Graduate Studies


First Advisor

Dr. Megan S. Kelley

Second Advisor

Dr. Marc A. Garcia

Third Advisor

Dr. Weiwen Chai

Date of this Version

Spring 4-17-2020


Rashoka, F. N. (2020). Roadblocks to Accessing Healthcare Services Among Marginalized Refugees: Insight From A Qualitative Study of Yezidis ( Master Thesis). University of Nebraska-Lincoln.


A THESIS Presented to the Faculty of The Graduate College at the University of Nebraska In Partial Fulfillment of Requirements For the Degree of Master of Science, Major: Nutrition and Health Sciences, Under the Supervision of Professor Megan S. Kelley. Lincoln, Nebraska: April, 2020

Copyright 2020 Falah N. Rashoka


Obstacles to navigate and access healthcare are a real concern for underserved populations, especially refugees and immigrants. Known barriers to health care include high cost of health services, inadequate or no health insurance, and lack of transportation. To reduce health disparities, there is an urgent need to better understand the barriers that hinder and resources that facilitate access to healthcare for underserved populations. From July 2019 to January 2020, a series of focus group discussions took place to investigate barriers to healthcare system access faced by the Yezidis refugees in Lincoln, Nebraska. A nine-member focus group included social workers, healthcare works, and members of the Yezidi community. This qualitative research study finds a number of obstacles to healthcare access, including lack of knowledge about the healthcare system, language and dialect barriers, lack of health insurance, and cultural and environmental barriers. Mental health treatment was identified as an urgent need to be addressed. Additional challenges included living in a poor and/or isolated neighborhood, health care system complexity, difficulty knowing where to go for health services, long waiting times for medical appointments, obstacles to get non-prescribed medication, and transportation barriers. Mistrust in the health system, the experience of discrimination, and social isolation were also perceived as barriers. In conclusion, the study found that many obstacles prevent refugees from accessing health care. Interpreting these barriers through a social-ecological lens can provide insight into possible intervention strategies. Approaches to address these barriers should include health education and policy change.

Advisor: Megan S. Kelley