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Myhre, Maja (2024) Access to healthcare for undocumented migrants: a qualitative study into the practices of healthcare professionals in Norwegian primary healthcare services. Doctoral thesis, London Metropolitan University.
This doctoral thesis examines the regulation and negotiation of undocumented migrants' (UDM) healthcare access to the Norwegian primary healthcare system. It seeks to understand healthcare professionals' decision-making processes and the influences facing them in their meetings with UDM patients. The thesis is based on a qualitative, phenomenological inquiry.
UDM are a population group facing significant material deprivation, social exclusion, persecution, human rights breaches, and lack of formal entitlements to welfare services. In Norway, UDM experience poor physical and mental health outcomes as well as substandard living and working conditions. Further to this, UDM are excluded from universal health coverage. Formal access restrictions stipulated in national legislation preclude UDM from making full use of the Norwegian primary healthcare system. However, due to their significant health needs, UDM still seek out primary healthcare services.
This qualitative study applies a phenomenological approach to unpack the practices and decision-making processes of healthcare professionals working in Norwegian primary healthcare services. The field work includes individual, semi-structured interviews and focus group discussions. The empirical data is analysed through thematic analysis.
The main findings of this study show that healthcare professionals experience the guiding policy on UDM primary healthcare access as confusing and ambiguous. Further, the study finds that healthcare professionals employ a wide range of strategies to increase accessibility of primary healthcare for UDM. These strategies are put in a system of local, practice-based policies. Finally, the research uncovers the various influences on healthcare professionals when making decisions on UDM healthcare, including their professional ethics, personal-political beliefs, and their ability to act autonomously.
The study concludes that the current, restrictive Regulation on healthcare access for UDM residing in Norway lacks workability and has poor understanding within the professional groups implementing it. Further, it concludes that there is significant willingness amongst Norwegian primary healthcare professionals to provide a full range of healthcare to this population group. The implications of this study for future policy and practice includes a contribution to the growing advocacy for policy change to improve primary healthcare access for UDM, in order to fulfil Norway's commitment to human rights convention, to protect the health of UDM and the public health of the nation.
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