Ing, it is estimated that many African migrants residing in Guangzhou have expired visas [26,27], and periodic police crackdowns against undocumented African migrants in Guangzhou have been reported in the media. Foreigners seeking care in Guangzhou have a number of health care settings to choose from: academic and public tertiary care hospitals, traditional Chinese medicine hospitals, and private clinics, including those that employ foreign physicians and cater specifically to foreigners. The latter tends to be the most expensive, while academic and public hospitals tend to be the more affordable option. In a typical Chinese hospital, a patient is assigned to a doctor at the time they register for care, on the same day as their visit. Rather than scheduling an appointment with in advance, patients choose an appointment slot with one of the physicians on duty that day. They are generally required to pay a consultation fee at the time of registration. If diagnostic tests or procedures are needed, the patient is required to pay for these procedures before receiving them. Because they lack health insurance, African migrants make these payments out of pocket. In China, foreign migrants generally do not have access to insurance. Health Citarinostat price insurance schemes offering coverage for foreigners have been piloted in Beijing, but have not yet been widely implemented [33]. Although the initial consultation fee at public hospitals is often a small amount of money, the cost of laboratory tests, procedures, and medications can be prohibitively expensive, particularly for small-scale traders. Africans living in China face a variety of barriers to accessing existing health care services in Chinese health facilities. Interpersonal discrimination, different expectations for medical care, tenuous legal status, and communication buy ABT-737 problems with Chinese health care professionals who do not speak foreign languages act as barriers to Africans’ utilization of health care services in China [23]. The absence of formal interpreter services in Chinese health facilities creates further challenges for Africans accessing care in China [23].Design and sampleWe employed a qualitative approach using semi-structured, in-depth interviews with 40 African migrants. We chose qualitative methods because we sought to generate a detailed, contextspecific understanding of African migrants’ trust in Chinese physicians [34]. We continued to conduct interviews until we reached theoretical saturation. We used purposive sampling for the recruitment of African migrants to ensure that the sample included 1) a diversity of countries in West Africa, East Africa, and Southern Africa, 2) men and women, and 3) long-term residents of Guangzhou (more than one year) and short term residents or visitors (one year or less). Prior to beginning recruitment we decided that it was important to recruit participants who varied according to region of origin, sex, and time in Guangzhou. Initially we recruited participants at random, resulting in a sample that was heavily West African and male. As our recruitment continued, we preferentially sought out women and participants from countries outside West Africa. Prior to participant recruitment, we conducted formative research to better understand the African population in Guangzhou and potential recruitment sites. We met with ten key informants, including African community leaders, African students, African traders, imams at the local mosques, and an African phys.Ing, it is estimated that many African migrants residing in Guangzhou have expired visas [26,27], and periodic police crackdowns against undocumented African migrants in Guangzhou have been reported in the media. Foreigners seeking care in Guangzhou have a number of health care settings to choose from: academic and public tertiary care hospitals, traditional Chinese medicine hospitals, and private clinics, including those that employ foreign physicians and cater specifically to foreigners. The latter tends to be the most expensive, while academic and public hospitals tend to be the more affordable option. In a typical Chinese hospital, a patient is assigned to a doctor at the time they register for care, on the same day as their visit. Rather than scheduling an appointment with in advance, patients choose an appointment slot with one of the physicians on duty that day. They are generally required to pay a consultation fee at the time of registration. If diagnostic tests or procedures are needed, the patient is required to pay for these procedures before receiving them. Because they lack health insurance, African migrants make these payments out of pocket. In China, foreign migrants generally do not have access to insurance. Health insurance schemes offering coverage for foreigners have been piloted in Beijing, but have not yet been widely implemented [33]. Although the initial consultation fee at public hospitals is often a small amount of money, the cost of laboratory tests, procedures, and medications can be prohibitively expensive, particularly for small-scale traders. Africans living in China face a variety of barriers to accessing existing health care services in Chinese health facilities. Interpersonal discrimination, different expectations for medical care, tenuous legal status, and communication problems with Chinese health care professionals who do not speak foreign languages act as barriers to Africans’ utilization of health care services in China [23]. The absence of formal interpreter services in Chinese health facilities creates further challenges for Africans accessing care in China [23].Design and sampleWe employed a qualitative approach using semi-structured, in-depth interviews with 40 African migrants. We chose qualitative methods because we sought to generate a detailed, contextspecific understanding of African migrants’ trust in Chinese physicians [34]. We continued to conduct interviews until we reached theoretical saturation. We used purposive sampling for the recruitment of African migrants to ensure that the sample included 1) a diversity of countries in West Africa, East Africa, and Southern Africa, 2) men and women, and 3) long-term residents of Guangzhou (more than one year) and short term residents or visitors (one year or less). Prior to beginning recruitment we decided that it was important to recruit participants who varied according to region of origin, sex, and time in Guangzhou. Initially we recruited participants at random, resulting in a sample that was heavily West African and male. As our recruitment continued, we preferentially sought out women and participants from countries outside West Africa. Prior to participant recruitment, we conducted formative research to better understand the African population in Guangzhou and potential recruitment sites. We met with ten key informants, including African community leaders, African students, African traders, imams at the local mosques, and an African phys.
