Borkan J M, Morad M, Shvarts S
Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Health Policy Plan. 2000 Jun;15(2):207-16. doi: 10.1093/heapol/15.2.207.
This study examines health and health care attitudes, practices and utilization patterns among the Bedouin Arab minority in the south of Israel. Particular attention is given to the effects of the new National Insurance Law that provides universal coverage for the first time, and to the identification of critical issues for further research.
Focus groups, adapted to Bedouin culture, were the primary method of data collection. Twelve groups (158 participants) from throughout the Negev met for 3-7 sessions each, using specially trained local moderators and observers. Issues discussed and analyzed included experience and satisfaction with the current health system (both modern and traditional), health service availability/barriers, health care needs, influences of social change, and the National Insurance Law.
Participants voice dissatisfaction with modern health services in the Bedouin sector and the state of health of Negev Bedouin. They place great emphasis on the connection between health and the rapid social and economic changes, which this traditionally nomadic group is undergoing. Traditional health care is felt to still exist, but its importance is waning. The National Insurance law is having a major impact on the Bedouin, particularly because it provides universal health insurance coverage where only partial coverage had been in effect.
This study, one of the first of its kind in the Bedouin sector, showed that the focus group method, if properly modified to cultural norms, can be a valuable research tool in traditional communities and in health service research. The findings from this research can be used to direct efforts to improve health policy and health services for this group, as well as preparing the way for further qualitative or quantitative studies.
本研究调查了以色列南部贝都因阿拉伯少数民族的健康状况、对医疗保健的态度、做法及利用模式。特别关注首次提供全民医保的新《国家保险法》的影响，以及确定有待进一步研究的关键问题。
采用适合贝都因文化的焦点小组作为主要数据收集方法。来自内盖夫各地的12个小组（158名参与者）分别进行了3至7次会议，由经过专门培训的当地主持人和观察员主持。讨论和分析的问题包括对当前医疗体系（现代和传统）的体验与满意度、医疗服务的可及性/障碍、医疗保健需求、社会变革的影响以及《国家保险法》。
参与者表达了对贝都因地区现代医疗服务以及内盖夫贝都因人健康状况的不满。他们非常强调健康与这一传统游牧群体正在经历的快速社会和经济变革之间的联系。传统医疗保健仍然存在，但其重要性正在减弱。《国家保险法》对贝都因人产生了重大影响，特别是因为它提供了全民医疗保险覆盖，而此前只有部分覆盖。
本研究是贝都因地区同类研究中的首批研究之一，表明焦点小组方法如果根据文化规范适当调整，可成为传统社区和医疗服务研究中有价值的研究工具。本研究的结果可用于指导为该群体改善健康政策和医疗服务的工作，并为进一步的定性或定量研究铺平道路。
