Asylum seekers’ perceptions of barriers in accessing and using the Norwegian health services
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Background: Asylum seekers are considered a vulnerable population due to their life experiences prior to, during and after migration. These experiences are found to cause complex health issues and a high burden of disease. However, asylum seekers often have insufficient access to health services in their country of resettlement; but these access barriers are not well explored. Providing good health services for asylum seekers entails cultural sensitivity and use of appropriate services. This requires us to understand the barriers asylum seekers face when accessing and using the health services. This will provide knowledge necessary for health authorities and health care providers to implement the changes needed, and thereby improve health services for this vulnerable population. Objectives: The objective of the study was to explore asylum seekers’ perceptions of barriers in accessingand using the Norwegian health services.' Method: This was a qualitative study using in-depth semi-structured interviews. Eight asylum seekers were included, originating from Russia, Iran, Iraq and Somalia. They were recruited from two different asylum reception centres in Norway. Interviews were conducted in English, Norwegian or with the use of an interpreter. Analysis was facilitated using systematic text condensation as modified by Malterud. Results: The study revealed that asylum seekers experience several barriers in accessing and using the Norwegian health services. They experienced that services were not available to them due to their status as asylum seekers. Moreover, they experienced difficulties navigating the health system and accepting and adapting to the way which it is organized. Long waiting time and unfamiliarity with the role of the general practitioner was considered significant barriers. Asylum seekers also report communication difficulties, including the use of interpreters and unsatisfactory doctor-patient interaction. The above mentioned barriers resulted in reduced confidence in the health services’ ability to provide necessary services to ensure good health 9among this population. Consequently, these barriers led the asylum seekers to fear that their health would deteriorate. Conclusion: Asylum seekers experience several obstacles when accessing and using the Norwegian health services. There is a need to adjust the services. Asylum seekers should be given easier access to GPs and mental health services to make sure they are not excluded from the health services.They should also be given more comprehensive information about the health services. Moreover, to improve the services one should raise awareness of cultural differences and intercultural communication among service providers, and availability of high quality professional interpreters should be increased. This will ensure skilful and comprehensive communication. The knowledge of asylum seekers’ health care access, intercultural communication and the quality of the interpreter services is still sparse and further studies are required.