BHUTANESE REFUGEES' HEALTH BEHAVIORS AND PERCEPTIONS: A QUALITATIVE APPROACH TO UNDERSTANDING BHUTANESE REFUGEES' POST-RESETTLEMENT EXPERIENCES WITH HEALTH CARE SERVICES IN MIDDLE TENNESSEE

Abstract

Extant research investigating the health perceptions and behaviors of Bhutanese refugees is limited, especially in resettled populations. The purpose of the current research was to explore Bhutanese refugees' perceived experiences with health services received post-resettlement as well as their post-resettlement health care practices and continued use of pre-resettlement health behaviors. A qualitative approach was utilized in the current study. Three audio-recorded focus groups were conducted with Nepali-speaking women in the Bhutanese refugee community. Participants were also asked to complete a demographic questionnaire. English transcripts were coded and analyzed using a grounded theory, constant comparison approach.

A total of 32 Bhutanese women participated in the three focus groups. Eight categories emerged from focus group data: difficulties in accessing transportation to receive health services, language barriers in communicating with health professionals, challenges in paying for health services, positive and negative perceptions of post-resettlement health treatments, positive and negative perceptions of post-resettlement health professionals, limited engagement in preventive health behaviors, challenges with the post-resettlement health care system, and use of conventional medicine as the primary health option. These categories were later refined into three categories: barriers to accessing post-resettlement health services, perceptions of post-resettlement health services, and limited health literacy. The three categories contribute to an understanding of how Bhutanese women manage their health post-resettlement and, furthermore, how post-resettlement health management serves as a component of taking care of oneself and one's community during resettlement.

These factors parallel the barriers experienced by other refugee populations. Health educators and health professionals should consider such barriers when designing and implementing health programs and offering health services to individuals in the Bhutanese refugee community. Future research is warranted to better understand health management in other subgroups of the Bhutanese refugee community and ways in which community resources may be modified and established to increase positive health outcomes within this community.