Dahal Rudra, Bajgain Bishnu Bahadur, Thapa-Bajgain Kalpana, Adhikari Kamala, Naeem Iffat, Chowdhury Nashit, Turin Tanvir C
Nepalese-Canadian Community, Calgary, Alberta, Canada.
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
J Migr Health. 2024 Mar 1;9:100223. doi: 10.1016/j.jmh.2024.100223. eCollection 2024.
Despite the Canadian universal healthcare system, new immigrants face a number of challenges in accessing primary healthcare (PHC) services. As immigration to Canada consistently increases, understanding various types of barriers to PHC and how they differ across different sub-groups is critical. We conducted a qualitative study among Nepalese immigrant men to learn from their experience with PHC access to inform healthcare providers, stakeholders, and policymakers to devise feasible approaches to enhancing access to care.
We undertook a qualitative research approach employing focus groups among a sample of first-generation Nepalese immigrant men who had prior experience with accessing PHC in Canada.
We conducted six focus groups in total with 34 participants (each group comprising 5-7 participants) in their preferred language, Nepalese, or English. Demographic information was collected prior to each focus group. Transcriptions of the discussions were prepared, and thematic analysis was employed in the qualitative data set.
Participants reported experiencing barriers at two stages: before accessing PHC services and after accessing PHC services. The barriers before accessing PHC were long wait time for an appointment with physicians, limited knowledge of own health- and services-related issues, limited service availability hours, cultural differences in health practices, and transportation and work-related challenges. The barriers after accessing PHC were long wait time in the clinic to meet with the physicians at the time of appointment, communication challenges and misunderstandings, high healthcare costs associated with dental and vision care and prescribed medicines, and inappropriate behaviours and practices of doctors and service providers. To our knowledge, this is the first study in Canada which explored barriers faced by Nepalese immigrant men in accessing PHC.
This study identifies barriers to accessing PHC in Canada from a group of immigrant men's perspective. It is important to account for these while making any reforms and adding new care services to the existing healthcare system so that they are equitable for these groups of individuals as well.
尽管加拿大实行全民医疗保健系统，但新移民在获得初级医疗保健（PHC）服务方面面临诸多挑战。随着移民到加拿大的人数持续增加，了解初级医疗保健的各种障碍以及它们在不同亚群体中的差异至关重要。我们对尼泊尔移民男性进行了一项定性研究，以了解他们获得初级医疗保健的经历，从而为医疗保健提供者、利益相关者和政策制定者提供信息，以制定可行的方法来改善医疗服务的可及性。
我们采用定性研究方法，对有在加拿大获得初级医疗保健经验的第一代尼泊尔移民男性样本进行焦点小组访谈。
我们总共进行了六个焦点小组访谈，共有34名参与者（每个小组由5至7名参与者组成），使用他们首选的语言尼泊尔语或英语。在每个焦点小组访谈之前收集人口统计学信息。准备了讨论记录，并对定性数据集进行了主题分析。
参与者报告在两个阶段遇到障碍：在获得初级医疗保健服务之前和之后。获得初级医疗保健服务之前的障碍包括预约医生的等待时间长、对自身健康和服务相关问题的了解有限、服务提供时间有限、健康习惯方面的文化差异以及交通和工作相关的挑战。获得初级医疗保健服务之后的障碍包括预约时在诊所等待见医生的时间长、沟通挑战和误解、与牙科、视力保健和处方药相关的高额医疗费用，以及医生和服务提供者的不当行为和做法。据我们所知，这是加拿大第一项探讨尼泊尔移民男性在获得初级医疗保健方面所面临障碍的研究。
本研究从一群移民男性的角度确定了加拿大获得初级医疗保健的障碍。在对现有医疗保健系统进行任何改革和增加新的护理服务时，考虑到这些障碍很重要，这样才能使这些人群也能公平受益。
