Donald C Cole1, Janet E McLaughlin2, Jenna L Hennebry3, Michelle A Tew4. 1. Occupational Health Clinic for Ontario Workers, 848 Main St E, Hamilton, ON L8M 1L9, Canada; Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College St, Toronto, ON M5T3M7, Canada; and Institute for Work & Health, 481 University Ave Suite 800, Toronto, ON M5G 2E9, Canada donald.cole@utoronto.ca. 2. Health Studies, RCE 242, Wilfrid Laurier University, Brantford, Ontario N3T 2Y3, Canada; and International Migration Research Centre, Balsillie School of International Affairs, Wilfrid Laurier University, 67 Erb Street West, Waterloo, ON, Canada jmclaughlin@wlu.ca. 3. International Migration Research Centre, Balsillie School of International Affairs - BSIA 243, Wilfrid Laurier University, 67 Erb Street West, Waterloo, ON, Canada; and Communications Studies, Wilfrid Laurier University, Waterloo, Ontario N2L 3C5, Canada jhennebry@wlu.ca. 4. Occupational Health Clinic for Ontario Workers, 848 Main St E, Hamilton, ON L8M 1L9, Canada mtew@ohcow.on.ca.
Abstract
INTRODUCTION: The intersecting vulnerabilities of migrant agricultural workers (MAWs) impact both their health and their access to health care in rural areas, yet rural clinicians' voices are rarely documented. The purpose of this study was to explore health professionals' perspectives on health care for MAWs in sending countries and rural Ontario, Canada. METHODS: Qualitative research design occurred over three distinct projects, using a multi-methodological approach including semi-structured interviews in Mexico, Jamaica and rural Ontario (n=43), and session field notes and questionnaires administered to healthcare providers (n=65) during knowledge exchange sessions in rural Ontario. A systematic analysis of these data was done to identify common themes, using NVivo software initially and then Microsoft Excel for application of a framework approach. RESULTS: Structural challenges posed by migrant workers' context included difficulties preventing and managing work-related conditions, employers or supervisors compromising confidentiality, and MAWs' fears of loss of employment and return to countries of origin prior to completing treatments. Structural challenges related to health services included lack of adequate translation/interpretation services and information about insurance coverage and MAWs' work and living situations; scheduling conflicts between clinic hours and MAWs' availability; and difficulties in arranging follow-up tests, treatments and examinations. Intercultural challenges included language/communication barriers; cultural barriers /perceptions; and limited professional knowledge of MAWs' migration and work contexts and MAWs' knowledge of the healthcare system. Transnational challenges arose around continuity of care, MAWs leaving Canada during/prior to receiving care, and dealing with health problems acquired in Canada. A range of responses were suggested, some in place and others requiring additional organization, testing and funding. CONCLUSION: Funding to strengthen responses to structural and intercultural challenges, including research assessing improved supports to rural health professionals serving MAWs, are needed in rural Canada and rural Mexico and Jamaica, in order to better address the structural and intersecting vulnerabilities and the care needs of this specific population.
INTRODUCTION: The intersecting vulnerabilities of migrant agricultural workers (MAWs) impact both their health and their access to health care in rural areas, yet rural clinicians' voices are rarely documented. The purpose of this study was to explore health professionals' perspectives on health care for MAWs in sending countries and rural Ontario, Canada. METHODS: Qualitative research design occurred over three distinct projects, using a multi-methodological approach including semi-structured interviews in Mexico, Jamaica and rural Ontario (n=43), and session field notes and questionnaires administered to healthcare providers (n=65) during knowledge exchange sessions in rural Ontario. A systematic analysis of these data was done to identify common themes, using NVivo software initially and then Microsoft Excel for application of a framework approach. RESULTS: Structural challenges posed by migrant workers' context included difficulties preventing and managing work-related conditions, employers or supervisors compromising confidentiality, and MAWs' fears of loss of employment and return to countries of origin prior to completing treatments. Structural challenges related to health services included lack of adequate translation/interpretation services and information about insurance coverage and MAWs' work and living situations; scheduling conflicts between clinic hours and MAWs' availability; and difficulties in arranging follow-up tests, treatments and examinations. Intercultural challenges included language/communication barriers; cultural barriers /perceptions; and limited professional knowledge of MAWs' migration and work contexts and MAWs' knowledge of the healthcare system. Transnational challenges arose around continuity of care, MAWs leaving Canada during/prior to receiving care, and dealing with health problems acquired in Canada. A range of responses were suggested, some in place and others requiring additional organization, testing and funding. CONCLUSION: Funding to strengthen responses to structural and intercultural challenges, including research assessing improved supports to rural health professionals serving MAWs, are needed in rural Canada and rural Mexico and Jamaica, in order to better address the structural and intersecting vulnerabilities and the care needs of this specific population.
Authors: Juan José Villalobos-Rodelo; Martha Mendoza-Rodríguez; Rosalina Islas-Zarazúa; Sonia Márquez-Rodríguez; Mariana Mora-Acosta; América Patricia Pontigo-Loyola; María de Lourdes Márquez-Corona; Carlo Eduardo Medina-Solís; Gerardo Maupomé Journal: Children (Basel) Date: 2021-02-03