Abstract
BackgroundReduction of health gaps between ethno-cultural groups has become a major concern for health services, with a strong emphasis on eliminating social and cultural barriers and improving accessibility for diverse populations.MethodsThe study is based on a Participatory Action Research where an involved researcher accompanied the project for a decade, as well as on eleven in-depth interviews with Bedouin women-mediators working in a perinatal health promotion project in Israel.ResultsThe research analyzes the work of Bedouin women health mediators who mediate between their Bedouin community and institutional health services and bridge over cultural gaps. The study presents the complex task of transferring messages across cultures, dealing with socio-cultural imperatives and the intricacy of multilayered power relations. The findings reveal an evolving process, beginning with a pragmatic mediation model in which the mediators are limited to instruction of pre-defined health materials, toward a transformative model of creating a ground for encouraging the mediators to act creatively according to socio-cultural circumstances.ConclusionThe research elaborates on the adoption and implementation of the transformative approach in mediation and provides further understanding of the complexity of mediation role in sensitive issues such as pregnancy, birth and infant care.
Highlights
The need to bridge over gaps in health between populations has occupied health institutions around the world for several decades
The position of the World Health Organization (WHO) appears in a series of documents of the Commission of the Social Determinants of Health (CSDH)
During the second decade of the program, greater focus was placed on the social and cultural conflictual situations experienced by the mediators, and the mediation role was expanded to “bridging language and cultural barriers” between the Hebrewspeaking medical team and the Arabic-speaking Bedouin women who visited to the clinics
Summary
The research analyzes the work of Bedouin women health mediators who mediate between their Bedouin community and institutional health services and bridge over cultural gaps. The study presents the complex task of transferring messages across cultures, dealing with socio-cultural imperatives and the intricacy of multilayered power relations. The findings reveal an evolving process, beginning with a pragmatic mediation model in which the mediators are limited to instruction of pre-defined health materials, toward a transformative model of creating a ground for encouraging the mediators to act creatively according to socio-cultural circumstances
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