title: A state of limbo--in transition between two contexts: Health assessments upon arrival in Sweden as perceived by former Eritrean asylum seekers.
abstract: BACKGROUND
  National statistics have shown that only about 40% of asylum seekers actually attend the optional health assessment offered upon their arrival in Sweden, but the reasons for this have not been fully explored. Health assessments for newly arrived asylum seekers have become a regular practice in most EU countries, but what is performed, how it is organized and whether it is mandatory or not varies between countries.
  
  
  OBJECTIVE
  The aim of the study was to explore and improve our understanding of how former asylum seekers from Eritrea perceived and experienced the health assessment during their asylum-seeking process.
  
  
  METHODS
  We used a qualitative research approach guided by grounded theory. Semi-structured interviews were conducted with 11 former asylum seekers from Eritrea. Data were analysed based on constant comparative analysis.
  
  
  RESULTS
  The asylum seekers expressed feelings of ambiguity and mistrust and felt that they were seen only as objects by the Swedish healthcare system during their asylum-seeking process. Poor communication and inability to overcome language and cultural barriers seemed to be the most important findings in the narratives. The core category was defined as 'A state of limbo - in transition between two contexts'.
  
  
  CONCLUSIONS
  There are reasons to believe that these issues with communication negatively affected both the quality of the health assessment and the number of asylum seekers attending the health assessment. Improved communication by the authorities towards the asylum seekers is, therefore, of vital importance.
authors.affiliation: The Public Health Agency of Sweden, Sweden Department of Public Health and Clinical Medicine, Umeå University, Sweden robert.jonzon@folkhalsomyndigheten.se.
authors.forename: Robert
authors.initials: R
authors.lastname: Jonzon
authors.affiliation: Center for Family Medicine (CeFAM), Karolinska Institute, Sweden.
authors.forename: Pille
authors.initials: P
authors.lastname: Lindkvist
authors.affiliation: Department of Public Health Sciences (IHCAR), Karolinska Institute, Sweden Nordic School of Public Health, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Johansson
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003144:Communication Barriers; D003469:Culture; D019017:Eritrea / Q000208:ethnology; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008403:Mass Screening / Q000523:psychology*; D036301:Qualitative Research; D012036:Refugees / Q000523:psychology* / Q000706:statistics & numerical data; D013548:Sweden
keywords: Asylum seekers; grounded theory; health assessments; migrant health; migration