Barriers to healthcare in West African immigrant women from the South Bronx and Harlem, NYC

Background: Recent immigrants are unlikely to seek medical care due to multiple factors, including lack of knowledge of the healthcare system and undocumented status. Little is known about the health-seeking behaviors and barriers of West African immigrant women (WAIM), a growing population in New York City (NYC). These care-seeking barriers are important because of the central role WAIM play in their families. The aim of this study was to assess the health-seeking behaviors and experiences of NYC WAIM. Methods: Participants were recruited from the South Bronx and Harlem into focus groups based on their length of residence in the US. Two focus groups of recent immigrants (<5 years in the US) and two of non-recent immigrants (5+ years in the US) were conducted in English. Content analysis was conducted on the translated and transcribed transcripts. Results: 39 women were recruited, of whom 37 participated in the study. The median age was 32 years. All the women were married and most had children (92%); most were non-recent immigrants (73%). Over half had at least a high school education and were employed. Many uninsured women (70%) consulted with their husbands before seeking care for themselves. Barriers to healthcare were being uninsured and undocumented, language differences, and perceived negative attitudes of medical providers and staff. Conclusion: These results confirm prior work on challenges immigrants face in accessing healthcare. Better understanding of WAIM's healthcare experiences can assist health professionals to work with this population.