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Modes of Governing: A Foucaultian Perspective on Encounters between Healthcare Providers and Muslim Women in Swedish Reproductive Healthcare
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Maternal and Reproductive Health and Migration.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).ORCID iD: 0000-0002-2900-2849
Department of Social Work, Malmö University.
Department of Social Work, Malmö University.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

There are probably few groups of patients in Sweden today that arouse as much associations and thoughts as do Muslims from the Middle East. The core dilemma in much of these discussions is whether healthcare providers should adjust the provision of care to Muslims’ divergent religious preferences, or if they would be better off to treat Muslims in the same way as other patients. These debates are often entangled with both a concern about politics of equality (i.e. ambitions to treat everyone the same) and politics of diversity (i.e. to treatpeople from ethnic and religious minority groups differently). Inspired by Foucault’s concept of governmentality, we in this study intended to explore the principles of ‘equality’ and 'diversity’ as governing tools for the shaping of healthcare providers and patients’ conduct. We found that although these governing tools are presented as non-conflicting in health policies, there seems to be an often-present trade-off between diversity and equality ideals in their practical implementation. When these policies are assigned meaning and implemented inpractice, they appear to generate unforeseeable consequences, both for healthcare providers and for the patients. It thus appears that the policies that were introduced with the intention of improving the structure of multicultural care encounters, in some cases, had an opposite effect.

Keywords [en]
Muslim, reproductive healthcare, diversity, equality, politics of recognition, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-392207OAI: oai:DiVA.org:uu-392207DiVA, id: diva2:1347340
Available from: 2019-08-31 Created: 2019-08-31 Last updated: 2019-09-05Bibliographically approved
In thesis
1. Sacred Ideals: Diversity and Equality in Swedish Reproductive Healthcare
Open this publication in new window or tab >>Sacred Ideals: Diversity and Equality in Swedish Reproductive Healthcare
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

To promote diversity (mångfald) and equality (jämlikhet) is a key task for a wide range of welfare institutions in Sweden. The two terms appeal to several aspects simultaneously: inclusiveness, moral goodness, awareness and willingness to facilitate a positive social change. Diversity and equality have become, as I suggest in this thesis, two sacred ideals in Swedish society today. In the context of reproductive healthcare, various forms of diversity and equality measures are thought of as solutions to, for instance, inequalities between immigrant groups and others, structural discrimination of minority groups, and difficulties faced by the Swedish healthcare system in caring for patients’ diverse needs and preferences in clinical encounters. In this thesis, diversity and equality are analysed as two important governing mechanisms in the organisation of healthcare in multicultural Sweden. The aim was to explore how these ideals contribute to shape the provision of reproductive healthcare, and its consequences.

Paper I shows that targeted interventions towards immigrant women in contraceptive counselling risk singling out some women from standard routes of care because they are categorised as “immigrants” or “Muslims”. Paper II shows that demands upon healthcare providers to accommodate Muslim patients’ presumed needs have the potential of also creating needs that were not there from the start. Paper III shows that many religious counsellors who are affiliated with Swedish healthcare as spiritual advisers present ideas on abortion that are less progressive than what is stipulated in Swedish abortion law. Paper IV shows that imperatives to promote gender equality in contraceptive counselling were taken seriously by providers in their encounters with non-Western women, at the possible expense of respect for relationship structures that do not conform to the ideals of gender equality.

The findings presented in this thesis show that the interventions and initiatives that sought to presumably help disadvantaged groups of people (i.e. Muslims, immigrant women) could, in fact, be obstacles to solving the problems they were meant to address. I argue that the governance of Swedish reproductive healthcare through diversity and equality ideals must be problematised and balanced with regard to their plausible consequences.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2019. p. 102
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1593
Keywords
diversity, equality, gender equality, religion, reproductive health, migration, multicultural encounters, Scandinavia, Sweden
National Category
Other Health Sciences
Identifiers
urn:nbn:se:uu:diva-392210 (URN)978-91-513-0737-4 (ISBN)
Public defence
2019-10-18, Rudbecksalen, Rudbecklaboratoriet, Dag Hammarskjölds väg 20, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2019-09-26 Created: 2019-08-31 Last updated: 2019-10-15

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Arousell, JonnaEssén, Birgitta

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