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Health promotion and public health
Fragmented health and well-being services as contributing barriers in overcoming the unmet needs of a population with special needs
  1. Nashit Chowdhury1,
  2. Tanvir C Turin1,2
  1. 1 Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  2. 2 Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  1. Correspondence to Dr Tanvir C Turin, University of Calgary, Calgary, AB T2N 4N1, Canada; turin.chowdhury{at}

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Commentary on: Brewer A. “We were on our own”: Mothers’ experiences navigating the fragmented system of professional care for autism. Soc Sci Med 2018; 215:61-8.

Implications for practice and research

  • Managing conditions like autism disorder requires a multidisciplinary approach that effectively integrates subsections of medical and other professionals and facilitating patients’ and caregivers’ access to required services.

  • The consequences of the rising trend of super-specialisation and sub-specialisation of medical professions on patients and their caregivers need to be studied in future studies.


Studies have shown that increasing fragmentation of the healthcare system leads to systemic deficiencies, lack of coordination between professionals from collaborating disciplines, increased expenditure, inequalities and deprofessionalisation.1 2However, information on how decentralisation or fragmentation affects healthcare receivers and their caregivers requiring multidisciplinary approach is limited. Brewer’s study examines how the subdivisions of professional jurisdictions of childhood disabilities between and within …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.