Materializing the international migrant health policy in health sciences curricula in Chile

TL;DR

This study examines how Chile's migrant health policy is reflected in health sciences curricula and finds that it is not effectively implemented.

Contribution

The study introduces the concept of 'cultural blinders' and highlights the need for coordinated policies to align curricula with migrant health goals.

Findings

Current health sciences curricula in Chile do not align with the International Migrant Health Policy.

Hindrances to policy materialization are more numerous and cohesive than facilitators.

A semantic network analysis revealed an ethnocentric model dominating professional education and clinical practices.

Abstract

In Chile, the International Migrant Health Policy (PSMI in Spanish) mandates the inclusion of topics such as migration, interculturality, human rights, social determinants of health, and gender in higher education curricula. However, it is unknown whether this effectively happens.

To understand the materialization of the PSMI in health sciences curricula.

This interpretative/hermeneutic study included semi-structured interviews with program directors, academic faculty, clinical professors, and students. It also involved a document analysis across different health sciences degree programs at three regional universities in Chile. Data analysis included open, axial, and selective coding with ATLAS.ti version 24.

A total of 179 informants participated. Three main categories emerged: Health Institution Setting, University Institution Setting, and Degree Program Setting, each comprising facilitating or hindering subcategories for materializing policy materialization. The hermeneutic analysis made it possible to interrelate these subcategories, producing a semantic network to understand the phenomenon. Facilitators were scarce and isolated from the network core, while hindrances were more numerous, cohesive, and robust, reinforcing an ethnocentric model of professional education validated by ethnocentric healthcare practices in clinical settings.

The concept of “cultural blinders” is proposed in place of “cultural blindness” as there is awareness of the cultural influences on healthcare that are nonetheless not integrated.

Current curricula do not align with the PSMI. Coordinated policies between the Ministry of Education and the Ministry of Health are imperative to reverse the existing healthcare status quo.

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