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Equity and Dignity in Maternity Care Provision in Canada, Finland and Iceland

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Abstract

Objective

In recent decades, governments around the globe have been under pressure to create more efficient and effective health care systems. Research shows, particularly in middle- and low-income countries, that many of these neo-liberal policies that have been enacted have had a largely negative effect with regard to equitable health services for lower-income populations and dignified working conditions for health providers. In this paper we highlight recent reforms in health care in Canada, focusing on formal care during pregnancy and childbirth, and compare these to parallel developments in two Nordic countries–Finland and Iceland.

Method

We draw upon secondary data sources and primary research findings.

Results

Our comparative analysis pays close attention to barriers in access to primary care services across the childbearing period for lower-income women in the three countries, as well as the factors that create poor working conditions for the predominantly female maternity care labour force.

Discussion

As Canada struggles to deal with the crisis in its maternity care system, it could learn from developments in Finland and Iceland that promote teamwork among primary health care professionals and high-quality care for lower-income populations.

Résumé

Objectif

Depuis plusieurs décennies, un peu partout dans le monde, on pousse les gouvernements à créer des systèmes de santé plus efficients et efficaces. La recherche, particulièrement dans les pays à faible revenu et à revenu intermédiaire, montre que bon nombre des politiques néolibérales qui ont ainsi été édictées ont nui dans une large mesure à l’équité des services de santé accessibles aux populations à faible revenu et à la dignité des conditions de travail des dispensateurs de soins de santé. Dans cet article, nous examinons les réformes récentes dans les soins de santé au Canada, notamment dans les soins réglementés offerts pendant la grossesse et l’accouchement, et nous les comparons aux changements apportés en parallèle dans deux pays nordiques: la Finlande et l’Islande.

Méthode

Nous avons fait appel à des sources de données secondaires et à des résultats de recherche primaires.

Résultats

Notre analyse comparative porte spécifiquement sur les obstacles à l’accès aux services de soins de première ligne pendant toute la période d’activité génitale pour les femmes à faible revenu dans les trois pays à l’étude, ainsi que sur les facteurs responsables des piètres conditions de travail de la main-d’œuvre (essentiellement féminine) des soins de maternité.

Discussion

Le Canada, aux prises avec la crise de son système de soins de maternité, pourrait tirer des enseignements de l’expérience de la Finlande et de l’Islande, qui favorisent le travail d’équipe entre les divers professionnels de la santé primaire et veulent assurer des soins de haute qualité pour les populations à faible revenu.

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Author information

Authors and Affiliations

  1. Swedish School of Social Science, University of Helsinki, P.O. Box 16, FIN-00014 University of Helsinki, Helsinki, Finland

    Sirpa Wrede PhD (Senior Researcher)

  2. Department of Sociology, University of Victoria, Victoria, BC, Canada

    Cecilia Benoit PhD (Associate Professor)

  3. Department of Sociology, University of Iceland, Reykjavik, Canada

    Thorgerdur Einarsdottir PhD (Professor)

Authors
  1. Sirpa Wrede PhD
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  2. Cecilia Benoit PhD
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  3. Thorgerdur Einarsdottir PhD
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Corresponding author

Correspondence to Sirpa Wrede PhD.

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Wrede, S., Benoit, C. & Einarsdottir, T. Equity and Dignity in Maternity Care Provision in Canada, Finland and Iceland. Can J Public Health 99 (Suppl 2), 16–21 (2008). https://doi.org/10.1007/BF03403799

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