Scientific Background
Disseminating health rights information to Ethiopian immigrants poses challenges related to social, cultural and language barriers.

Objectives
To identify from Ethiopian immigrants’ perspective their particular needs and views regarding health rights and to develop theory-based narrative formats that present health-rights information in culturally-centered ways that can help enhance perceived efficacy to pursue their attainment.

Methods
Interviews with Ethiopian immigrants and healthcare and health rights practitioners. Participants included 143 interviewees (135 Ethiopian immigrants and 31 professionals\paraprofessionals); video and print formats were produced and shown to participants who were asked assess them.

Findings
Participants expressed lack of knowledge of health rights and a low sense of self efficacy to attain them. Major obstacles included language barriers; lack of trust in the system; cultural customs and beliefs; perception of short doctor visits and providers’ lack of understanding of their culture; feeling of discrimination. The narrative materials were assessed as informative, culturally appropriate, addressing actual barriers, and enhancing self efficacy and mutual help. Preferences were for more ‘entertaining’ formats. Limitations of the materials: Language still a barrier; ignore changes needed in the system; might raise unmet expectations; do not address people having to meet requirements of the system; focus on specific rights but not on rights as a whole.  

Conclusions
Findings underscore importance of involving the Ethiopian immigrants themselves in characterizing cultural and organizational barriers. There is a preference for entertaining narrative materials (Edutainment). There is a dilemma whether showing how to attain certain rights may detract from getting the system to provide resources to meet linguistic and cultural needs. 

Policy Implications / recommendations
Produce - in a participative process - narrative health rights materials tailored to the needs and cultural beliefs of members of minority groups that address logistical and cultural barriers as identified by them. Create resources such as a ‘warm line’ and establish accessible and permanent translation services.

(1)  Department of Communication and the Herzog Institute, Tel Aviv University
(2)  Tene Briut Organization
(3)  School of Public Health, Haifa University
(4)  Herzog Institute, Tel Aviv University

Research number: R/136/2008