Abstract
BackgroundImmigrants face barriers in accessing healthcare services in high-income countries. Inequalities in health and access to healthcare services among immigrants have been previously investigated. However, little is known on the sub-Saharan African immigrants’ (SSA) access to the Norwegian healthcare system.MethodsThe study had a qualitative research design. We used the snowball technique to recruit participants from networks including faith-based organizations and cultural groups. Forty-seven qualitative in-depth interview and two focus group discussions with immigrants from sub-Saharan African were conducted from October 2017 to July 2018 in Oslo and its environs. Interviews were conducted in Norwegian, English or French, audio-recorded and transcribed verbatim into English. The analysis was based on a thematic approach, using NVivo software. Interview data were analyzed searching for themes and sub-themes that emerged inductively from the interviews.ResultsOur findings reveal barriers in two main categories when accessing the Norwegian healthcare services. The first category includes difficulties before accessing the healthcare system (information access, preference for doctors with an immigrant background, financial barriers, long waiting time and family and job responsibility). The second category includes difficulties experienced within the system (comprehension/expression and language, the black elephant in the room and dissatisfaction with healthcare providers).ConclusionHealthcare is not equally accessible to all Norwegian residents. This ultimately leads to avoidance of the healthcare system by those most in need. Lack of seeking healthcare services by immigrants from Sub Saharan Africa may have significant implications for the long-term health of this group of immigrants. Therefore measures to address the issues raised should be prioritized and further examined.
Highlights
Immigrants face barriers in accessing healthcare services in high-income countries
Five women and four men participated in the first focus group discussion (FGD), while seven women and 2 men were in the second FGD
Our findings revealed that lack of sufficient finances or income might force sub-Saharan African immigrants’ (SSA) immigrants to seek alternative or self-treatment, and may mean that most SSA immigrants in Norway might not be able to make payments for high-cost procedures such as eye and dental care and physiotherapy
Summary
Immigrants face barriers in accessing healthcare services in high-income countries. Little is known on the sub-Saharan African immigrants’ (SSA) access to the Norwegian healthcare system. Sub-Saharan African (SSA) consists of regions economically classified as low-income countries and having some of the worse human development and health indices in the world [1, 2]. Due to the economic situations and political instabilities in some regions of SSA, people tend to migrate to other parts of the world, amounting to 4.15 million sub-Saharan African migrants in Europe in 2017 [3]. After a period in the host countries the “healthy migrant effect” may wear off, and the health of many immigrants eventually worsen [5]. Immigrant’s disparities in health and access to healthcare services have attracted increased attention in high-income countries [5]. The relationship between cultural and social norms and health care utilization patterns seem to differ between sending
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