Meaning of health : migration experience and health seeking behaviour of West African women in Australia

Health concepts strongly influence people’s health seeking behaviour. In an increasingly multicultural Australia, the cohort of patients presenting for health care services are from cultural backgrounds that may have different concepts of health from that of the health care providers. West African immigrant women are among the recent immigrants to Australia who may have a different notion of health from the dominant western philosophy that guide health care provision in Australia. Understanding the meaning of health for these women and its influence on their health seeking behaviour will assist nurse in effective healthcare delivery. This qualitative study explored the meaning of health and the impact of this meaning on West African women’s health seeking behaviour. Guided by constructivist assumptions, participants were recruited through the snowballing technique. Twenty-one West African women living in Australia and willing to participate in the study were engaged in face-to-face audio-taped interview. Through continuous interplay of data collection and data analysis, four emerging themes namely being healthy, being spiritual, being a migrant and encountering health care system were identified. Findings revealed that West African women’s meaning of health incorporated biomedical ideas, belief in mystical forces and the participants’ social positioning as women. The women waited for physical symptoms of illness before presenting at health care facilities. Most of them believe that mystical forces such as witches, wizards and evil eye can cause illness. Patriarchal subservient positioning encouraged by traditional African culture subjected these women to domestic violence experience and overwork. Furthermore, the study revealed that West African women’s meaning of health was the major determinant of these women’s health seeking behaviour. It determined the type of health care services used by these women. The findings from this study demonstrate that meaning of health, migration experience and the participants’ personal experiences with the health care system are fundamental to their health seeking behaviour. The women’s meaning of health is subjective, dynamic and it is influenced by a combination of world views. Despite a high level of educational achievement as well as occupation of most of the women, belief in higher mystical forces was a significant cultural framework supporting their explanations of health. As immigrants these women experienced isolation and they had positive and negative experiences as they encountered the health care system in their new country. Influenced by their cultural belief and their experiences of settling in a new country, these women underutilised health care services in Australia and delayed access. It is suggested that provision of health care services aimed at meeting these women’s health care needs should incorporate these women’s meaning of health to enhance their participation. Implication of the study for nursing practice and recommendation for further research were also suggested