Exploring health care experiences and access challenges: A qualitative study of African migrants in Guangzhou, China

Abstract

This study analyzes the health care experiences and barriers of African migrants in Guangzhou, China, employing the Cultural Ecological Access Framework (CEAF). Using 35 participant in-depth interviews, the study describes the challenges of accessing health care as multi-dimensional: the participants faced language barriers, legal and financial discrimination, culturally inappropriate care, and lack of competent clinicians. The results explain how migrants’ interactions with health providers and the services, as well as the community and policy, enable or disable their abilities to receive—and sometimes to seek—their medical needs. Support networks served participants as both a coping strategy and as an important informant to aid in navigating the health system. At the institutional and structural level, unfamiliar workflows, insufficient interpreting resources, and exclusionary health policy severely impede access. Utilizing CEAF, the study highlights how different forms of power, including culture and structural relations, bind together explaining the care of Africans in China. The findings call for inclusive and responsive African migrant health policies in China.