Tshitangano, T. G.Mudau, A. G.Manyuma, Duppy2025-10-152025-10-152025-09-05Manyuma, D. 2025. Strategies to Improve Access to Healthcare Services for Refugees and Asylum Seekers in Gauteng Province, South Africa. . .https://univendspace.univen.ac.za/handle/11602/2998PhD (Public Health)Department of Public HealthIntroduction: South Africa currently hosts approximately 250,250 refugees and asylum seekers, the highest among the nine countries included in the UNHCR’s Multi-Country Office. The constitution of South Africa and the Refugee Act of South Africa grant refugee and asylum seekers the right to access healthcare services as South African citizens, despite the provisions in the legislation that grant refugees and asylum seekers similar rights as South African citizens in terms of access to health services, they still experience challenges in accessing these services in Gauteng Province. Aim: This study aimed to develop strategies to improve refugees' and asylum seekers' access to health care services in Gauteng Province, South Africa. Methods: The study was conducted in three phases. An exploratory sequential mixed methods design was employed in Phase 1 of the study, where the initial phase adopted a qualitative approach, and the subsequent phase adopted a quantitative approach. Phase 1 (a) of this study employed a qualitative approach in Gauteng Province among 16 conveniently sampled Health professionals and 20 purposively sampled refugees and asylum seekers. Unstructured interviews were used to collect data, which was analysed thematically. The results from Phase 1 (a) were then used to inform Phase 1 (b). Phase 1 (b) adopted a quantitative approach based on the findings from the initial qualitative approach to strengthen and ensure the generalisability of the qualitative phase to a broader population. Data was collected through structured self-administered questionnaires from n=353 health professionals and n=367 refugees and asylum seekers who were randomly sampled. Descriptive analysis was performed on the collected data. Ethical principles of informed consent, anonymity, privacy, confidentiality, and avoidance of harm were adhered to throughout the study. Results: The results from health professionals, refugees, and asylum seekers were reported separately. Nine themes emerged during data analysis. Four themes emerged from data collected from refugees and asylum seekers: Turnaround time, Hospital charges, Treatment by the hospital staff, and Practice in the hospital. Five themes emerged from data collected from health professionals: Communication challenges, corrupt activities by asylum seekers and refugees, hospital charges, attitude of asylum seekers, refugees and staff, and patients’ health-seeking behavior Phase 1 (c) focused on meta-inference and conceptualization. Where a conclusion was drawn based on the qualitative and quantitative data gathered. Phase 2 focused on developing strategies using analysis of Strengths, Weaknesses, Opportunities, and Threats and a Build, Overcome, Explore, and Minimize Model to guide the process. The developed strategies include the purpose, core values, and 17 strategic objectives with action plans. In Phase 3, the Delphi Technique was used to validate the developed strategies with 13 validators considered experts in healthcare, migration, and academics. Conclusion: There is a need to eliminate the language barriers between health professionals, refugees, and asylum seekers to ensure optimal access to services. Continuous provision of education in the refugee community will improve their understanding of the South African health system. Cultural competency training is needed to ensure acceptability between health professionals, refugees, and asylum seekers. There should be a collaboration between the community structures and local and international organizations with the Department of Health to address the existing challenges.1 online resource (xvi, 243 leaves): color illustrationsenUniversity of VendaAccessUCTDAsylum SeekersHealthcare servicesPatientRefugeesStrategiesThesisManyuma D. Strategies to Improve Access to Healthcare Services for Refugees and Asylum Seekers in Gauteng Province, South Africa. []. , 2025 [cited yyyy month dd]. Available from:Manyuma, D. (2025). <i>Strategies to Improve Access to Healthcare Services for Refugees and Asylum Seekers in Gauteng Province, South Africa</i>. (). . Retrieved fromManyuma, Duppy. <i>"Strategies to Improve Access to Healthcare Services for Refugees and Asylum Seekers in Gauteng Province, South Africa."</i> ., , 2025.TY - Thesis AU - Manyuma, Duppy AB - Introduction: South Africa currently hosts approximately 250,250 refugees and asylum seekers, the highest among the nine countries included in the UNHCR’s Multi-Country Office. The constitution of South Africa and the Refugee Act of South Africa grant refugee and asylum seekers the right to access healthcare services as South African citizens, despite the provisions in the legislation that grant refugees and asylum seekers similar rights as South African citizens in terms of access to health services, they still experience challenges in accessing these services in Gauteng Province. Aim: This study aimed to develop strategies to improve refugees' and asylum seekers' access to health care services in Gauteng Province, South Africa. Methods: The study was conducted in three phases. An exploratory sequential mixed methods design was employed in Phase 1 of the study, where the initial phase adopted a qualitative approach, and the subsequent phase adopted a quantitative approach. Phase 1 (a) of this study employed a qualitative approach in Gauteng Province among 16 conveniently sampled Health professionals and 20 purposively sampled refugees and asylum seekers. Unstructured interviews were used to collect data, which was analysed thematically. The results from Phase 1 (a) were then used to inform Phase 1 (b). Phase 1 (b) adopted a quantitative approach based on the findings from the initial qualitative approach to strengthen and ensure the generalisability of the qualitative phase to a broader population. Data was collected through structured self-administered questionnaires from n=353 health professionals and n=367 refugees and asylum seekers who were randomly sampled. Descriptive analysis was performed on the collected data. Ethical principles of informed consent, anonymity, privacy, confidentiality, and avoidance of harm were adhered to throughout the study. Results: The results from health professionals, refugees, and asylum seekers were reported separately. Nine themes emerged during data analysis. Four themes emerged from data collected from refugees and asylum seekers: Turnaround time, Hospital charges, Treatment by the hospital staff, and Practice in the hospital. Five themes emerged from data collected from health professionals: Communication challenges, corrupt activities by asylum seekers and refugees, hospital charges, attitude of asylum seekers, refugees and staff, and patients’ health-seeking behavior Phase 1 (c) focused on meta-inference and conceptualization. Where a conclusion was drawn based on the qualitative and quantitative data gathered. Phase 2 focused on developing strategies using analysis of Strengths, Weaknesses, Opportunities, and Threats and a Build, Overcome, Explore, and Minimize Model to guide the process. The developed strategies include the purpose, core values, and 17 strategic objectives with action plans. In Phase 3, the Delphi Technique was used to validate the developed strategies with 13 validators considered experts in healthcare, migration, and academics. Conclusion: There is a need to eliminate the language barriers between health professionals, refugees, and asylum seekers to ensure optimal access to services. Continuous provision of education in the refugee community will improve their understanding of the South African health system. Cultural competency training is needed to ensure acceptability between health professionals, refugees, and asylum seekers. There should be a collaboration between the community structures and local and international organizations with the Department of Health to address the existing challenges. DA - 2025-09-05 DB - ResearchSpace DP - Univen KW - Access KW - Asylum Seekers KW - Healthcare services KW - Patient KW - Refugees KW - Strategies LK - https://univendspace.univen.ac.za PY - 2025 T1 - Strategies to Improve Access to Healthcare Services for Refugees and Asylum Seekers in Gauteng Province, South Africa TI - Strategies to Improve Access to Healthcare Services for Refugees and Asylum Seekers in Gauteng Province, South Africa UR - ER -