Bridging Gaps: Provider Perspectives on Integrating Systems for Health Equity

TL;DR

This study explores how providers in under-resourced areas face barriers to delivering equitable health services and suggests system-level changes to improve child and family health outcomes.

Contribution

The study introduces a multilevel framework based on provider perspectives to address systemic barriers and promote health equity in community-based organizations.

Findings

Providers identified macro-level barriers like racism and rights-based policy gaps.

Community-level factors such as environmental impacts and social cohesion influence service delivery.

Improving organizational integration and provider supports is critical for equitable care.

Abstract

Health equity is shaped by multiple factors intersecting with service delivery in community-based organizations (CBOs). Providers in under-resourced areas are often the first point of contact for families seeking child development, mental health, and behavioral support. However, system-level barriers hinder service delivery and access. This study explores provider perspectives to identify barriers and inform system-level changes that promote equity in child and family health. Using a narrative qualitative design, in-depth interviews were conducted with 21 health and mental health professionals from child- and family-serving CBOs. Guided by ecological and strengths-based frameworks, interviews examined provider insights on challenges, strengths, and supports affecting service delivery. Key themes emerged across macro (rights-based policies, racism/oppression), community (environmental impacts, social cohesion), organizational (secondary stress, system fragmentation, provider supports), and family levels (basic needs, parenting support, service access). Findings highlight the need for a multilevel approach that prioritizes rights-based policies, strengthens community cohesion, and improves system integration. Enhancing CBO capacity to address these determinants could advance equity-oriented service delivery and mitigate structural barriers that perpetuate health disparities.