Keywords

1 Introduction

In this chapter, we address agency involvement among migrant women and discuss how a model of a Health Party contributed to generating and promoting learning agencies for migrant women. Norway’s public healthcare system is based on public financing, universal health coverage, and culturally socialised “taken-for-granted knowledge” of accessing and using the health system. Despite the existence of an indigenous population, the Sami, and national minorities, Norway has traditionally been perceived to be a homogeneous society with one culture where information about the Public Health care system was passed on to the same ethnic population and between generations. However, with global mass immigration, there are significant populations of immigrants and their descendants from various countries. The Norwegian government promotes equality and diversity, and the country has policies to support multiculturalism and integration. Since 2018, there has been a rapid rise in the number of international migrants, accounting for more than 10% of the European and 16% of the Norwegian population (Diaz and Kumar 2018). As Norway undergoes a significant demographic change with increasing heterogeneity, the country is also experiencing an increase in social inequality in health, including risks such as poor living conditions accompanied by poor health outcomes among groups of immigrants (Abebe et al. 2017; Goldblatt et al. 2023; Statistics Norway 2023). Immigrants and Norwegian-born individuals with immigrant parents are a complex group with different reasons for immigration, ethnic, and socio-economic backgrounds: this may impact risk factors for disease, the use of health services, and expectations and demands on and for healthcare services. There are differences in their levels of health literacy. Recent and previous migrant populations, including refugees, may not be familiar with how the Norwegian healthcare system is organised and may experience encounters with the healthcare system as discriminatory, or lacking cultural sensitivity. There can be various reasons behind this challenge, including the lack of knowledge about cultural sensitivity for minorities to access welfare and healthcare services in Norway (Moe and Hedlund 2019; Hedlund and Moe 2010). Most European countries’ policies have strived towards equitable welfare and health services to citizens regardless of ethnicity, religion, region, country of origin, and other characteristics. Yet the literature describes challenges in providing healthcare for multicultural populations by doctors and other healthcare professionals (Varvin and Aasland 2009; Debesay et al. 2014). Making healthcare responsive to patients’ and locals’ needs remains a work in progress. This may be particularly apparent in the lack of sensitivity to the healthcare needs of migrant women. Biological differences and sociocultural variations related to gender must also be considered when dealing with a diverse patient and client group. Recent health policy reforms have stressed the need for better patient and public involvement (Kasper et al. 2022). By 2011, it was claimed that existing involvement mechanisms in Norway were dominated by suggestions from health professionals and their interests (Solbjør and Steinsbekk 2011). Later, researchers claimed that in Scandinavia, few approaches to health research highlight the needs and priorities of migrants, particularly migrant women (Bradby et al. 2015). An approach highlighting the needs and priorities of migrant women will be essential because it can inform the public healthcare system about how best to access these women’s well-being and good health. By so doing, it will also contribute to several of the Sustainable Development Goals (SDGs) by the United Nations, such as SDG 3: Good health and well-being, SDG 5: Gender equality, and SDG 10: Reduced inequalities. This chapter provides a concrete case of such an approach. Called a Health Party, inspired by Tupperware Parties, a host invites female friends, family, and acquaintances to a party, where the goal, besides being a social event, is to share information about a health-related topic and create a space for discussion.

2 Health Literacy and Migrant Women in Norway

In the Norwegian context, health literacy refers to a person’s ability to find, understand, assess, and apply health information in a way that enables this person to make knowledge-based decisions related to health (Norwegian Health Directorate 2021). For Norwegian health authorities, health literacy means having competence when making decisions about lifestyle choices, disease prevention measures, disease self-management, and use of health and care services. Health literacy will relate to individual and system-oriented efforts. In 2021, a survey was carried out in Norway about health literacy from five selected immigrant groups following citizenship and/or place of birth: Pakistan, Poland, Somalia, Turkey, or Vietnam, called the HLS19, part 2 (Le et al. 2021). This survey showed that one out of three had low levels of general health literacy in these migrant populations and that migrant persons who score low on health literacy might lack critical skills for meeting expectations in the health system in general and in individual health services. The survey did not focus on migrant women or sex-gender issues. On a general basis, the survey showed that migrants from these countries found it difficult to navigate the healthcare system and challenging to find information about how to handle mental health problems.

