Building bridges or negotiating tensions? experiences from a project aimed at enabling migrant access to health and social care in Sweden

A current challenge for many European countries is to enable forced migrants to access health and social care that meets their needs. One solution is to use paraprofessionals - that is, trained individuals who are not professionals - to act as bridge-builders between minority communities and the health and social care sectors. This paper explores the development of a quality improvement project in Sweden. The project aimed to recruit and train forced migrants who had lived in Sweden for more than five years to act as bridge-builders. The aim was to use their unique experiences and knowledge in two ways - to work with service staff in developing new ways of working, and to become culturally competent paraprofessionals working with their own communities. This paper focuses on how an understanding of the role evolved as the participants reflected on their experiences and undertook an inquiry process culminating in the development of three possible models of what the task of a bridge-builder should be in developing culturally appropriate health and social services that are responsive to the needs of forced migrants. The conclusion reflects on what was learned and how the experiences from this project may be useful for others who are struggling with the same kind of problem in Sweden and in other countries.