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

Abstract

BackgroundThai 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.MethodsGuided 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.ResultsParticipants 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.ConclusionsDespite 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.

A qualitative study on the experiences of southern European immigrant parents navigating the Norwegian healthcare system

“…Our participants described practices of bringing medicines from Southern Europe for unsupervised treatment for themselves or their children and seeking healthcare in their countries of origin. Such practices have also been noted among other immigrant groups [12,19].…”

“…In Scandinavia, communication problems and low socioeconomic status are key barriers that immigrants face when accessing healthcare [10][11][12]; communication is challenged not only by the language barrier but also by divergent cultural understandings of disease, treatment, and the role of the doctor [11,[13][14][15][16][17][18]. For instance, for Thai women living in Norway and Sweden, culture is a major factor contributing to their unwillingness to access the healthcare system-including, when necessary, by asserting their right to interpretation services [19,20]. Seeking to overcome their health problems, these women engage in self-treatment, seek care from social networks, and travel to their country of origin for medical consultation; the latter strategy has also been observed among Poles, the largest immigrant group in Norway [12].…”

‘Who is telling the truth?’ Migrants’ experiences with COVID-19 related information in Norway: a qualitative study

“…However, partly because of this reliance on formal/informal sources, many were confused and accessed unreliable information. Migrants’ lack of competence in Norwegian has previously been cited as one of the main obstacles to equitable health services [ 32 - 34 ] and may have resulted in limited access to reliable information on the pandemic, especially on the measures implemented by the authorities. According to a previous study of the Republic of Korea during the MERS epidemic, migrants may not be aware of the seriousness of the epidemic and may not know how to protect themselves when there is a lack of information in their mother tongue [ 35 ].…”

A qualitative study of rural healthcare providers’ views of social, cultural, and programmatic barriers to healthcare access

“…Patients who experience communication difficulties with providers may feel coerced, which generates disempowerment and leads patients to employ more covert ways of engagement [ 71 , 72 ]. Language barriers can further compromise communication and hinder outcomes or patient progress [ 73 , 74 ]. Any miscommunication between a patient and provider can affect one’s access to healthcare, namely affecting appropriateness-related barriers.…”