1. Experiences in Accessing Health Care for Women in Amsterdam: Personal and Professional Perspectives Emily Sands and Lauren Sterling

2. Research Question How do the intersections of cultural traditions interact in personal and professional perceptions of access to and quality of health care received by Muslim and non-Muslim women in the Netherlands? How do the intersections of cultural traditions interact in personal and professional perceptions of access to and quality of health care received by Muslim and non-Muslim women in the Netherlands?

3. Background: Islam in NL Islam #2 Religion after Christianity (around 1 million Muslims in NL) Islam #2 Religion after Christianity (around 1 million Muslims in NL) Major immigrant groups : Turkish, Moroccan, Kurdish (East, more established); Surinamese (Bijlamer, newer, more liberal) Major immigrant groups : Turkish, Moroccan, Kurdish (East, more established); Surinamese (Bijlamer, newer, more liberal) Muslim immigrants concentrated in low- income neighborhoods Muslim immigrants concentrated in low- income neighborhoods Discrimination occurs in many areas Discrimination occurs in many areas

4. Background: Healthcare in NL Primarily general practitioners Primarily general practitioners –Independent or part of a group Somewhat nationalized, but moving towards more privatized Somewhat nationalized, but moving towards more privatized Most comprehensive sex education Most comprehensive sex education

5. Why Amsterdam? Dutch-Islam Conflict 63% Dutch citizens think Islam is incompatible with European life 63% Dutch citizens think Islam is incompatible with European life 68% feel threatened by Muslim youth 68% feel threatened by Muslim youth 47% fear living under Muslim rule in the NL 47% fear living under Muslim rule in the NL –Motivation poll Also, conflicts in health care access Also, conflicts in health care access

6. Current Events/Literature Rotterdam Hospital controversy Rotterdam Hospital controversy Issues of discrimination and access Issues of discrimination and access Lots of Literature on Gender issues, access to care by women, Muslim women issues, health literacy, culturally appropriate care Lots of Literature on Gender issues, access to care by women, Muslim women issues, health literacy, culturally appropriate care –Hamdan 2006, van Wijk 1996, others –Medisch journal, Harborview International Clinic, other Health Services info

7. Research Question, Again How do the intersections of cultural traditions interact in personal and professional perceptions of access to and quality of health care received by Muslim and non-Muslim women in the Netherlands? How do the intersections of cultural traditions interact in personal and professional perceptions of access to and quality of health care received by Muslim and non-Muslim women in the Netherlands?

8. Hypothesis Dutch stereotypes and discrimination reduce constructive communication and compromise with cultural beliefs of immigrants Poor health outcomes, Low education, Decrease ability to self-advocate In positive terms Muslim tradition limits access and power of women to health care

9. Conceptual Framework Cultural Traditions Cultural Traditions

10. Research Methods Survey Questionnaires for Women (patients) Survey Questionnaires for Women (patients) – in English, Dutch, Arabic (French?) Online survey for professionals Online survey for professionals Interviews with Professionals Interviews with Professionals –Primary care providers –Community leaders –Tertiary care workers (Hospitals) –Cultural Competence/Literacy Specialists

11. Data Collection/Analysis Measure health care results in 2 ways Measure health care results in 2 ways –Access to Care  Translated health information  Location of Health care services  Other Services: dietary restrictions, interpreters, female doctors –Quality of Care  Practices and compromises made  Cultural training availability  Cultural Sensitivity

12. Purpose and Goal The purpose of this research is to examine and compare how Muslim and non-Muslim women perceive their health care that they receive in Amsterdam in comparison to how professionals view their experiences with these groups. The purpose of this research is to examine and compare how Muslim and non-Muslim women perceive their health care that they receive in Amsterdam in comparison to how professionals view their experiences with these groups. This information will enable health care professionals to tailor their care to be more specific and well received, with the intention of increasing the health of the patients. This information will enable health care professionals to tailor their care to be more specific and well received, with the intention of increasing the health of the patients.

13. Questions?