Migrants from non-Western backgrounds in Norway have, very generally, poorer health outcomes compared with the native population on some measures, and women are even more affected than men, according to research (Forland 2009; Blom 2011). Individually, many migrants are more likely to be exposed to certain illnesses and health problems such as diabetes, HIV, hepatitis B, tuberculosis, lack of vitamin D, and mental health problems (Spilker et al. 2009). Migrants may face health risks and challenges related to socio-economic, cultural, religious, and gender backgrounds. Their interactions with health care providers and welfare services can be shaped by what migrant women consider to be the political, legal, and gender regimes and accepted norms in their host country. Choices and actions related to health and sickness will influence their experience accessing and using health services (Attanapola 2013; Diaz and Kumar 2018). Consequently, the way in which migrant women relate to health literacy and make informed choices about the use of health care is not entirely a learning process predetermined by their original cultural background. Thus, migrant women must acquire new strategies for interacting with new and unfamiliar healthcare systems.

Other research demonstrates that culture and migration are two different determinants of health (Thurston and Vissandjée 2005) and that the migration experience is often overlooked, or confused with, culture. Similarly, the extent to which ethnicity and culture, including cultural and religious practices, influence health status and outcomes is heavily contested (Abebe 2010; Balaam et al. 2013; Viken et al. 2015; Kale et al. 2018). Cultural differences, for example, holding a different explanatory model of health and illness, can impact the relationship between health professionals and patients/service users and influence the delivery of services (Avis et al. 2008). It is also reasonable to think that these differences in ethnic and cultural background can influence migrant women’s health literacy and thus impact the use of health services and health outcomes. Migration is a complex and dynamic process that can alter and exaggerate health inequalities linked to individual, social, environmental, and health-related factors (Abebe 2010). The health of migrants and their use of health services has recently received more attention in European countries (Debesay et al. 2014; Indseth et al. 2021). Studies in Norway and other Western countries identify significant variations in health status between and even within ethnic groups and a strong association between ethnicity and health outcomes (Kumar et al. 2004; Jenum et al. 2005; Kinnunen et al. 2019; Stalheim et al. 2023).

During the pandemic, we learned that migrant groups might be more vulnerable, both individually and on a collective level, in terms of their ability to understand public health information (Indseth et al. 2021; Hussaini and Ezzati 2022). Previous studies in Norway also document a significant disparity between some immigrant women’s own culture and that of the host society regarding gender expectations; immigrant women often feel powerless and marginalised (Attanapola 2013). However, to be effective in the communication about health issues between health and welfare providers, who usually belong to the majority population, the migrant population requires an understanding and engagement in cultural issues rather than simply preparing information materials in other languages and using interpreters (Ask and Berg 2011; Diaz and Kumar 2018; Zhao et al. 2021). Migrants’ and particularly migrant women’s perspectives and priorities must also be given attention to give them equal access to health care (Bradby et al. 2015; Lebano et al. 2020).

3 Health Party as Learning Agency

Learning about using health information and interacting with health and welfare services can be addressed as shaping agencies. That is a process where actors learn how to break down complexity into manageable steps that can be understood and used when interacting with health care services. The agency is then understood as a process for how migrant women engage and enact the social structure of a Public Health care system. The concept of agency, as understood by Giddens (1984), emphasises practical consciousness and how persons relate to social actions in a system. According to Giddens, there will always be a relationship between learning about agency in a duality of specific structures. Individuals’ ability to be reflective will produce and reproduce the knowledge they need in their social life. This requires that migrant women actively participate in the learning process, putting themselves at the centre of the learning, while relating their life situations and experiences to the information being disseminated. Through this active participatory learning, they also learn to be agents in the health care system, having acquired knowledge about when and where to seek help and information and how the system can benefit them.

