The study explored factors hindering African women’s access to quality reproductive healthcare in Beijing. To our knowledge, this is one of the few studies that solely investigate reproductive healthcare experiences among African migrant women in Beijing, China. Findings indicate that lack of reproductive health awareness, discriminatory immigration policy, discontentment with local health services, and language barrier were the key challenges preventing African women from accessing quality reproductive healthcare in Beijing. Concerning intersectionality theory  and Anderson Behavioural Model of Health Service Utilization [21, 22] findings imply that access to reproductive healthcare is influenced by not a single factor but rather a combination of socio-cultural, institutional, and personal factors.
Culture affects health beliefs and health literacy, which then can influence healthcare experiences . There is a clear indication that cultural norms and health beliefs arising from participants’ backgrounds, individual, and interpersonal levels underscore African women’s attitudes towards reproductive healthcare participation in Beijing. This evidence aligns with Anderson’s Behavioural Model of Health Service Utilization which suggests the antecedent factors which impede the use and need of healthcare services. Generally, it is believed that women who understand the importance of reproductive healthcare do prioritize access . Thus, it is not surprising that the majority of the women interviewed had little participation in reproductive healthcare. This is problematic, as per the definition of reproductive health by WHO; reproductive health exists at all stages of life  as opposed to participants’ ideological points of view that restrict reproductive health to childbearing as evidenced by the findings.
Discrimination immigration policies present some challenges to African women in accessing reproductive healthcare. Discriminatory immigration policy reported concerning access to reproductive healthcare was related to employment restrictions on participants and difficulty in securing visas and birth certificates for newborn babies. Issues with discrimination against Africans are not new both in academic and non-academic discourse [9, 11]. However, our findings concerning discrimination were not related to race or ethnicity as previous research has it. In our study, participants reported immigration status discrimination which permits discriminatory practices in employment and the regularization of immigration status of Chinese-born African babies. In particular, this issue is related to biased immigration laws in China which restrict jobs to nationals from certain countries. It is was clearly expressed that immigration policies were not friendly to Africans who do not fall within the foreigner resident professional category (foreigners who enter China with valid visas due to work and talent introduction),thereby making it difficult for African women to engage in employment to earn extra income to afford reproductive healthcare. Although on paper, China’s immigration law applies to all foreign residents, most institutions do not treat Africans the same way they treat any other foreigner. There is a lack of proper characterization of the African immigrant in regularizing their status and the ability to enjoy social and economic rights in China . For example, within the current immigration law, foreigners who enter China with valid visas due to work and talent introduction are classified as foreigner resident professionals who hold permits for work. Regrettably, most African immigrants do not fit this category due to their occupational profile and their precarious statutes that make them unfit for this category . On the other hand, immigration policy does not allow the smooth regularization of stay of China-born African babies. In most instances, these babies are denied the hukou status  and legal documentation regardless of the status of mothers. Together, these issues contribute to the challenges African women faced in accessing reproductive healthcare services in Beijing.
Results from the study indicate discontentment with reproductive healthcare services among African women in Beijing. For example, within the current Law on Health Care for Mothers and Infants in China, sex screening of fetuses is strictly forbidden. Consequently, engaging in fetal sex identification of an unborn baby is against the law and tantamount to arrest . This law took effect in June 1995 in the wake of the rampant abortion as a result of the growing preference for boys over girls leading to a serious sex imbalance of newborn babies . African women contested being subjected to this law and resisted that “Chinese doctors can not apply Chinese regulations on their bodies because they are not Chinese”. Unfortunately, this law does not discriminate; it applies to everyone in China and fails to consider the implication it might have on culturally different individuals. Extending this law to African women implies dissatisfied antenatal care and a major obstacle towards the planning and preparing for baby process. African women expressed discontentment with this law and were reluctant to access gestation services (the most familiar aspect of reproductive health among participants). In effect, this law was particularly pertinent to the barriers to reproductive healthcare among African women that were interviewed.
Findings from the study indicate that African women and Chinese healthcare providers cannot communicate. Language access is yet another challenge that African women faced in navigating accessible reproductive healthcare. In addition, we found that language barrier leads to miscommunication between Chinese medical professionals and African women. The language barrier identified in our findings aligns with previous studies [1, 11, 28]. Previous research has demonstrated the association between language barrier and less satisfaction with health services between both parties. Similarly, language barrier decreases the quality of healthcare delivery and patient safety [29, 30]. Ideally, the use of health services demands effective communication between a patient and health service provider. However, healthcare facilities are far from overcoming language barriers in healthcare despite the increasing number of migrant patients. This calls for urgent attention for Chinese healthcare facilities to keep abreast of the communication needs of their diverse patients to provide better solutions.