A Social-ecological Perspective on Understanding Facilitators to Access Primary Health Care Services among Ethiopian Immigrant Women in the United States

Abstract: Using a social-ecological model (SEM), this qualitative study explored the facilitators of access to primary health care (PHC) among Ethiopian immigrant women in the U.S. Data were collected through in-depth interviews ( N =21, ≥18 years) and analyzed thematically using Nvivo12. At the individual level, stable employment, insurance, immigration status, proactivity, education, communication skills, and internet usage were identified as facilitators of PHC access. Interpersonal support from family and friends was highlighted as a key facilitator. Institutional facilitators included interpretation services and the sociocultural background of health care providers. On the community level, support from community organizations and residing in certain locations were recognized as facilitators of PHC access. No policy-level facilitators were identified. The findings underscore the importance of strengthening individual and interpersonal capacities, including job opportunities, social support, legal assistance for immigration status, and education and communication skills. Further research is needed to analyze policy gaps and suggest viable solutions.