A Health Party is a bottom-up community programme developed by Kvinnenettverket Noor (hereafter NOOR), a women’s organization initiated by migrant women. This programme aims to influence how migrant women focus on, learn about, and discuss health issues as well as how they interact with health care (Zhao et al. 2021). This implies that Health Parties could inspire migrant women to reflect and interact with healthcare systems. The term “Health Party” is not used here as a widely recognised term in science. It refers to a bottom-up initiative and method where social gatherings or events promote health and well-being. Just like a Tupperware party, where individuals gather to socialise and purchase Tupperware products, a Health Party may involve women coming together to learn about and discuss various health topics, participate in health-related activities, and are possibly willing to “purchase” or consume health information or services (Zhao et al. 2021). A Health Party as a social gathering aims to create a supportive and empowering environment for migrant women to address their needs and concerns regarding interactions with doctors or other health and welfare service providers. A Health Party is often organised by community organisations, or individual community members interested in promoting health and wellness for their communities. The specific activities and topics covered during a Health Party may vary depending on the organisers’ and participants’ needs and interests. Health parties combine educational presentations of health-related topics with social activities, such as informal group discussions, cooking, sharing a meal, yoga, or mindfulness practice. These events may also provide an opportunity for migrant women to access healthcare resources, understand information, and discuss health worries and health conditions with professionals or local health service providers and programmes. By participating in a Health Party, a health professional gets access to migrant women’s health and information needs and their perspectives and cultural premises for utilising health care services.

By creating a relaxed and social atmosphere, a Health Party can help migrant women overcome cultural and language barriers, promote health equity, and empower them to take charge of their well-being. All these facilitate the shaping of the learning agency and ensure migrant women’s active participation in learning. The Health Party can teach migrant women to reflect more on their interactions with healthcare professionals. Migrant women get access to priorities regarding shared decision-making and user involvement in interactions with healthcare professionals. Compared to traditional patient involvement approaches that often reinforce existing societal hierarchies and adopt a top-down expert-driven health communication model, a Health Party will represent a bottom-up, user-driven approach (Zhao et al. 2021; Mehrara et al. 2022). Health Parties represent an integrated, coherent patient and user pathway that may teach migrant women how to improve user skills and utilise health information. This chapter examines the role of Health Parties in fostering agency among migrant women, specifically focusing on their impact on learning and promoting health literacy.

4 Research Design and Methods

4.1 Design

The current study is inspired by the approach of “community-based participatory research” (CBPR) (Hacker 2017). This design conducts research focusing on collaboration between a partner that initiates a project, community members, and other stakeholders (Hacker 2017). In the case of Health Parties, data is collected from the main stakeholders, the hosts, and the participants. The CBPR approach recognises the significance of securing participation by social groups in the research processes (Cargo and Mercer 2008; Alcalde-Rabanal et al. 2018). CBRP promotes a democratic and inclusive approach to research, fostering collaboration and empowering communities or social groups to participate actively in the entire research process (Isaacs et al. 2020).

4.2 Methods

The study is based on data collected from NOOR’s Health Party project through participant observations and semi-structured interviews. Other results from this project are published elsewhere (Zhao 2017; Zhao et al. 2021). The data for results presented here was collected by a researcher with a migrant background during Autumn 2015 and Spring 2016. She participated in seven Health Parties, four of which took place in private homes; the other three took place in borrowed meeting rooms. The topics discussed at the different Health Parties varied and covered topics such as diabetes and diet, asthma and allergies, thyroid disorders, mental health and coping with stress, reproductive health, menopause, and an HPV screening programme. Detailed notes were recorded after each of the Health Parties, focusing on the contents and forms of interactions carried out and the informal conversations the researcher had with participants and the resource persons during the Health Parties. The five hosts who arranged these seven Health Parties and, one resource person, a gynaecologist who has a migrant background and attended several Health Parties were interviewed about their experiences at Health Parties as well as their reflections.

