Evaluating Diversity, Equity, and Inclusion (DEI) Practices in Addressing Structural Barriers in Medical Social Work Practice: Evidence from Ibadan, Nigeria

Abstract

Promoting diversity, equity, and inclusion (DEI) in medical social work is essential for reducing
systemic inequalities and ensuring fair care for all patients. This study examined how DEI
initiatives can improve cultural competence among medical social workers in community health
centres. A workshop-based DEI training was implemented, and participants’ competence was
measured using the Cultural Competence Self-Assessment Questionnaire (CCSAQ). The study
used a pretest–posttest design, with participants completing the CCSAQ before and after the
training. Data were analyzed with paired-samples t-tests. Some participants could not complete
the posttest due to a strike at the study site, resulting in 11 matched cases for analysis. The findings
showed significant improvement in two areas of cultural competence: Organizational Policies and
Procedures (t(10) = -5.64, p < .001, d = -1.70) and Reaching Out to Communities (t(10) = -2.86, p
= .017, d = -0.86). These results suggest that the DEI workshops were effective in strengthening
institutional policies and community engagement. Positive, though not significant, improvements
were also seen in Knowledge of Communities, Personal Involvement, and Resources and
Linkages. The study concludes that DEI initiatives can enhance the cultural competence of medical
social workers and help promote more inclusive and equitable care. It recommends continuous
DEI training for social workers, regular policy reviews to support fairness and inclusion, and
stronger community partnerships to sustain and expand these outcomes.