Health Care Choices of Ghanaian adult immigrants in Calgary, Canada University of Lethbridge, Alberta, Faculty of Health Sciences Evans Oppong Supervisors: Dr. Jean Harrowing and Dr. Peter Kellett

Purpose of study To explore factors that influence Ghanaian adult immigrant health care choices in Calgary, Alberta, Canada. And to better understand the factors that intersect to influence Ghanaian immigrants health care choices during the first 5 to 10 years post-arrival to Calgary, Alberta, Canada. To explore how beliefs, health status, and social determinants affect Ghanaian immigrant health care choices. Theoretical Framework Social constructivist theory, (Gergen, Lightfoot, & Sydow, 2004, Coll & Chapman, 2000. Andrews, 2012, A. Thomas, Menon, Boruff, Rodriguez, & Ahmed, 2014)

Thematic analysis and using NVivo 11 software (Braun &Clark,2014) Methods Purposive snowball sampling (n=10) Individual interviews and field notes. Thematic analysis and using NVivo 11 software (Braun &Clark,2014)

Tension between worlds Navigating and migrating into new space Struggle before and after migration Leaving behind and picking up new things Gender (Ghana vs Canada experience) Aggrieved Masculinity entitlement Ascending Femininity Men Men Canada In 2014, Hernandez, Han, and Ogrodniczuk “women seek help-men die” (p. 348)

Quotes from participants “She refuses me different times [sex], and I can’t do anything to her here. I can’t complain to anyone. It’s a shame to let someone know this...” “A man stabbed his wife all because, there is competition in some families, our ladies have grown horns we are nothing to them... it’s sad. Marriages are going down. When I brought my husband I told him that here in Canada, leave “those things” [exercising power on women]. You know Ghanaian men belief that they should have total control in the house even here [Canada]. So, I told him that is not like that here, the government will deal with him if that happens and he must follow the law of the land. (Woman putting fear in his husband).

Example of Tension between worlds Traditional medicine – Western medicine – physical health (if situation worsen) Side effect cultural process vs religious belief ( traditions, herbs, prayers ,counting on God, support of pastors)

Intersecting Pathways to health care choice Barriers Mixed Facilitators Racism (structural) Navigating system, Travel Lack of access to TM Language, not recognize education qualification Technology Influence from back home Time of work) Immigrant association Experienced immigrant(often through church

Implications Support to immigrant families for guiding gender roles Challenges in mental health among men (often present as stress/shame) but in many ways a lot of depression and anxiety). In some cases suicide radiation (they feel trapped) Raising awareness about immigrant health Could creates a sense of crisis including trauma, tension, domestic violence , homophobia etc