4.3 Participants

The participants at the Health Parties belong to different migrant communities in the same Norwegian county. They originally came from Asian, African, and Latin American countries. The participants in the interviews were hosts at the Health Parties. These hosts were often key figures in local migrant communities. One of the hosts was a Norwegian social worker, a lead figure in a local project promoting the work and social participation of migrant women in particular. One interviewee attended several Health Parties as a resource person/health professional. Observations were of both participants and their interactions at seven Health Parties. The number of participants in the studied Health Parties varied: the most minor Health Party had five participants while the largest had 12. The age of the participants varied from 17 years old to mid-50s. Their time of residence in Norway varied from several months up to 20 years, which means that their proficiency in the Norwegian language also varied. In most Health Parties, participants with better proficiency in Norwegian helped those relatively new in Norway with translation when needed. A translator was engaged only in one Health Party where participants used different mother tongues, and one participant was a newly arrived migrant.

4.4 Ethics

The Norwegian Data Protection Service (NSD: Project No. 46809) granted ethical approval to study the Health Parties. Anonymity and digression were secured as a condition of data access. Informed consent was provided by all participants and interviewees at seven Health Parties. No participant objected to the researcher’s access to the Health Party. The participants and interviewees were informed of their rights to withdraw from the research process at any time and assured that any data related to them would be deleted. Also, participants were informed that the data collection contained information about the composition among the participants, relationships, and interactions with each other and communication and interaction between the resource person(s) in addition to the atmosphere, the role of the host, and the role of the active and passive participants. The researcher also emphasised external conditions that influenced the execution of the Health Party, such as seating arrangements, projector/IT equipment, catering, and brochures provided.

4.5 Analysis

The research interviews were transcribed verbatim, including the field notes from the researcher’s observations, and then all data were analysed. Included in the data analysis was information about how and by whom the Health Party was organised, the topic of each Health Party, and more detailed information on how the participants interacted with each other; to what degree did the experts give the information that was understood; and to what degree did the migrant woman ask questions, share their experiences, and find the topics relevant and useful.

A thematic analysis was undertaken (Braun and Clarke 2006). The data material was coded, read several times, and discussed among the research team (authors of this chapter). Ideas about the overall research question emerged and were discussed. Patterns were identified and re-coded. There were codes about access to health information, collaboration, participatory voice, individual and collective learning, language problems, experiences from interaction with the resource person/professional, use of technology, and cultural diversity. These were during a rigorous process of discussion and review of data merged into the two main themes: (1) Key ability to seek health information and (2) cultural sensitivity in identifying health issues. We describe and discuss these two themes in the coming sections, demonstrating how they contribute to answering the research question on how the Health Party contributes to generating and promoting learning agencies for migrant women.

5 Results

5.1 Key to Seeking and Understanding Health Information

The results show that participating in Health Parties equipped migrant women with fundamental abilities about how they should seek and receive healthcare information. Those who hosted Health Parties were mostly migrant women themselves. This made the hosts emphasise the importance of accessing knowledge and how it was even more critical to be able to address questions together with others at the Health Party and with the healthcare professional in attendance. One expressed it like this:

Yes, I have been to other information meetings, not really as a receiver of information, but as an interpreter for such meetings. These meetings concern children and schools, and I was there as an interpreter. Yes. That’s how you received the information. If we compare them to Health Parties, then maybe Health Parties are more detailed, ... with aids, projector, and other things. So maybe it’s better because there are so many... [facilitations]. You can also understand and speak or ask questions. But when you are in a large group, you lose some information, or when you are interpreting, because everyone is talking. It was a mixed group. And it wasn’t just me who was the interpreter. There were also Russian, Somali, and other languages. (Informant A)

The informant compared Health Parties with other information meetings she participated in as a migrant and language interpreter. According to her, what makes Health Parties different is that it provides more space for learning, in the informant’s own words, room to “understand”, to “speak” with other participants, and to “ask” questions, which is related to size (a much smaller group) and the informal setting. She also talked about facilities, including the projector. Several participants spoke about the positive effects of using PowerPoint slides, which make it easier to follow the information given and more manageable to ask questions because, for many participants, spoken Norwegian, with different dialects, is more complex than written Norwegian. Therefore, Health Parties facilitate an arena-generating learning agency by providing space for learning, and technology like a projector, in addition to an informal setting, invites active participation and discussion.

