"Where to find those doctors?" A qualitative study on barriers and facilitators in access to and utilization of health care services by Polish migrants in Norway.

Elżbieta Anna Czapka,Mette Sagbakken

doi:10.1186/s12913-016-1715-9

Abstract

BackgroundPoles constitute the largest group of migrants in Norway. Research confirms a steady inflow and a minimal outflow of Polish migrants. One of the key aspects of migrants’ structural integration is access to health care services. This study explored barriers to and facilitators of Polish migrants’ access to Norwegian health care services.MethodsA qualitative interview-based study was carried out between November 2013 and July 2014. The study is part of a larger, ongoing mixed-method study of Polish migrants’ access to health care services in Norway. Semi-structured interviews were conducted with 19 Polish migrants in Oslo. The interviews were transcribed, coded, and analyzed. Thematic analysis was performed to identify barriers and facilitators related to the use of Norwegian health care services.ResultsMigrants experienced several barriers to and facilitators of access to health care services in Norway. The barriers most often mentioned were problems resulting from insufficient command of the language, related communication problems, and lack of knowledge about navigating the Norwegian health care system. Other barriers related to the organization of the health care system, perceptions of doctors’ skills and practices, and attitudes among health personnel. Factors such as having a Polish social network, meeting friendly health personnel, and perceptions of equal treatment of all patients, facilitated access to and use of health care services.ConclusionsThe study shows that there are both system- and patient-related barriers to and facilitators of migrants’ access to health services in Norway. These findings suggest that successful inclusion of migrants into the Norwegian health system requires regular evaluation of access and utilization of health care services.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1715-9) contains supplementary material, which is available to authorized users.

Highlights

Poles constitute the largest group of migrants in Norway
The final framework focused on open and overall themes such as barriers and facilitators experienced by Polish migrants when accessing the Norwegian health services and included subthemes such as utilization of health care services in Norway, health information received upon arrival in Norway, migrants’ health information needs, use of interpreter and communication with health personnel
The aim of this study was to identify the main barriers and facilitators experienced by post-accession Polish migrants in accessing and utilizing health care services in Norway

Summary

Introduction

Poles constitute the largest group of migrants in Norway. Research confirms a steady inflow and a minimal outflow of Polish migrants. One of the key aspects of migrants’ structural integration is access to health care services. This study explored barriers to and facilitators of Polish migrants’ access to Norwegian health care services. Health care is an important aspect of integration [1], and access to health care services is one element of the structural integration of migrants [2]. Structural integration includes the acquisition of rights and access to positions within the main institutions and arenas in the host society: employment, housing, education, health care, citizenship, and participation in political life [2]. Policy may not match the reality “on the ground”; i.e., entitlement to health care services does not guarantee that migrants have full access to existing services [5]

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