# Transition, Adjustment, and Healthcare Avoidance: African Immigrant Women’s Experiences and Perceptions of Navigating Primary Healthcare in the USA

## TL;DR

This study examines how African immigrant women, especially from Ethiopia, face challenges in accessing primary healthcare in the U.S. due to transition and adjustment difficulties.

## Contribution

The study provides new insights into the healthcare avoidance behaviors of Ethiopian immigrant women in the U.S. and highlights structural and acculturative barriers.

## Key findings

- Transitional challenges delay Ethiopian immigrant women's access to primary healthcare.
- Confusion about the U.S. healthcare system leads to mixed perceptions and avoidance of care.
- Healthcare is only sought for life-threatening conditions, check-ups, or maternal services.

## Abstract

This study explores the transition and adjustment of African immigrant women, particularly Ethiopian immigrant women (EIW), as they navigate the U.S. healthcare system and their ability to access and utilize healthcare services. A qualitative cross-sectional design with a mix of purposive and snowball sampling techniques was utilized to recruit EIW (N = 21, ≥18 years) who arrived in the U.S. within the last five years. One-on-one in-depth interviews were conducted to collect data. The interviews were audio-recorded, transcribed verbatim, and analyzed thematically using Nvivo12 software. The thematic analysis revealed three major themes: (1) settling into new life in the U.S. delays EIWs’ ability to access primary healthcare; (2) adjusting to the U.S. healthcare system: confusions and mixed perceptions; and (3) avoidance of care: EIW’s reasons for PHC visits changed in the U.S. Participants avoided healthcare, except for life-threatening conditions, general check-ups, and maternal healthcare services. Transitional support for legal, residential, employment, and health information could help tackle the challenges of accessing primary healthcare for EIW. Future research should analyze access to healthcare in relation to the everyday struggles of immigrant women, as well as legal and complex structural issues beyond acculturative issues.