Beliefs, perceptions, and behaviors impacting healthcare utilization of Syrian refugee children

Abstract

Background Approximately 18,000 Syrian refugees have resettled to the United States. Half of these refugees are children, whose age and refugee status jeopardize their abilities to attain quality healthcare. Information on Syrian refugees' health in the U.S. is limited. This qualitative study sought to explore Syrian refugee parents' beliefs, perspectives, and practices regarding their children's health through in-depth interviews. Methods Eighteen Syrian refugee parents residing in Cincinnati, Ohio were interviewed in Arabic by bilingual researchers using semi-structured in-depth interviews. The interviews were recorded, transcribed, and translated. Three members of the research team independently coded each interview using an inductive thematic analysis approach. Results Analysis identified four salient themes: stressors preclude health seeking behaviors, parents perceive health barriers, parents are dissatisfied with the healthcare system, and parents use resilience behaviors to overcome barriers. Stressors included poor housing and neighborhoods, reliving traumatic experiences, depression and anxiety, and social isolation. Dissatisfaction included emergency room wait times, lack of testing and prescriptions. Health barriers included missed appointments and inadequate transportation, translation services, health literacy and care coordination. Parents reported resilience through faith, by seeking knowledge, use of natural remedies, and utilizing community resources.

Newcomer challenges with accessing healthcare services in Saskatchewan, Canada

“…Current study results align with Woodgate et al (Woodgate et al, 2017), a study based in Manitoba, Canada, that demonstrated recent newcomers do not always understand how or where to access healthcare services. In the United States, Syrian refugee parents also reported numerous difficulties with navigating the healthcare system, often resulting in missed appointments for their children (Alwan et al, 2020) Theme 2: Limited awareness of healthcare services A few service providers and newcomers specifically mentioned not being aware of healthcare services. Many newcomers did not expect some healthcare services to be available simply because they are not offered in their home country, such as home care services.…”

“…Several studies indicate lack of familiarity with the healthcare system is a barrier to accessing healthcare among newcomers (Wu et al, 2005;Son, 2013). A Syrian refugee parent noted that if a child is sick, they did not understand where to take the child to access appropriate care (Alwan et al, 2020). Similarly, Syrian refugees in Toronto, Canada expressed concerns regarding lack of accurate and user-friendly information about healthcare services (Guruge, Sidani, Illesinghe et al, 2018).…”

“…Renfrew et al (2013) have observed that low health literacy is a significant barrier to care among newcomers. Syrian refugees have experienced difficulty with comprehending diagnoses, treatment plans, and medication administration (Alwan et al, 2020).…”

“…In the United States, Syrian refugees have described similar challenges with translation services, including differences in colloquial Arabic dialects among interpreters (Alwan et al, 2020). Interpretation issues noted underscore the growing importance of using medically trained interpreters.…”

“…Refugees may also experience a sense of discrimination and stigmatization that deters them from accessing healthcare (Szajna & Ward, 2015). In addition to the above barriers, recent Syrian refugee parents have reported that preoccupation with previous trauma, depression and anxiety, and social isolation were barriers to seeking healthcare for their children (Alwan, Schumacher, Cicek-Okay, et al, 2020).…”