org/10.4236/ojps.2012.21001

Baxter, P., & Jack, S. (2008). Qualitative Case Study Methodology: Study Design and Implementation for Novice Researchers. The Qualitative Report, 13(4), 544-559. Retrieved from http://nsuworks.nova.edu/tqr/vol13/iss4/2/

Braun, V. (2009). 'The women are doing it for themselves' The Rhetoric of Choice and Agency around Female Genital 'Cosmetic surgery'. Australian Feminist Studies, 24(60), 233-249. https://doi.org/10.1080/08164640902852449

Carey, G., Crammond, B., & De Leeuw, E. (2015). Towards health equity: a framework for the application of proportionate universalism. International Journal for Equity in Health, 14(1), 81. https://doi.org/10.1186/s12939-015-0207-6

Castañeda, H., Holmes, S. M., Madrigal, D. S., Young, M.-E. D., Beyeler, N., & Quesada, J. (2015). Immigration as a social determinant of health. Annual review of public health, 36, 375-392.

https://doi.org/10.1146/annurev-publhealth-032013-182419

Cort, P. (2011). TAKING THE COPENHAGEN PROCESS APART- Critical Readings of European Vocational Education and Training Policy. (PhD Dissertation ). Aarhus University, Aarhus, Denmark.

Darj, E., & Lindmark, G. (2002). Not all women use maternal health services. Language barriers and fear of the examination are common. Lakartidningen, 99(1-2), 41-44.

Davies, A. A., Basten, A., & Frattini, C. (2006). Migration: a social determinant of the health of migrants. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.462.6286&rep=rep1&type=pdf

Dejin-Karlsson, E., & Östergren, P.-O. (2004). Country of origin, social support and the risk of small for gestational age birth. Scandinavian Journal Of Public Health, 32(6), 442-449. https://doi.org/10.1080/14034940410028172

Esping-Andersen, G. (1996). Welfare states in transition: National adaptations in global economies. London: Sage.

Gjerstad, B., Johannessen, Ø. L., Nødland, S. I., Skeie, G., & Vedøy, G. (2016). Policies in Municipal Public Services and Migration to Norway. 159-184. Retrieved from www.jstor.org/stable/24919782

Goodwin, S. (2011). Analysing Policy as Discourse: Methodological Advances in Policy Analysis. In L. Markauskaite, P. Freebody, & J. Irwin (Eds.), Methodological choice and design. Scholarship, policy and practice in social and educational research (pp. 167-180). London: Springer. https://doi.org/10.1007/978-90-481-8933-5_15

Helsenorge. (2015). Interpreter in the health services in Norway. Right to an interpreter Retrieved from https://helsenorge.no/other-languages/english/rights/right-to-an-interpreter

Helsesøstre. (2007). Jærstrendene - manges helsekilde Helsesøstre. (1), 1-81. Retrieved from https://www.nsf.no/Content/252225/HELSES_1_07.pdf

International Organisation for Migration. (2017). Social determinants of migrant health. Retrieved from https://www.iom.int/social-determinants-migrant-health

Kangas, O., & Kvist, J. (2012). Nordic Welfare States. In B. Greve (Ed.), The Routledge Handbook of the Welfare State (pp. 148-160): Routledge Handbooks Online.

Kvamme, E., & Ytrehus, S. (2015). Barriers to health care access among undocumented migrant women in Norway. Society, Health & Vulnerability, 6(1), 1-17. https://doi.org/10.3402/shv.v6.28668

Lancaster, K., & Ritter, A. (2014). Examining the construction and representation of drugs as a policy problem in Australia's National Drug Strategy documents 1985-2010. International Journal of Drug Policy, 25(1), 81-87. https://doi.org/10.1016/j.drugpo.2013.07.002

Ministry of Health and Care Services. (2007). National strategy to reduce social inequalities in health-Report No. 20 (2006-2007) to the Storting. Retrieved from https://www.regjeringen.no/en/dokumenter/report-no.-20-to-the-storting-2006-2007/id449531/

Muula, A. S. (2007). Ethical and Practical Consideration of Women Choosing Cesarean Section Deliveries without "Medical Indication" in Developing Countries. Croatian medical journal, 48(1), 94-102. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080500/

Navarro, V., & Shi, L. (2001). The political context of social inequalities and health. Social science & medicine, 52(3), 481-491. Retrieved from https://doi.org/10.1016/S0277-9536(00)00197-0

https://doi.org/10.1016/S0277-9536(00)00197-0

Nørredam, M., & Krasnik, A. (2011). Migrants' access to health services. In B. Rechel, P. Mladovsky, W. Devillé, B. Rijks, R. Petrova-Benedict, & M. McKee (Eds.), Migration and health in the European Union (pp. 67-78): Open University Press, Maidenhead.

Norwegian Directorate for Health. (n.d). Gruppekonsultasjoner: Helsestasjonen bør gi alle foreldre tilbud om å delta i gruppekonsultasjoner. Retrieved from https://helsedirektoratet.no/retningslinjer/helsestasjons-og-skolehelsetjenesten/seksjon?Tittel=helsestasjon-05-ar-3952#gruppekonsultasjoner:-helsestasjonen-bør-gi-alle-foreldre-tilbud-om-å-delta-i-gruppekonsultasjoner

Norwegian Ministries. (2008). Action Plan for Combating Female Genital Mutilation. Retrieved from https://www.regjeringen.no/globalassets/upload/hod/dokumenter-fha/kjonnslemlestelse/handlingsplan_kjonnsl_eng_nett.pdf

Ny, P. (2007). Swedish Maternal Health Care In a Multiethnic Society - Including The Fathers. (Doctoral Dissertation ). Malmö University, Sweden.

