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Accessing public healthcare in Oslo, Norway: the experiences of Thai immigrant masseuses.

ABSTRACT: BACKGROUND:Thai massage is a highly gendered and culturally specific occupation. Many female Thai masseuses migrate to Norway as marriage migrants and as such are entitled to the same public healthcare as Norwegian citizens. Additionally, anyone who is not fluent in Norwegian is entitled to have an interpreter provided by the public healthcare system. Norway and most other countries aspire to universal health coverage, but certain immigrant populations continue to experience difficulties accessing appropriate healthcare. This study examined healthcare access among Thai migrant masseuses in Oslo. METHODS:Guided by access to healthcare theory, we conducted a qualitative exploratory study in 2018 with Thai women working as masseuses in Oslo, Norway. Through semi-structured in-depth interviews with 14 Thai women, we explored access to healthcare, health system navigation and care experiences. We analyzed the data using thematic analysis and grouped the information into themes relevant to healthcare access. RESULTS:Participants did not perceive that their occupation limited their access to healthcare. Most of the barriers participants experienced when accessing care were related to persistent language challenges. Women who presented at healthcare facilities with their Norwegian spouse were rarely offered interpreters, despite their husband's limited capacity to translate effectively. Cultural values inhibit women from demanding the interpretation services to which they are entitled. In seeking healthcare, women sought information about health services from their Thai network and relied on family members, friends and contacts to act as informal interpreters. Some addressed their healthcare needs through self-treatment using imported medication or sought healthcare abroad. CONCLUSIONS:Despite having the same entitlements to public healthcare as Norwegian citizens, Thai migrants experience difficulties accessing healthcare due to pervasive language barriers. A significant gap exists between the official policy that professional interpreters should be provided and the reality experienced by study participants. To improve communication and equitable access to healthcare for Thai immigrant women in Norway, health personnel should offer professional interpreters and not rely on Norwegian spouses to translate. Use of community health workers and outreach through Thai networks, may also improve Thai immigrants' knowledge and ability to navigate the Norwegian healthcare system.

SUBMITTER: Tschirhart N

PROVIDER: S-EPMC6805446 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Accessing public healthcare in Oslo, Norway: the experiences of Thai immigrant masseuses.

Tschirhart Naomi N Diaz Esperanza E Ottersen Trygve T

BMC health services research 20191021 1

<h4>Background</h4>Thai massage is a highly gendered and culturally specific occupation. Many female Thai masseuses migrate to Norway as marriage migrants and as such are entitled to the same public healthcare as Norwegian citizens. Additionally, anyone who is not fluent in Norwegian is entitled to have an interpreter provided by the public healthcare system. Norway and most other countries aspire to universal health coverage, but certain immigrant populations continue to experience difficulties ...[more]

PMID: 31638984

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Project description:BackgroundImmigrant women have higher risks for poor pregnancy outcomes and unsatisfactory birth experiences than the general population. The mechanisms behind these associations remain largely unknown, but they may result from differential care provided to immigrant women or unsatisfactory interactions with health providers. This study aimed to investigate immigrant and non-immigrant women's experiences of health care during childbirth, particularly assessing two dimensions: perceived general quality of care and attainment of health care needs during childbirth.MethodsThis was a cross-sectional study carried out over 15 months in 2020 and 2021, and data were collected from a self-completed questionnaire. The labour and birth subscale from the Experience of Maternity Care questionnaire was used to assess the primary outcome of care experiences. A total of 680 women completed the questionnaire approximately within two days after birth (mean 2.1 days) at a hospital in Trondheim, in central Norway. The questionnaire was provided in eight languages.ResultsThe 680 respondents were classified as immigrants (n = 153) and non-immigrants (n = 527). Most women rated their quality of care during childbirth as high (91.5%). However, one-quarter of the women (26.6%) reported unmet health care needs during childbirth. Multiparous immigrant women were more likely than multiparous non-immigrant women to report that their health care needs were unmet during childbirth (OR: 3.31, 95% CI: 1.91-5.72, p < 0.001, aOR: 2.83, 95% CI: 1.53-5.18, p = 0.001). No other significant differences between immigrant versus non-immigrant women were found in subjective ratings of childbirth care experiences. Having a Norwegian-born partner and a high level of Norwegian language skills did not influence the immigrant women's experience of childbirth care.ConclusionsOur findings indicate that many women feel they receive high-quality health care during childbirth, but a considerable number still report not having their health care needs met. Also, multiparous immigrant women report significantly more unmet health care needs than non-immigrants. Further research is required to assess immigrant women's childbirth experiences and for health care providers to give optimal care, which may need to be tailored to a woman's cultural background and individual expectations.

