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

Promoting diversity, equity, and inclusion (DEI) in medical social work is essential for reducingsystemic inequalities and ensuring fair care for all patients. This study examined how DEIinitiatives can improve cultural competence among medical social workers in community healthcentres. A workshop-based DEI training was implemented, and participants’ competence wasmeasured using the Cultural Competence Self-Assessment Questionnaire (CCSAQ). The studyused a pretest–posttest design, with participants completing the CCSAQ before and after thetraining. Data were analyzed with paired-samples t-tests. Some participants could not completethe posttest due to a strike at the study site, resulting in 11 matched cases for analysis. The findingsshowed significant improvement in two areas of cultural competence: Organizational Policies andProcedures (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 strengtheninginstitutional policies and community engagement. Positive, though not significant, improvementswere also seen in Knowledge of Communities, Personal Involvement, and Resources andLinkages. The study concludes that DEI initiatives can enhance the cultural competence of medicalsocial workers and help promote more inclusive and equitable care. It recommends continuousDEI training for social workers, regular policy reviews to support fairness and inclusion, andstronger community partnerships to sustain and expand these outcomes.