Exploring challenges related to health literacy of Albanian immigrants in Germany: a qualitative study among a younger, educated cohort

Background Albanian immigrants in Germany face health literacy challenges due to language barriers, cultural differences, and unfamiliarity with the healthcare system, which intersect with systemic issues such as medical staff shortages. Purpose This qualitative study explored the health literacy and health challenges of Albanian immigrants in Germany, examining their capacity to navigate healthcare services, make informed decisions, and identify barriers and facilitators influencing their experiences. Methods Semi-structured interviews were conducted with 15 Albanian immigrants (mean age 27; predominantly younger and highly educated). Participants were recruited via online communities and cultural centers. Data were analyzed using thematic content analysis guided by thematic saturation principles. Results Participants reported multiple barriers to healthcare access. Language proficiency gaps impeded accurate communication of medical concerns, with several describing difficulty understanding diagnoses, treatment plans, and medical terminology. Bureaucratic delays and long waiting times for appointments deterred timely care utilization, and securing a family doctor proved challenging depending on region of residence. Despite these obstacles, participants expressed strong trust in physicians and satisfaction with treatment quality once received. Statutory health insurance mitigated financial concerns for most. Systemic strains, particularly staff shortages, exacerbated communication gaps and care delays, with physician participants acknowledging workforce deficits contribute to prolonged waiting periods. Shared decision-making was inconsistently practiced; some reported needing to insist on referrals. Experiences of friends and relatives further shaped expectations, with accounts of misdiagnosis due to language barriers reinforcing concerns about systemic responsiveness. Conclusions Socioeconomic factors, including education level, employment status, and insurance coverage, shaped participants’ healthcare experiences, with higher education and statutory insurance mitigating financial concerns, yet systemic barriers such as bureaucratic delays, communication gaps and provider shortages persisted regardless of socioeconomic position. Despite these barriers, participants maintained trust in the system, valuing statutory health insurance, quality treatment, and provider professionalism.