Project description:ObjectiveTo explore reasons for attending a general emergency outpatient clinic versus a regular general practitioner (RGP).DesignCross-sectional study using a multilingual anonymous questionnaire.SettingNative and immigrant walk-in patients attending a general emergency outpatient clinic in Oslo (Monday-Friday, 08:00-23:00) during 2 weeks in September 2009.SubjectsWe included 1022 walk-in patients: 565 native Norwegians (55%) and 457 immigrants (45%).Main outcome measuresPatients' reasons for attending an emergency outpatient clinic versus their RGP.ResultsAmong patients reporting an RGP affiliation, 49% tried to contact their RGP before this emergency encounter: 44% of native Norwegian and 58% of immigrant respondents. Immigrants from Africa [odds ratio (OR) = 2.55 (95% confidence interval [CI]: 1.46-4.46)] and Asia [OR = 2.32 (95% CI: 1.42-3.78)] were more likely to contact their RGP before attending the general emergency outpatient clinic compared with native Norwegians. The most frequent reason for attending the emergency clinic was difficulty making an immediate appointment with their RGP. A frequent reason for not contacting an RGP was lack of access: 21% of the native Norwegians versus 4% of the immigrants claimed their RGP was in another district/municipality, and 31% of the immigrants reported a lack of affiliation with the RGP scheme.Conclusions and implicationsAccess to primary care provided by an RGP affects patients' use of emergency health care services. To facilitate continuity of health care, policymakers should emphasize initiatives to improve access to primary health care services. KEY POINTS Access to immediate primary health care provided by a regular general practitioner (RGP) can reduce patients' use of emergency health care services. The main reason for attending a general emergency outpatient clinic was difficulty obtaining an immediate appointment with an RGP. A frequent reason for native Norwegians attending a general emergency outpatient clinic during the daytime is having an RGP outside Oslo. Lack of affiliation with the RGP scheme is a frequent reason for attending a general emergency outpatient clinic among immigrants.

Project description:ObjectiveTo explore the experiences of people living with long COVID and how they perceive the healthcare services available to them.DesignQualitative systematic review.Data sourcesElectronic literature searches of websites, bibliographic databases and discussion forums, including PubMed LitCovid, Proquest COVID, EPPI Centre living systematic map of evidence, medRxiv, bioRxiv, Medline, Psychinfo and Web of Science Core Collection were conducted to identify qualitative literature published in English up to 13 January 2021.Inclusion criteriaPapers reporting qualitative or mixed-methods studies that focused on the experiences of long COVID and/or perceptions of accessing healthcare by people with long COVID. Title/abstract and full-text screening were conducted by two reviewers independently, with conflicts resolved by discussion or a third reviewer.Quality appraisalTwo reviewers independently appraised included studies using the qualitative CASP (Critical Appraisal Skills Programme) checklist. Conflicts were resolved by discussion or a third reviewer.Data extraction and synthesisThematic synthesis, involving line-by-line reading, generation of concepts, descriptive and analytical themes, was conducted by the review team with regular discussion.ResultsFive studies published in 2020 met the inclusion criteria, two international surveys and three qualitative studies from the UK. Sample sizes varied from 24 (interview study) to 3762 (survey). Participants were predominantly young white females recruited from social media or online support groups. Three analytical themes were generated: (1) symptoms and self-directed management of long COVID; (2) emotional aspects of living with long COVID and (3) healthcare experiences associated with long COVID.ConclusionsPeople experience long COVID as a heterogeneous condition, with a variety of physical and emotional consequences. It appears that greater knowledge of long COVID is required by a number of stakeholders and that the design of emerging long COVID services or adaptation of existing services for long COVID patients should take account of patients' experiences in their design.

Project description:BACKGROUND:Immigrants and their Norwegian-born children make up approximately 18% of the total population in Norway. While several studies have been conducted on immigrants' utilization of healthcare services, immigrant families are systematically underrepresented in international studies of children with disabilities. By focusing on experiences of immigrant parents of children with disabilities navigating health and rehabilitation services in Norway, this study generated knowledge of how accessible and tailored the services were from their point of view. METHODS:This study took a qualitative approach, using semi-structured interviews to explore the experiences of immigrant parents of children with disabilities from non-Western countries. The interviews were transcribed, coded, and analyzed via an inductive thematic analytic approach. RESULTS:The findings show how the "immigrant experience" influenced the way the parents looked at, experienced, and even praised the services. The parents appreciated the follow-up services provided by the pediatric rehabilitation centers, which they experienced as predictable and well-organized. While navigating the services, they experienced several challenges, including the need for information, support, and timely help. They felt exhausted because of years of struggle in the healthcare system to access the help and services they needed. They expressed how this struggle had affected their own health. The feeling of being treated differently from the majority was another challenge they experienced while navigating the services. The findings also show how parents' experiences of communication with healthcare providers were influenced not only by their own language and communication skills but also by the healthcare providers' intercultural communication skills and dominant organizational culture. CONCLUSIONS:The parents' experiences show that there is still a gap between the public ideal of equal healthcare services and the reality of the everyday lives of immigrant families of children with disabilities. By exploring immigrant parents' experiences, this study highlights the importance of mobilization at both the individual and systemic levels to fill the current gap and provide tailored and accessible services to the entire population.

