Table 2 Overview of themes and sub-themes

Post-migration stressors impacting health negatively

Lack of social support

“I’m completely on my own.…I take care of [my son], but it’s a big problem when I get sick. There’s no one to take care of me” (IP9)

Experiencing discrimination

“I feel like people avoid … helping me since I wear hijab. That’s why I don’t feel comfortable going with my son to see the doctor, and I let his father take him” (IP6)

Loss of social and professional status

“They won’t recognise my university degree from Syria, so I probably won’t have a chance of finding a good job (..) This is a huge source of worry in my life” (IP9)

Maintaining and changing social roles

“I neglect doing things for my wellbeing and prioritise things for the wellbeing of my family.” (IP2)

Feeling dissatisfied with the medical, cultural, and organisational aspects of healthcare

Perceived problems in accessing healthcare

“He didn’t see her [my daughter], because he had no capacity for new patients (..)Until today we can’t find a doctor for my daughter.” (IP4)

Perceived effectiveness and quality of medical care

“In Syria, they would’ve at least taken care of her [my daughter’s] pain. But here, they just sent her home and told her to see a specialist” (IP5)

Medical mistrust

“I wish I could find this one doctor that I can trust and be fully confident in what he does and says. But when I don’t see results, when my and my family’s health problems and symptoms don’t get better, I only get frustrated and sceptical about healthcare here “(IP6)

Cultural barriers in healthcare communication

I didn’t understand the coldness with which she (her gynaecologist) treated me, and she clearly didn’t understand my nature either, we had no channels for proper communication. (IP8)

Being vulnerable because of the language deficiency

Feeling powerless due to the language barrier

“It’s like having a handicap” (IP3)

The language barrier limiting access to healthcare

“ I was advised to see German doctors, but I can’t because I don’t know the language (…) I was told that this doctor is the best option available to me in Arabic, so I’m going to continue treatment with him even though I don’t see any improvement.” (IP4)

Lacking the information, experience, and agency to navigate the healthcare system

Lacking information about the healthcare system and offers

“The problem is that everything is in German (language), even when the target group is immigrants (…) I’ve been living here for two years and didn’t know that this family-centre in my neighbourhood exists. They could’ve helped me with my pregnancy or told me about the midwife thing.” (IP8)

Lacking the necessary experience to navigate the healthcare system

I really don’t understand how the system here works. When I see a doctor, I just get transferred to another doctor, and I don’t feel like my case has been treated. I’m frustrated and have no control at all, the system is just impossible. (IP6)

Reacting passively to unsatisfying healthcare

“I know that I have the right to speak up, because they [the health professionals] are getting paid for it, so I must receive the healthcare that I need. But (…) I don’t want to cause any troubles” (IP4)

Having chances for resilience

Experiencing liberating conditions for women

“In Syria, the entire system and society would’ve stood against me [and my decision to abort my pregnancy], but here, the law protects me.” (IP7)

Having resources for better healthcare

“It’s an advantage that I can always afford taking my child to the doctor, and that the insurance covers everything. In Syria, as a single mother, my salary might not be enough to take my child to the doctor every time he gets sick.” (IP9)

Receiving help/advice from locals

“I thought that there was nothing to be done about what happened [dental malpractice with high out-of-pocket payment] and that I had to bear with the unsatisfying results and costs. But thank God it was solvable, only because of the help of this woman [the social volunteer]” (IP2)