Abstract
BACKGROUND: The Arab Bedouin minority is considered as one of the most vulnerable populations in Israel due to socio-cultural factors that affect their healthcare utilization patterns. This study investigates continuity of care and health literacy within the Bedouin community, aiming to identify gaps and barriers to healthcare services (HS) utilization for Bedouins, as perceived by healthcare providers serving this community. METHODS: A qualitative study was conducted June 2019 and January 2022, involving in-depth semi-structured interviews with 32 healthcare providers from community health centers/clinics in Bedouin villages and towns in Southern Israel, as well as Soroka Medical Center. Thematic analysis was used to analyze the collected data, and trustworthiness was ensured through audit, reflexivity, and peer debriefing. RESULTS: Healthcare providers identified factors that hinder HS utilization and the absence of various healthcare options for Bedouin patients. Interviews revealed discontinuity in treatment due to insufficient health literacy and unaffordability of medications. Additionally, many Bedouins choose to forgo or delay their visits to the community health services and visit the Emergency Department directly, because of physical, cultural, and gender barriers. Elderly Bedouins are a particularly vulnerable subgroup, susceptible to complications from chronic diseases such as diabetes and hypertension. CONCLUSIONS: This study highlights the necessity of targeted interventions to improve healthcare access for Bedouin minority population, particularly tailoring HS to elderly subgroups. Potential interventions comprise health education programs designed to enhance health literacy, address medication affordability, and confront cultural and gender barriers obstructing access to primary care services. These findings hold implications for public health policies and initiatives addressing healthcare disparities among minority groups worldwide. KEY MESSAGES: • Health literacy is a key barrier for the Bedouin minority in Israel, with global implications for addressing healthcare disparities in minority groups. • Targeted interventions, like health education programs, are needed to improve healthcare access for Bedouin minority, especially the elderly subgroup.