Africans and use of Health services 23/2/2019

Health Workshop in Aberdeen 23/2/2019

General discussion

In the discussion on the topics in the workshop there was a general consensus that Africans needs to be more proactive in their wellbeing because many people do not understand the way the health system works. Therefore, do not use it effectively.

There is an assumption on the part of some Africans that the health system here works just the same way the health system in their home countries works i.e. every health condition is treated in one place, be it emergency or not. Such assumption indicates such people do not know the difference between a GP surgery, emergency treatment and other services. They are likely to show up in GP surgery for something that may not be for GP surgery or may not call an emergency number when they should. The problem is seen as a lack of contact with Africans and the health system. Most of the information about health services in the African community is by the word of the mouth which may not be correct.

The question is who is responsible for making sure Africans understand the system? What outreach work is going in the community?

Within our community, there is a high level of stress due to social, environmental and immigration issues that impact on the mental health of Africans, yet no one is working with Africans on this issue, providing them with information on how to identify symptoms in their families, friends or communities. It is not only in mental health, but the same also goes for domestic violence and abuse in the community, men’s health, sickle cell and young people’s health etc. There is just no contact between the NHS and the community.

This lack of contact means services may not be used effectively. With no deliberate outreach work with the African community, it means there is lack the correct information to even inform each other. Often the community only come to know of health issues when harm is done.

Challenges identified:
  1. There are issues of understanding how the health system works. This lack of knowledge make Africans feel they are discriminated against but this may not be true but such perception persists due to lack of correct information. For example, how does a new person in Aberdeen understand how the system works? They are told to register with a GP and they do but the uses of other associated health services are absent and sometime there is differences in the way they are treated. For example, when a foreign student or visitor pays health insurance what does that entail? What services are they entitled to? Are they entitled to all services provided or only some aspect? How do they know what they are entitled to?
  2. They lack of contact and updated information on health services may contribute to problems the African community not using the health services appropriately or effectively. Without information, the NHS will find it difficult to provide an appropriate support system for Africans.
  3. How does NHS support Africans without working with them?
  4. There is an increase in the number of Africans in Scotland yet they do not know what policies are on screening for sickle cell, the support system in place to support sufferers? What counselling services are available to those suffering from sickle cell anaemia, and those that are carriers of the gene?
  1. We do not know which capacity building work the NHS is doing with African community to help take care of their health. We understand that the NHS will not have a special health service for Africans but at least it can supply 
  2. Africans with information, training, and an outreach worker and empower the community activists to support African community so that they can access health services effectively and efficiently.
  3. The NHS should support community research that can provide local information on local issues. The idea of copying research in the south of the border and apply it to Africans in Scotland is unacceptable.


  1. There is a need for health awareness, therefore there a need for outreach worker in the African community to raise awareness of health information in the African community. The last time such work was done was 1998 in Aberdeen through health promotion. Africans should not be left alone to grope in the dark trying to use the health systems.
  2. There is a need for capacity building of the community in some areas of health such as mental health how to identify symptoms, avoid, stress, manage etc taking on board the cultural barriers that prevent people using the services. NHS should help the community talk about such issues to break taboo associated with mental health. The same applies to domestic violence and abuse. There should be capacity building of individuals and groups through training and workshops.
  3. There should be an awareness of African Men’s health, young people in areas such as mental health, and domestic violence/abuse especially among foreign students who may not understand the seriousness of such behaviour here due to differences in cultural worldview.
  4. We need information on women genital mutilation, barrenness and uptake of IVF among African women in Scotland and any concerned services that African women do not use so that something can be done about it.
  5. We want information on health and care for the elderly Africans if there is none then the discussion should be in place with the community right now.
  1. There should be deliberate programs that build the capacity of African community to participate in consultation and decision making in the care system, especially at the policy level. There should be a partnership with the local community groups.
  1. Provide support to local groups, to train and research their people for better access to health care services and use the local people community groups to disseminate information within the community.
  2. The NHS should know that one size does not fit all. NHS staffs need training to understand the African worldview and health. When an African is asking questions or reluctance to use services or using it in the wrong way, it shows there is gaps in information, understanding due to culture, value or worldview contribute to acceptance or refusal of services. A little understanding of where a user is coming from would improve things for both user and staff, for example, if an African speaks loud is she or he been aggressive, threatening or uncooperative or abusive? Or she or he says “Oh God, forbid bad this bad thing” or “It is not my portion in Jesus’ name” is she cursing the nurse or doctor? But response to some of these statements may encourage or discourage someone using that service.
  3. In terms of policy, there should be wide consultation with Africans and other minority communities to have an input and seat at the table. Often services are provided without Africans in mind or an assumption that they are temporary residents. The idea of lifting findings in England and transpose it on Scottish Africans is not right. Majority of Africans in Scotland come directly from mainland Africa with their own world view that might differ from those that are born here or from elsewhere. We need a local solution to local problems; therefore more research into Africans in Scotland should be done. There is a need to build local experts on Africans in Scotland.

                                            Compiled by:

                                      Bertha D Yakubu: (MPhil Public Health)