Health-seeking under uncertainty: a qualitative study of decision-making among Ukrainian refugee women in Norway

Background Health-seeking among refugee populations is commonly examined through frameworks of access and barriers to care. However, less attention has been given to how decisions to seek care are made under conditions of uncertainty and healthcare system unfamiliarity. This study examines how Ukrainian refugee women in Norway navigate these circumstances when making healthcare decisions. Methods Thirty Ukrainian refugee women aged 18–24, 25–54, and 55+ participated in five age-segmented focus group discussions. Data were analyzed using reflexive thematic analysis, focusing on how participants interpreted symptoms, evaluated care options, and navigated different forms of care. Results Participants frequently engaged in self-management and periods of waiting before seeking formal care, using time to assess symptoms and determine whether professional help was warranted. Decisions were shaped not only by symptom severity but also by expectations of healthcare responsiveness, including anticipated delays, limited intervention, and costs. Communication challenges, information gaps, and clinical encounters further influenced decision-making. Many participants also engaged in transnational care practices, including remote consultations and medicines from Ukraine. While experiences varied across age groups, participants navigated shared conditions of uncertainty. Conclusions This study conceptualizes health-seeking as an iterative process and identifies adaptive responses through which women navigate healthcare systems. Delayed healthcare engagement should not be interpreted solely as an access problem but as a reasoned response shaped by prior experiences, expectations of healthcare responsiveness, and ongoing decision-making under uncertainty. Promoting health equity therefore requires attention not only to formal access, but also to communication, information, and healthcare responsiveness.