The data analysis revealed that the experience of participation at a Health Party lowered the barrier to asking questions about the topic being addressed, even if the information was given in Norwegian. There was a 15-min break at one Health Party after the resource person finished the presentation. Several of the participants were new arrivals in Norway and were not so familiar with the Norwegian language. They started asking each other: “How much have you understood?” They told the researcher that this is not only a question of understanding the information given but also of learning from listening to “the real Norwegian,” in other words, to practice how you communicate in Norwegian outside a classroom and in “real situations”. They said it might be about what they did and did not understand. Shortly after the break, when the resource person started talking again, she was asked whether she could use Bokmål instead of her dialect, which some participants perceived as challenging to understand. Bokmål is one of the official Norwegian languages and a more literary language than many Norwegian dialects (except Oslo and its close surroundings). When speaking the (more formal) language of Bokmål, it became more accessible for the participants to understand the information given. Newly arrived migrants unfamiliar with the dialect in their area, they expressed the importance of getting to know people and Norwegian society in general. They stated that this was a motivation for attending a Health Party. Meanwhile, they expressed the need to know more about the Norwegian system, for example, what is available/accessible and what kind of rights you have as a patient.

These diverse and interrelated needs shaped the migrants’ motivation to attend a Health Party. The analysis showed how this motivation could be interpreted as a prerequisite for willingness to learn. The participants positioned themselves as real active learning subjects, not merely passively receiving information. Several hosts underlined this aspect, which was confirmed in the analysed observations. Hosts expressed that migrant women were more active and curious at the Health Party than their experiences with women attending other settings and “information meetings”. Some migrant women were curious about what a Health Party was, and during the Health Party, they expressed more awareness of their needs for information and well-being. By discussing issues and asking questions, migrant women participating in a Health Party develop an agency in a supportive environment. The resources activated through participation in a Health Party provided new insights and guidance that migrant women could use in their interactions with healthcare services. Participation in a Health Party taught migrant women the importance of creating a supportive and inclusive environment where cultural and language barriers could be overcome, promoting health equity, and encouraging them to take an active role in their well-being. This indicates that the Health Party became a learning arena for active participation, which gave migrant women valuable experience in their ability to seek health information and learn.

5.2 Cultural Familiarity and Sensitivity in Collective Learning

When planning a Health Party, the host decides the topic. However, sometimes new health issues or topics were also identified during a Health Party. For example, one host who was a nurse herself first arranged a Health Party about the topic of HPV infection and cervical cancer because she had read about migrant women being under-represented in their participation in the screening programme in Norway. During this Health Party and particularly during informal discussions, the new topic of menopause came up. The participants then decided collectively that they wanted another Health Party focusing on menopause, and they immediately invited the same resource person, a gynaecologist, to come to the new Health Party.

The host needed to discuss relevant health issues related to the chosen topic with her guests and the resource person. Resource persons often expressed a need to have at least some information about the guests before a Health Party because they consider this information could help them prepare for the presentation. Some hosts said they discussed what might interest the participants when communicating with a resource person. In this way, the host, who knew the potential participants, was essential in identifying relevant health issues to discuss. This also ensured that the resource person would talk in a supportive way and be sensitive to cultural differences. From the observed data, the Health Party created a supportive and inclusive environment where cultural and language barriers were overcome. Because the participants knew each other well, asking and participating in conversations was easier. They also helped each other to translate questions. The host and those who had stayed in Norway longer also helped explain the information. This highlights the positive effects of promoting learning agency through collective learning, which has a community-oriented empowerment approach (Ansari et al. 2012).