Pierson, C., & Leimgruber, M. (2010). Intellectual Roots. In F. G. Castles, S. Leibfried, J. Lewis, H. Obinger, & C. Pierson (Eds.), The Oxford Handbook of the Welfare State (pp. 1-15): Oxford University Press. https://doi.org/10.1093/oxfordhb/9780199579396.003.0003

Rawls, J. (1972). A theory of justice. Oxford: Clarendon Press.

Rechel, B., Mladovsky, P., Devillé, W., Rijks, B., Petrova-Benedict, R., & McKee, M. (2011). The future of migrant health in Europe. In B. Rechel, P. Mladovsky, W. Devillé, B. Rijks, R. Petrova-Benedict, & M. McKee (Eds.), Migration and health in the European Union (pp. 245-250): Open University Press, Maidenhead.

Reeske, A., & Razum, O. (2011). Maternal and child health-from conception to first birthday. In B. Rechel, P. Mladovsky, W. Devillé, B. Rijks, R. Petrova-Benedict, & M. McKee (Eds.), Migration and health in the European Union (pp. 139-154): Open University Press, Maidenhead.

Regjeringen. (2017). NOU 2017: 2 Integration and trust- Long-term onsequences of high immigration - Translation of chapter 1.1.: Regjeringen.no Retrieved from https://www.regjeringen.no/en/dokumenter/nou-2017-2/id2536701/

Ricoeur, P. (1971). The model of the text: meaningful action considered as text. Social Research, 38, 529-562.

Ringard, A., Sagan, N., Saunes, I. S., & Lindahl, A. K. (2013). Norway: Health system review. Health Systems in Transition, 15(8), 1-162.

Seeleman, C., Essink-Bot, M.-L., Stronks, K., & Ingleby, D. (2015). How should health service organizations respond to diversity? A content analysis of six approaches. BMC health services research, 15, 510-510. https://doi.org/10.1186/s12913-015-1159-7

SSB. (2017a). 07111: Immigrants and Norwegian-born to immigrant parents, by sex and age. Groups of country background. Retrieved from https://www.ssb.no/en/statbank/table/07111/

SSB. (2017b). Immigrants and Norwegian-born to immigrant parents, 1 January 2017. Retrieved from https://www.ssb.no/en/befolkning/statistikker/innvbef

SSB. (2017c). Key figures for the population. Retrieved from https://www.ssb.no/en/befolkning/nokkeltall/population

Stavanger Kommune. (2016a). TEGRA, svangerskapskurs og barselgruppe. Retrieved from http://www.stavanger.kommune.no/no/Tilbud-tjenester-og-skjema/Barn-og-familie/Helsestasjon/Gruppetilbud1/TEGRA/

Stavanger Kommune. (2016b). TEGRA, svangerskapskurs og barselgruppe. http://www.stavanger.kommune.no/no/Tilbud-tjenester-og-skjema/Barn-og-familie/Helsestasjon/Gruppetilbud1/TEGRA/

Stevens, E. E., Patrick, T. E., & Pickler, R. (2009). A History of Infant Feeding. The Journal of Perinatal Education, 18(2), 32-39. https://doi.org/10.1624/105812409X426314

Strand, M., Brown, C., Torgersen, T. P., & Giaever, O. (2009). Setting the political agenda to tackle health inequity in Norway: WHO Regional Office for Europe.

Sykepleierforbund, N. (2014). NSF Lokalen Retrieved from https://www.nsf.no/vis-artikkel/2205224/264607/NSF-Lokalen----oktober-2014

Tallarek née Grimm, M. J., Helgesen, M. K., & Fosse, E. (2013). Reducing social inequities in health in Norway: Concerted action at state and local levels? Health policy, 113(3), 228-235. https://doi.org/10.1016/j.healthpol.2013.09.019

Tronstad, K., Nygaard, M. O., & Bask, M. (2018). Accumulation of welfare problems among immigrants in Norway. In: Norwegian Institute for Urban and Regional Research (NIBR).

van der Wel, K. A., Dahl, E., & Bergsli, H. (2016). The Norwegian policy to reduce health inequalities: key challenges. Nordisk välfärdsforskning, 1(01), 19-29. https://doi.org/10.18261/issn.2464-4161-2016-01-03

Whitehead, M., & Dahlgren, G. (2007). Concepts and principles for tackling social inequities in health: Levelling up Part 1. WHO Collaborating Centre for Policy Research on Social Determinants of Health University of Liverpool: WHO Regional Office for Europe

World Health Organization. (2007). The Right to Health- JOINT FACT SHEET WHO/OHCHR/323. 1-2. Retrieved from http://www.who.int/mediacentre/factsheets/fs323_en.pdf

Photo by Andreas Wohlfahrt from Pexels
Published
2020-03-24
How to Cite
Mehrara, L., & Young, S. (2020). Health Equity and Universal Provision in Norway: A Case Study. Nordic Journal of Social Research, 11(1), 39-65. https://doi.org/10.7577/njsr.2638
Section
Articles