Project description:BACKGROUND:Patient experience is an important indicator of quality of health care. In Norway, little is known about the quality of health care for immigrants. The aim of this study was to compare patient-reported experiences with general practice between the Norwegian-born population and immigrant groups. METHODS:We performed secondary analyses of data from a national survey on patient experiences with general practice, including assessments of general practitioners (GPs) and their GP offices. The survey was carried out in Norway in 2018-19. The total number of respondents was 2029, with a response rate of 42.6%. Region of birth was available for 1981 participants, and these were included in the analyses ("Norway" (N?=?1756), "Asia, Africa or South America" (N?=?95), "Eastern Europe" (N?=?70) and "Western Europe, North America or Oceania" (N?=?60)). Five indicators of patient experiences were used as dependent variables in bivariate and multivariate analyses, with region of birth as the main exposure variable and other background variables about the patient as adjustment variables: "the GP" (measures related to communication and competency), "auxiliary staff" (politeness, competency, organization), "accessibility" (waiting times), "coordination" (with other services) and `enablement` (GP facilitates coping with/understanding illness). RESULTS:Immigrants as a whole reported poorer experiences with general practice than the majority population, with significantly poorer scores on four of five patient experience indicators. Patients from Asia/Africa/South America reported poorer experiences than those from Norway on the indicators "GP", "auxiliary staff", "accessibility" and "coordination": on a scale from 0 to 100 where 100 is the best, the difference ranged from 7.8 (GP) to 20.3 (accessibility). Patients from Eastern Europe reported lower scores on "GP" and patients from Western Europe/North America/Oceania reported lower scores on "auxiliary staff". These associations were still significant after adjustment for sex, age, self-rated physical and mental health, number of contacts with the GP and education. CONCLUSIONS:For countries with a substantial proportion of foreign-born patients in the health system, immigrant background is an important parameter in quality improvement work. Immigrant background is also an important parameter in health service research.

Project description:BACKGROUND:The European Action Plan for Sexual and Reproductive Health emphasizes the importance of improving access to contraceptive services for disadvantaged groups. However, a prior study showed that the prevalence of abortion is two times higher among refugees compared to non-immigrants in Norway. Similarly, a recent study reported that 50% of Somali women in Oslo had unintended childbirth on one occasion or more. These findings are supported by several studies in Europe that showed immigrant and refugee women have higher rates of unintended pregnancy and abortion than Non-immigrant women, and more than half of immigrants, who seek abortion are not using any form of contraception, raising concerns about their access to utilization of modern contraception. However, none of these studies have explored reasons underlying immigrant women's underutilization of modern contraception. The present study aimed to explore the barriers and facilitators to contraceptive usage among Somali immigrant women in Oslo area. METHODS:A qualitative study using unstructured in-depth interviews with twenty one Somali women of reproductive age, >18 years, was conducted in Oslo from May-August 2018. The participants were recruited using purposive sampling method. Interviews began with a general question and were followed with some probing questions, and were continued until data saturation was reached. Data were analyzed using thematic analysis. RESULTS:Although the majority of the participants were educated, aware of the importance of contraceptive methods and interested in child spacing, systemic and socio-cultural barriers were found to be hindering their access to contraception. Several barriers were identified, including: language problems, lack of adequate information, religious beliefs, gender roles and social pressure. CONCLUSION:Eliminating the barriers which prevent women from receiving their desired form of contraception will have important public health implications, including lengthening inter-pregnancy intervals, and fewer unplanned pregnancies and abortions. These findings can support policy makers, civil society organizations and health providers to develop cultural sensitive programmes and educational interventions, which help Somali immigrant women overcome the identified barriers to contraception.

Dataset Information

Accessing public healthcare in Oslo, Norway: the experiences of Thai immigrant masseuses.

Publications

Accessing public healthcare in Oslo, Norway: the experiences of Thai immigrant masseuses.

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