In this article we use two immigrant projects, operating in a Swedish context, as a basis for discussing and analysing the potential of joint projects as a tool for change in human welfare service organisations that target the general public. The extensive use of projects in the development of a slimmed-down public sector can be seen as originating from the contradictory promises of projects regarding flexibility and rationality in the new public management context. Projects are also used as a way to obtain more resources for specific long-term needs, but they are seldom implemented as intended in the regular 'mainstream' organisation. Therefore the long-term development of social services and healthcare for immigrants remains inadequate. It appears that politicians, managers and civil servants prefer to focus on the positive aspect of projects to legitimate the organisations and to bring about change by targeting and steering activities. However, they tend to overlook the negative consequences of using projects, and there is a risk that a backlash will undermine the legitimacy of organisations. Citizens and participants in general, and immigrants in particular, experience frustration and distrust as a result of the short-term nature of project-based action. The problems that the projects were expected to address may remain, or even increase.
A current challenge for many European countries is to enable forced migrants to access health and social care that meets their needs. One solution is to use paraprofessionals - that is, trained individuals who are not professionals - to act as bridge-builders between minority communities and the health and social care sectors. This paper explores the development of a quality improvement project in Sweden. The project aimed to recruit and train forced migrants who had lived in Sweden for more than five years to act as bridge-builders. The aim was to use their unique experiences and knowledge in two ways - to work with service staff in developing new ways of working, and to become culturally competent paraprofessionals working with their own communities. This paper focuses on how an understanding of the role evolved as the participants reflected on their experiences and undertook an inquiry process culminating in the development of three possible models of what the task of a bridge-builder should be in developing culturally appropriate health and social services that are responsive to the needs of forced migrants. The conclusion reflects on what was learned and how the experiences from this project may be useful for others who are struggling with the same kind of problem in Sweden and in other countries.