During the initial phase of the Covid-19
pandemic, European nations have struggled to provide health information to
immigrant and minority populations. Using Norway as a case example and taking the social and economic rights
framework as the point of departure, this blog highlights six elements for a
grounded and inclusive approach to health
information about Covid-19.
High profile examples from Sweden, Germany, and the UK show significant
challenges related to the provision of inclusive and non-discriminatory health
information to immigrant and minority populations. While Norway with its strict
policy measures appears to have been fairly successful in
combatting Covid-19, reports show a disproportionate rate of patients with
immigrant backgrounds. The lack of efforts
to make relevant information about the spread of SARS-CoV-2 available to people
in immigrant communities, has sparked substantial criticism.
The UN Convention on Economic, Social and Cultural Rights (CESCR) Article 12 and the CESCR Committee’s General Comment No. 14 on the Right to Health (GC14) require the state to ensure all residents access to institutions that can provide healing, care and relief. This, according to GC 14 entails a duty to: “Provide education and access to information concerning the main health problems in the community, including methods of preventing and controlling them.” To be available, accessible, adequate and understandable, health information must consider the interplay between factors like age, gender, language, social situation, level of education, cultural beliefs and possible disabilities of individuals within different groups. This in turn, requires a participatory approach to the design of health and information measures. Using the Norway context as a case example (here and here), we identify six elements of inclusive health information:
- Plans for national health preparedness must integrate and mainstream a socio-cultural diversity perspective ahead of a crisis. The Norwegian national preparedness plans for infectious diseases have for many years been criticized by civil society for the lack of a social diversity perspective.
- National information strategies must consider what information channels are suitable for reaching different population groups. While social media have made information more accessible, digital literacy and ability to access online information vary. When considering relevant information channels, sectors with high exposure jobs held by many immigrants, such as taxi drivers, bus drivers, health workers, shop workers or cleaners must be targeted.
- Information must be translated into the languages spoken by different population groups and disseminated via adequate digital and analog channels. This involves ensuring that posters carrying important information in the public realm (on buses, in public places, and in shops,) are made available in a range of languages in areas where immigrants live. Such information must be timely. Timelines are crucial: there is much to suggest that efforts to reach immigrant communities were far from sufficiently systematic and targeted when the national measures were announced,
- Information on how to protect oneself against infection should be communicated in an understandable and respectful manner. If a translation of a public health circular lists health institutions unfamiliar to the community and uses a technical and bureaucratic language, many people will not understand it. There may also be a need for a “cultural” translation of measures to prevent the spread of infection, with concrete examples that are likely to be understood.
- To be relevant, the information provided must be designed in a way that considers the living conditions among and within various population groups. One important factor is home size, given, for example, that 38 percent of Norwegian-Somalis live in overcrowded accommodation. In such circumstances, standard information about social distancing is not adequate. Instead concrete information about what measures people who live in crowded areas may resort to, is needed.
- Finally, “one size-fits-all” public information campaigns based on one-way communication are rarely effective. The content and structure of the information should be developed in collaboration with the affected communities and with organizations with linguistic and cultural competence, and knowledge about and trust from immigrant communities.