Abstract
BackgroundThe ongoing role of colonialism in producing health inequities is well-known. Postcolonialism is a theoretical approach that enables healthcare providers to better understand and address health inequities in society. While the importance of postcolonialism and health (PCH) in the education of clinicians has been recognized, the literature lacks guidance on how to incorporate PCH into healthcare training programs. This study explores the perspectives of key informants regarding content related to PCH that should be included in Canadian healthcare training programs, and how this content should be delivered.MethodsThis qualitative study involved in-depth, semi-structured interviews with nineteen individuals with insight into PCH in Canada. Data were analyzed collaboratively to identify, code and translate key emergent themes according to the six phases of the DEPICT method.ResultsThree themes emerged related to incorporating PCH into Canadian healthcare training programs: (1) content related to PCH that should be taught; (2) how this content should be delivered, including teaching strategies, who should teach this content and when content should be taught, and; (3) why this content should be taught. For the Canadian context, participants advised that PCH content should include a foundational history of colonization of Aboriginal Peoples in Canada, how structures rooted in colonialism continue to produce health inequities, and how Canadian clinicians’ own experiences of privilege and oppression affect their practice. Participants also advised that this content should be integrated longitudinally through a variety of interactive teaching strategies and developed in collaboration with Aboriginal partners to address health inequities.ConclusionsThese findings reinforce that clinicians and educators must understand health and healthcare as situated in social, political and historical contexts rooted in colonialism. Postcolonialism enables learners to understand and respond to how colonialism creates and sustains health inequities. This empirical study provides educators with guidance regarding PCH content and delivery strategies for healthcare training programs. More broadly, this study joins the chorus of voices calling for critical reflection on the limits and harms of an exclusively Western worldview, and the need for action to name and correct past wrongs in the spirit of reconciliation and justice for all.
Highlights
The ongoing role of colonialism in producing health inequities is well-known
We focus on postcolonialism and health (PCH) in the Canadian context, which includes: (1) how the legacies of colonialism intersect with the social determinants of health2 to produce disparities in health status among populations that Canadian healthcare providers (HCPs) may encounter in Canada and in ‘global health’ settings, and; (2) how colonialism has shaped the ways that Canadian HCPs and others understand health, illness, healthcare, medicine, well-being and ability
What experiences have Aboriginal populations had resulting from colonialism in Canada? Participants expressed the necessity of teaching about the history of the colonization of Aboriginal Peoples in Canada when discussing Aboriginal health
Summary
The ongoing role of colonialism in producing health inequities is well-known. Postcolonialism is a theoretical approach that enables healthcare providers to better understand and address health inequities in society. While the importance of postcolonialism and health (PCH) in the education of clinicians has been recognized, the literature lacks guidance on how to incorporate PCH into healthcare training programs. This study explores the perspectives of key informants regarding content related to PCH that should be included in Canadian healthcare training programs, and how this content should be delivered. “Culture”, another concept constructed to identify non-European peoples as inferior and uncivilized, was often used in conjunction with race [3]. These strategies were employed historically as tools of colonial conquest and continue to shape the health and illness of people today
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