Ms Yara Alagha:

I thank the Senator for her questions. The national maternity strategy was Ireland's first ever maternity strategy to be developed. It came about because of recommendations from the Health Information and Quality Authority, HIQA, and was commissioned after the tragic death of Savita Halappanavar. While it is meant to be an inclusive strategy in light of that context, it fails to address specifically the absence of culturally appropriate services within maternity care. The HSE also has the national intercultural health strategy, which promises an integrated approach to healthcare for users from diverse and ethnic backgrounds who may face health inequalities, but it contains very basic information on religious and cultural contexts.

In the review of the strategy, we need to consider more comprehensive guidelines and best practice guidance similar to those adopted by the NHS in the UK, which deals with best practice from the moment a child is born and maternity care to elderly care and end-of-life care. At every point, we need to ensure that a person's dignity is preserved and faith is respected. We can all agree on that, but the question is how to do a better job. While our research covered a small proportion of people from one faith, I am sure that much could be said about research done on people of different faiths and their experiences of engaging in healthcare and other State care settings. The extent to which these strategies are implemented and met remains uncertain because we do not have the necessary disaggregated data. We will never know until we have the relevant research. Our research highlights that perhaps these strategies are either not being implemented or are not enough. This matter needs to be investigated, starting with reviews of the guidelines. Are they working in practice? Do they need to be strengthened? Do they need to be better enforced? Do healthcare workers need to be better informed and how do we go about doing that? For example, would it be through mandatory training sessions? These are all questions that the Department of Health, in conjunction with the Departments of Justice and Children, Equality, Disability, Integration and Youth, needs to be looking into. We in the Amal Association would love to see this matter being hashed out further and discussed in committee and by the relevant Ministers. I hope that answers the Senator's questions.