Ukrainian families’ transnational living and perception of Germany’s health care system in times of war

Abstract Aim Since the beginning of the war in Ukraine in 2022, about 3.7 million children have become refugees. For Ukranian children referred to pediatric wards in Germany, significant levels of frustration have been noted by Ukrainian parents in their communication with health staff. This study aimed to analyze expectations and perceptions of vulnerable Ukrainian parents with regard to underlying problem areas in their health care provision. Subject and methods Embedded in a qualitative, participatory approach, eight narrative interviews and one focus group were conducted in the Children’s and Adolescents’ University Hospital of Leipzig. The interviews were thematically analyzed from the perspective of a medical anthropology framework. Results We identified Ukrainian medical culture, with a rather authoritarian nature of communication and stricter medical treatment of infectious diseases, as influencing parents’ expectations. Prompt and quick appointments in Ukraine, with clinician income based on the number of patients treated, contrasted with barriers and long waiting times when accessing pediatric care in Germany. Families tended to return to Ukraine for medical appointments. Conclusion Discrepancies concerning the self-treatment of infections and unintended discrimination emphasize the need for intercultural training of health staff. The high-quality care of chronically ill children in Germany is a relevant pull factor. However, the treatment of future refugee populations may benefit from a de-economization and inclusion of refugee health staff. German Clinical Trials Register No. DRKS00030789, registration date February 3, 2023.