How Universal Is Universal Health Care? A Policy Analysis of the Provision of Maternal Health Care for Immigrant Women in Norway.

In Norway, with universalism remaining the core principle of its health policy, the challenges associated with growing ethnocultural diversity as a result of increasing immigration are demanding universal health care to be suitable for its population, and accessible beyond a statutory right.

This dissertation critically examines the intersection of immigration and Norway’s universal welfare ideology within the context of immigrant maternal health. It questions how universal, universal health care is in the face of growing diversity by analyzing the implications of Norway’s decentralized approach to addressing the maternal health needs of immigrant women. This is undertaken qualitatively across four research articles, which employ interviews, participant observations, and documents as sources of data to critically investigate Norway’s universal health policy and its implications for practitioners and immigrant service users. These articles are synthesized as an intertwined whole in the six foundational chapters of the dissertation.

The findings of this dissertation identify universalism as an inherently normative policy position whereby diversity is marginalized. This trickles down to how immigrant women are recognized and met in this system at the practice level. The effects produced by this decentralized system on the service users is conforming, requiring them to accept a generalized provision, and needs to be addressed at its roots by questioning the underpinning assumptions of Norway’s universal policy.

Consequently, this dissertation argues that universalism and its egalitarian ethos are utopic. It concludes by underscoring that the future of Norwegian universalism requires the adoption of a multicultural focus and the embeddedness of cultural diversity in its socio-political ideology of redistribution principles to address inequity in its diversifying society. This study offers important contributions to policy, practice, and theory in the intersecting fields of migration, public health, public policy, social work, and medical sociology.

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Lydia Mehrara