Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
Int J Equity Health. 2019 Aug 14;18(1):125. doi: 10.1186/s12939-019-1027-x.
Immigrants 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.
The 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.
Our 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).
Healthcare 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.
移民在高收入国家获得医疗服务时面临障碍。先前已经研究了移民在健康和获得医疗服务方面的不平等问题。然而，对于撒哈拉以南非洲移民（SSA）获得挪威医疗保健系统的情况知之甚少。
本研究采用定性研究设计。我们使用滚雪球技术从包括宗教组织和文化团体在内的网络中招募参与者。2017 年 10 月至 2018 年 7 月，在奥斯陆及其周边地区对来自撒哈拉以南非洲的 47 名移民进行了定性深入访谈和 2 次焦点小组讨论。访谈以挪威语、英语或法语进行，录音并逐字转录为英语。分析基于主题方法，使用 NVivo 软件。访谈数据的分析旨在寻找主题和子主题，这些主题和子主题是从访谈中归纳得出的。
我们的研究结果揭示了在获得挪威医疗服务时存在的两个主要障碍类别。第一类包括在获得医疗系统之前的困难（信息获取、偏好有移民背景的医生、经济障碍、长时间等待和家庭和工作责任）。第二类包括在系统内遇到的困难（理解/表达和语言、房间里的大象和对医疗保健提供者的不满）。
并非所有挪威居民都能平等获得医疗保健。这最终导致最需要医疗保健的人回避医疗系统。撒哈拉以南非洲移民不寻求医疗服务可能对这群移民的长期健康产生重大影响。因此，应优先考虑并进一步研究解决这些问题的措施。