This meant that the resource persons were required to visit the Health Party outside of their office hours and to talk about health issues in a “non-clinic setting”, that is, a setting where they were not consulted to assist, treat, or address a personal sickness or health issue, but to share, not only their pieces of knowledge but sometimes also life experiences. The resource person needed to promote health equity and diminish distance to the participants to encourage them to speak about their health and well-being. A gynaecologist, an Arab migrant, attended as a resource person at several health parties. She used her background and experiences when addressing health issues. She could tell, based on her cultural background and experience as a migrant, what would be strange or difficult to talk about. Meanwhile, as a professional working in the Norwegian healthcare system, she also knew what information was necessary for the migrant women to know. Some participants described her as very “pleasant” to talk with. Here is a quote illustrating how cultural background and sensitivity could lower barriers to speaking about and identifying health issues:

Host::

…… Yes, many of us are shy. So, it is good to have the security that they can ask.

Interviewer::

Yes, I saw a lot of people asking the resource person questions.

Host::

XX (name of the expert) is very pleasant. I also think they [the participants] see her as part of us, right? She also has an ethnic minority background, and you feel a kind of togetherness when she talks -don’t you? When she talked about the gynecologic test which is part of [name of the Norwegian national screening program], she emphasized that it is for all Norwegian women, including us. When we moved to Norway, we were included in statistics.

Interviewer::

So, do you think that the fact that XX has a migrant background contributed to more questions from the participants?

Host::

Yes, also, because the topic is gynecologist examination and HPV, they [the participants] want a female doctor. So, in a way, XX got through to this group. Because many want a female doctor. When it’s a female doctor, they’re not so shy.

This means that the resource person worked to create a sense of familiarity and cultural understanding when addressing health issues. This made the participants identify with the resource person, creating a sense of “community” between the health expert and the participants at the Health Party. Participants overcame the “shyness” and created a safe atmosphere to ask, speak, and learn. The experience of talking about health issues at the Health Party could be an eye-opener for migrant women to overcome shyness and talk about other health issues of general concern. As one host who arranged several Health Parties expressed, “There is more ‘health’ and less ‘party’ when a Health Party is arranged. People got more aware of their health in general”. In this way, the Health Parties create a bridge over “troubled waters” about health issues complex to discuss in public due to shyness or cultural differences. As one host who herself worked in the health care system said:

I thought afterwards that we could have more parties, more [health] topics, because there is a lot of information that has not reached people, especially in our group. I have the impression that many people do not understand the symptoms they may have, for example, diabetes, metabolism, and menopause; there is so much you could get information about. It is pretty useful. Health Parties are a reasonable proposition. We could also talk about these topics after you [the resource people and the researcher] left, right? Because we don’t usually talk about these topics. We are a little too shy to talk to the doctor about anything. Because we feel that, yes, many of us are shy. So, it is good to experience security so that they can ask. (informant E)

The results show that when migrant women discuss at the Health Party with a resource person working as a health specialist who was migrant, it creates an atmosphere of trust. This contributes to migrant women exploring and asking questions about disease risk and how to improve health and well-being. This experience made migrant women overcome their shyness about talking to professionals about sensitive or private topics and made them communicate confidently. The migrant women expressed relief that the party did not follow a strict timeline for consultancy and discussion so they could reflect and develop at their own pace. If wanted, the participants could stay longer, and they often continued the discussion and even shared the information further with other friends who did not come to the Health Party. When several participants found the topic interesting, it created a new awareness about addressing health issues in interactions with professionals and what was most relevant to discuss.

6 Discussion

The analysis of the first theme (key ability to seek and understand health information) shows that the Health Party provides a platform for migrant women to learn about health issues and how to take action. As per Giddens’ (1984) theory on agency, the Health Party is an effective platform for empowering migrant women with knowledge and skills related to health issues, enabling them to take charge of their well-being. In line with Abebe (2010) and Abebe et al. (2017), this study confirms that migrant women can represent a complex group with different backgrounds. They may share a common experience of an unfamiliar healthcare system and what influences their choices and interactions (Thurston and Vissandjée 2005). Health Parties provide a platform for sharing knowledge and actively seeking and interpreting health information together in an informal setting. This setting lowers the barrier of language issues or other challenges to understanding the information given. Thus, in the setting of a Health Party, migrant women understand more and become less vulnerable in their ability to understand the health information provided (Debesay et al. 2014). The experiences and knowledge gained through Health Parties empower migrant women with the skills to navigate information that may otherwise hinder their access to healthcare services and impede this system’s ability to answer their questions (Bradby et al. 2015; Lebano et al. 2020). Health Parties, therefore, create a “safe space” for learning how to use health information and interacting with health and welfare services.

