Exploring Young African Migrant Women Conceptualisation of Their Health, Healthcare Experiences, and Improvement of Services in Aotearoa, New Zealand
The increasing diversity of the Aotearoa New Zealand population has noticeably impacted on healthcare service provision, access, and utilisation, with health service underutilisation more prevalent among young immigrants. The research presented in this thesis explored the shared experiences and insights of young African migrant women between the ages of 16 and 35 years regarding Aotearoa New Zealand youth healthcare services. This objective was pursued by creating a platform for an open and creative dialogue for the participants to rewrite their narratives and reposition their knowledge to interact or negotiate with mainstream knowledge on equal terms; as well as challenge the shapes and forms of discrimination and segregation, barriers to access and engagement with services, and the prospect of what must be the betterment of their wellbeing. I applied a decolonising theoretical framework in line with African epistemology. The philosophical teachings of these theories are vast; in this study, I focused on the key tenets that reflect the research context, the participants’ life worlds and my positionality. The decolonising process involved asking how my research would: 1) challenge dominant ideologies; 2) ensure collective community validity of knowledge; 3) reflect the significance of race and racism and their interconnectedness with gender; and 4) empowered the participants for social change which suited the population being studied, whose culture and traditions are passed down orally. Data were collected by using storytelling sharing circles – a focus group method common in Africa contexts and practiced in research amongst Indigenous people for generations in various parts of the world. Findings were thematically analysed with a decolonising lens to ensure minimal misinterpretation of findings or loss of meaning. A triangulation approach was employed which used field notes involving observation and in-depth reflection to evidence meaning and aid in the understanding of contextual information, encounters, and information gathered during individual storytelling, and the storytelling circles. Sixteen young African women of African origin and identity participated in the main study. The research encountered hurdles in the collective and collaborative research processes. Eight participants were interviewed individually to capture data behind the unforeseen challenges. Only four of the 16 participated until the end of the research project. They developed a video artefact, which openly discussed their culture, ways of thinking and behaviour, and how these influenced their access to and use of youth health services, and their recommendations. Four common themes emerged: (1) making meaning of our health and wellbeing; (2) young African women’s experience and views of Aotearoa New Zealand health services; (3) participants’ shared prosperity and aspirations for positive health outcomes; and (4) barriers to democratic participation and collective action. The findings show a visible epistemological tension—both in the application of African philosophical principles in conducting research and contesting and contrasting the participants’ cultured bodily expression or embodiment against the mainstream biomedical narratives perpetuated by Aotearoa New Zealand’s services providers. The concepts of ‘embodiment’ and ‘embodied belonging’ provided a more nuanced understanding of how migration, exclusion, and marginalisation contribute to shape health-related inequities for young African women’s lives; the conditions of their existence and bodies which do not just tell stories but hold histories; and how their struggle for integration sought to regain health and sustain their wellbeing which cannot be divorced from religion and spirituality, and their social positioning as young African Black migrant women. These findings have implications for research, policies, and clinical practice. For instance, the study’s findings provide an evidence-based definition of health and wellbeing for young African migrant women to combat a ‘one-size-fits-all’ definition which has implications for the design of a model of care for this group. The study also unearthed different social factors operating concurrently and, therefore, accounts for a dimension of non/belonging and its effects on the domain of health, illness, and healthcare delivery for migrants. In this research, the discourse of African philosophy demonstrates its ability to serve as a guide for research with other marginalised groups and Indigenous people because it addresses issues pertinent to most formerly colonised (and collective) societies.
Young African migrant women, Health and wellbeing, Healthcare services, African epistemology, Decolonising methodology, Embodiment, Aotearoa New Zealand
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