Refugee health often is shaped by interactions with clinicians in care settings that lack ethnocultural match. The article analyses intersubjective perspectives concerning key aspects of 41 ethnoculturally discordant medical encounters involving asylum seekers, mainly from the former Soviet Union, the former Yugoslavia, Kurdish areas in the Middle East, and Somalia, resident during summer 2002 in five Finnish reception centres. Attaining congruent perspectives is an important challenge in transnational encounters involving clinicians and displaced persons. The healthcare perspectives of asylum seekers and their attending Finnish physicians showed little correspondence. Transnational competence (TC) offers an innovative comprehensive framework for assessing and addressing ethnoculturally discordant healthcare encounters. In this study, we most frequently encountered congruent perspectives regarding health status at the time of arrival, illness explanations, utilization of ethnocultural healthcare practices, and perceptions regarding the presence of mental health problems, depression, and place-of-origin contributors among patients attended by high-TC physicians. The findings also suggest that the TC of all medical-encounter participants makes a difference in terms of asylum seekers' satisfaction with medical encounters, confidence in the future value of the attending physician's recommendations, and perceived healthcare effectiveness in their new surroundings - perspectives with the potential to exert a positive impact on health outcomes for forced migrants and receiving societies. © Oxford University Press 2005; all rights reserved.

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Somalia World Eurasia refugee Finland Scandinavia Europe health care Northern Europe Eastern Hemisphere asylum seeker