Discussion of the second theme (cultural familiarity and sensitivity in collective learnings) shows that migrant women at the Health Party overcame challenges for doctors to provide healthcare for multicultural populations (Debesay et al. 2014; Varvin and Aasland 2009). This happened when a doctor was open about their migrant experiences and were sensitive to multicultural diversity when addressing health issues. Thus, essential skills to meet expectations of migrant women or sex-gendered issues in health care means involving health professionals with awareness to be culturally sensitive (Hedlund and Moe 2010) and allowing for solid patient involvement in the consultation (Kasper et al. 2022). We found that the Health Party was a platform for building trust between health professionals and healthcare users. It created a space for learning to have safe discussions about delicate issues that some migrant women consider “private” in a group setting. Experiences from the Health Party could unease the way migrant women navigate the healthcare system and how they understand public health information (Zhao et al. 2021; Hussaini and Ezzati 2022). Learning agency through the platform of a Health Party shows how migrant women’s awareness and knowledge about health issues improved and made them search for pathways which were helpful for them to be comfortable and cope with interactions with health professionals. All these positive results are essential aspects of health literacy, particularly as to an individual’s ability to seek and understand facts and information, as well as the development of communicative and interactive skills (Nutbeam 2000).

7 Conclusion

This chapter offers insights into how Health Parties foster health literacy and learning agencies among migrant women. As the introduction highlights, the migrant population, especially migrant women, requires increased competency to engage with the Norwegian healthcare system.

Throughout the chapter, we demonstrate that learning agency, cultivated through participation in Health Parties, provides a space for active involvement. Migrant women, through these events, not only gain a better understanding of health issues but also learn to ask questions, reflect, and address health concerns collaboratively with professionals. This approach allows them to develop agencies tailored to their specific needs for health information and practice Norwegian language skills in real-life situations, thereby promoting health literacy on an individual level. The analysis underscores the significance of technical facilitation and cultural sensitivity in identifying health issues, emphasising the positive effects of collective learning. These aspects create a safe, supportive, and trustful atmosphere, reducing barriers to participation in health communication. Migrant women, as a result, develop increased awareness and knowledge about health issues, fostering confidence in navigating the Norwegian public health care system and overcoming potential barriers. This, in turn, contributes to learning agencies at both the individual and collective levels of health literacy.

Health Parties for migrant women as a bottom-up community health programme can thus have positive outcomes as to the UN’s Sustainable Development Goal (SDG) 3, (Good health and well-being). Given the topics that were usually taken up in the health parties, it particularly contributes to 3.7 Sexual and reproductive health, 3.1 Maternal morbidity, and 3.2 Neonatal and child morbidity. Since the ability to access the Norwegian health systems was a major focus when these health issues were discussed at the Health Parties, it also contributes to 3.8 Universal health coverage under SDG 3. Meanwhile, the findings underscore the need for a culturally sensitive public health system in Norway that accommodates diversity, moving away from a system centred on Norwegian (majority) culture and customs. Such an approach can improve health literacy at both individual and systemic levels.

8 Implications

The study’s implications for Health Parties suggest that the development of these platforms may enhance health literacy for migrant women. It is crucial for Norwegian health authorities to collaborate with migrant communities, employing bottom-up strategies to disseminate health information and address health-related issues. The Health Parties model could be expanded more extensively, providing more migrant women with opportunities to access information and prioritise health issues daily. This expanded approach could contribute to more significant equity in healthcare access and health information seeking for migrant women. It will also teach healthcare systems competence to approach migrant women with more cultural sensitivity.