Theme 1: Health beliefs of migrant women

The first theme that emerged from the data was the beliefs held regarding health by the participants. This belief was explored in answers to questions that focused on the concept of health and illness and belief concerning medication and treatment.

Sub-theme 1: Beliefs about the meaning of health

The participants held the condition of being healthy to be defined by physical, mental, and spiritual aspects of wholeness and well-being; some participants described being healthy in general terms involving the three dimensions of emotional, physical, and spiritual health, others used descriptions that encompassed mental and physical health while another participant focused on physical attributes of health. Participant 2 (P2) stated:

“The word healthy means, I have to be able to perform all my activities, without any worries like, I'd have to be physically healthy, we have to be spiritually healthy. Every aspect of health to be fulfilled for me to be healthy”.

Similarly, P12 emphasized the biological parameters for health, describing being healthy as:

“We are out of disease and we don't have to take any medicine, we don't have any kind of diseases. We are like, we have proper weight as per our height and this thing. So not like to eat too much fat, or just too much lean also but yes, which shows that okay, we are fine as per our age, height, and weight”.

Being energetic and happy were highlighted by some of the participants as key attributes of being healthy. These definitions seem to suggest that emotional and physical well-being or productivity are key manifestations of health.

For instance, P1 stated:

“In our culture also culture of health is, an energizing good spirit, impeccable and happiness, something like that in perfect health. Its bouncing is at its full health level”.

Similarly, P11 stated:

“it is mean like being energetic, having enough energy to do your everyday chores hours, and being happy according to my culture”.

P8 also includes social well-being in her description of health stating that healthy is “The state of physical, mental and social well-being”.

Sub-Theme 2: Beliefs about causes of disease

In terms of beliefs regarding the causes of disease, the participants also held the causes of disease as being environmental, biological, genetic, mental, and spiritual. Some of the study participants described the causes of disease in terms of environmental and biological aspects, while others described the causes of disease in terms of spiritual/religious factors in addition to one or more other causes such as biological, environmental, and behavioural factors. One of the participants stated that “Obviously, there are a lot of reasons behind getting ill. Like, sometimes the environment we can say. And sometimes there's bacteria, viruses, and sometimes Stress, Stress is the most important factor that causes illness” (P2). Emphasizing on environmental and biological causes of disease, few participants stated that:

“I grew up in an environment where they didn't believe it was your fate, this is God will, but I was the one who made me negligent or careless, or naturally when the cold season is cold, even if you're careful. There's a chance you'll get influenza because you can't limit your contact with people anyway” (P1).

Similarly, the role of personal negligence as a cause of ill-health, in addition to environmental and genetic factors was highlighted as one participant mentioned:

“mostly I think because of some negligence or because of any small negligence on the part of health I think we've been sick. Like, they may be taking good care when we are going out in winter, then we can get severe cold or cough. And also ...sort of air pollutions, because of that also some people are prone to some kind of allergies…. how we eat that affects our body....”

(P12).

In terms of the belief that sickness can be caused by God or spiritual factors, a participant stated that:

“Everything is belongs to almighty that we believe in our culture that everything happens by the will of God. But it has not taken as, like, punishment or fraud or whatever is just like in our fate.

That is by the by the will of God” (P11).

Likewise, another person stated that disease is a reaction that derives from a curse or a person’s behavior; for instance, that a cruel person will suffer from some form of the disease because of what they had done to others.

Sub-Theme 3: Beliefs regarding treatment and medication

Some of the participants believed in the use of traditional medicines, others believe in prayer and spiritual modes of healing, and some participants do not believe in using traditional medicine. One participant described the use of faith healers in her culture stating that:

“like when I was child, or we had some kind of these faith healers, like, who we believed had some kind of powers so that they can recite some mantras..., maybe some kind of vermilion, this red color, and all those things they do to the one who is ill. And then the illness is to go away. I don't know if how” (P2).

One also expressed the belief that traditional medicine was preferred over western medicine due to unwanted side effects.

Others stated that “traditional medicine has its place in our culture, for example, sometimes mild diseases such as colds, there are different drugs like medicines in traditional medicine for colds I use them first “(P4).

The responses of few other participants indicated that traditional treatments and medicine are used for minor ailments and western medicine for severe conditions. Besides, the role of prayer to treat illness was emphasized by stating “these are the prayers which we religiously and, in our culture, we learned it in our life…but sometimes, like, there are specialized peoples who know and have more knowledge so they can just pray for us” (P11).