title: A qualitative study on African immigrant and refugee families' experiences of accessing primary health care services in Manitoba, Canada: it's not easy!
abstract: Immigrant and refugee families form a growing proportion of the Canadian population and experience barriers in accessing primary health care services. The aim of this study was to examine the experiences of access to primary health care by African immigrant and refugee families.
  
  
  
  Eighty-three families originating from 15 African countries took part in multiple open ended interviews in western Canada. Qualitative data was collected in six different languages between 2013 and 2015. Data analysis involved delineating units of meaning from the data, clustering units of meaning to form thematic statements, and extracting themes.
  
  
  
  African immigrant and refugee families experienced challenges in their quest to access primary health care that were represented by three themes: Expectations not quite met, facing a new life, and let's buddy up to improve access. On the theme of expectations not quite met, families struggled to understand and become familiar with a new health system that presented with a number of barriers including lengthy wait times, a shortage of health care providers, high cost of medication and non-basic health care, and less than ideal care. On the theme of facing a new life, immigrant and refugee families talked of the difficulties of getting used to their new and unfamiliar environments and the barriers that impact their access to health care services. They talked of challenges related to transportation, weather, employment, language and cultural differences, and lack of social support in their quest to access health care services. Additionally, families expressed their lack of social support in accessing care. Privately sponsored families and families with children experienced even less social support. Importantly, in the theme of let's buddy up to improve access, families recommended utilizing networking approaches to engage and improve their access to primary health care services.
  
  
  
  African immigrant and refugee families experience barriers to accessing primary health care. To improve access, culturally relevant programs, collaborative networking approaches, and policies that focus on addressing social determinants of health are needed.
authors.affiliation: Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada. Roberta.Woodgate@umanitoba.ca.
authors.forename: Roberta Lynn
authors.initials: RL
authors.lastname: Woodgate
authors.affiliation: Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada.
authors.forename: David Shiyokha
authors.initials: DS
authors.lastname: Busolo
authors.affiliation: Departments of Pediatrics and Child Health, Rady Faculty of Health Sciences, Max Rady College of Medicine, Medical Microbiology and Community Health Sciences, University of Manitoba, Winnipeg, MB, R3E 3P5, Canada.
authors.forename: Maryanne
authors.initials: M
authors.lastname: Crockett
authors.affiliation: Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada.
authors.forename: Ruth Anne
authors.initials: RA
authors.lastname: Dean
authors.affiliation: Nor-West Co-op Access Center, 785 Keewatin Street, Winnipeg, MB, Canada.
authors.forename: Miriam R
authors.initials: MR
authors.lastname: Amaladas
authors.affiliation: Medical Officer of Health, Winnipeg Regional Health Authority, 490 Hargrave Street, Winnipeg, MB, R3A 0X7, Canada.
authors.forename: Pierre J
authors.initials: PJ
authors.lastname: Plourde
mesh_terms: D000328:Adult; D000349:Africa / Q000208:ethnology; D000368:Aged; D001294:Attitude to Health; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D005190:Family / Q000523:psychology*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008350:Manitoba; D008875:Middle Aged; D011320:Primary Health Care; D036301:Qualitative Research; D012036:Refugees / Q000523:psychology* / Q000706:statistics & numerical data; D064890:Social Determinants of Health; D055815:Young Adult
keywords: Health services’ access and use; Immigrant; Primary care; Qualitative research; Refugee; Social determinants of health