Women from ethnic minorities are voicing their concerns that they face endemic structural racism when seeking and accessing healthcare, and they feel that their symptoms and signs are more often dismissed. It is vital that patients are listened to when they say that they feel this is also due to structural racism in healthcare.
In this BMJ Opinion piece, Amali Lokugamage and Alice Meredith propose that the foundation of any translation of Cultural Safety education to maternity services should consider these five key ingredients:
- A catalogue of patient experience videos explaining their encounters with structural inequity in healthcare from a diverse group of patients
- The creation of a basic module of education in decolonising the history of health, raising awareness of lingering colonial racial bias
- An educational tool is required to enhance healthcare professional’s reflective practice
- Access to continuity of care models for disadvantaged women
- Part of the Cultural Safety model is that when vulnerable patients feel culturally unsafe (due to racial discrimination), they can request carers from a similar ethnic background as themselves.
In relation to the final point, the authors note:
"There may not be enough numbers of appropriately trained personnel from the same cultural background requiring affirmative action in recruitment. An additional confounding consequence may be to cause “auto segregation” in society and could limit personal development in all healthcare personnel or systems in order to produce equitable healthcare for all. Also, the global phenomenon of disrespectful maternity care, described by the World Health Organisation in their document on the prevention and elimination of disrespect and abuse during childbirth, points to the existence of unjust interactions in countries where care is delivered by professionals from a similar background to their patients. Furthermore, by potentially allowing such requests to become day-to-day practice, there are recognised pitfalls as described recently by Roger Kline, including increased segregation towards healthcare providers, and even racism against doctors from ethnic minorities. So, this final element could be thorny when considering possible translation to a UK setting."