Maghrebi minors as translators in health services in Tarragona (Spain): a qualitative study of the discourse of the Maghrebi adults

BACKGROUND In the province of Tarragona (Spain), 24% of immigrants come from countries in the Maghreb. 40% of Maghrebis residing in Spain say their linguistic command of Spanish is inadequate, which could hinder their relationship with healthcare professionals. The use of minors as translators by health services is a fairly common practice. The suitability of using children as translators has been questioned, although there has been little specific research on the subject and most has been from the perspective of professionals. The aim of this study was to qualitatively analyze the discourse of Maghrebi adults to the use of Maghrebi minors as translators in the health services. METHODS A qualitative study using 12 in-depth interviews and 10 focus groups with Maghrebi adults living in Tarragona. The scope of the study was primary healthcare and hospital services in the area. A content analysis was performed using open coding. RESULTS The practice studied is attributed to a lack of funding for translation resources, and prioritization of adults' work over children's education. It is seen as a convenient solution to the community's communication problems, although it is considered unreliable and detrimental to the rights of the child. The attitudes of healthcare professionals to the phenomenon studied varies from acceptance without any ethical concerns to concern about its effects on the child. The solutions proposed are the organization of translation resources with a proactive approach which are adapted to real needs, and a change in the focus of language training activities for the adults in the community. CONCLUSIONS It is necessary to reconcile access to healthcare for Maghrebi adults with the rights of children who act as translators in the healthcare context. This requires coordination between health and educational institutions, changes in the organization and provision of translation resources, and a guarantee that immigrants have employment rights under the same conditions as Spanish nationals.