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Title: South Asian women's access to healthcare in Edinburgh
Author: Paul, Sheila
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1997
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The thesis opens with a review of some key literature on minority ethnic groups and healthcare and identifies gaps in research, policy and theoretical analysis. I make particular reference to debates about culture, and 'race' and gender difference in the literature on minority ethnic groups and healthcare. I identify three key problems. Firstly, I challenge studies that focus on the attributes of healthcare users or on measures of health and disease rather than on the attributes of health services and the perspectives and experiences of those who use healthcare. Secondly, I criticise the stereotypical notions of minority ethnic culture which are often used to explain patterns of access, to shape public policy, and to drive research. Thirdly, I criticise a literature on minority ethnic groups and healthcare which is generally gender blind and a literature on women's healthcare which is generally 'race' blind. I argue that these three tendencies contribute to the invisibility of minority ethnic women in debates on health and health service inequalities. This thesis attempts to challenge these problems. The main body of the thesis draws on findings from 36 qualitative semi-structured interviews with women from the four main South Asian ethnic categories present in Edinburgh (Pakistani, Bangladeshi, Indian (of Hindu heritage) and Sikh). I use women's perceptions and experiences of healthcare in the three healthcare arenas to assess enablements and constraints on access, to explore women's pathways into and around healthcare and to illustrate how and why they use healthcare in particular ways. The research findings are examined in the light of a wider literature on minority ethnic groups and health, and on women's health. My findings challenge conventional understandings of South Asian women's healthcare practices and their patterns of service use. My study shows that user perspectives are important in understanding access to healthcare. User perspectives allow me to show that access is linked to the life experiences of South Asian women and has many dimensions. Access is affected not only by uptake of, or physical distance to, services but is affected by social position. My findings show that ideas about 'race' and gender difference affect South Asian women's access and attitudes to, as well as their experience and patterns of, healthcare. I also argue that access to healthcare is affected not so much by the attributes of individual women as by the attributes of health services, and that health services and providers play a role in reflecting and reproducing ideas about 'race' and gender difference. I conclude by emphasising the need for health policy makers and providers to understand the attitudes and experiences of South Asian women. They need to challenge the structural constraints on access if they are to alleviate South Asian women's access problems and deliver ethnically sensitive services.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available