Department of Public Health, Academic Medical Centre, University of Amsterdam, The Netherlands.
BMC Health Serv Res. 2012 Mar 24;12:75. doi: 10.1186/1472-6963-12-75.
Sub-Saharan African populations are growing in many European countries. Data on the health of these populations are rare. Additionally, many sub-Saharan African migrants are confronted with issues of low socio-economic status, acculturation and language difficulties, which may hamper their access to health care. Despite the identification of some of those barriers, little is known about the enabling factors. Knowledge about the enablers and barriers in access to healthcare experienced is important in addressing their health needs and promoting healthcare access. This study aimed to investigate the enabling factors as well as barriers in access to the Dutch healthcare system among the largest sub-Saharan African migrant group (Ghanaians) living in Amsterdam, the Netherlands.
Six focus groups were conducted from November 2009 to February 2010. A semi-structured interview guideline was used. Discussions were conducted in English or Twi (Ghanaian dialect), recorded and transcribed verbatim. Analysis was based on the Andersen model of healthcare utilisation using MAXQDA software.
Knowledge and perceived quality of the health system, awareness of diseases, family and community support, community initiatives and availability of social support were the main enablers to the healthcare system. Difficulties with the Dutch language and mistrust in health care providers were major barriers in access to healthcare.
Access to healthcare is facilitated mainly by knowledge of and the perceived efficiency and quality of the Dutch healthcare system. However, poor Dutch language proficiency and mistrust in health care providers appear to be important barriers in accessing healthcare. The enablers and barriers identified by this study provide useful information for promoting healthcare access among this and similar Sub-Saharan African communities.
撒哈拉以南非洲人口在许多欧洲国家不断增长。关于这些人群健康的数据十分稀缺。此外，许多撒哈拉以南非洲移民面临社会经济地位低下、文化适应和语言困难等问题，这可能会阻碍他们获得医疗保健。尽管已经确定了其中的一些障碍，但对于促进医疗保健机会的促进因素知之甚少。了解获得医疗保健方面的促进因素和障碍对于满足他们的健康需求和促进医疗保健机会至关重要。本研究旨在调查在荷兰阿姆斯特丹生活的最大的撒哈拉以南非洲移民群体（加纳人）获得荷兰医疗保健系统的促进因素以及障碍。
2009 年 11 月至 2010 年 2 月期间进行了六次焦点小组讨论。使用半结构化访谈指南。讨论以英语或 Twi（加纳方言）进行，记录并逐字转录。分析基于 Andersen 医疗保健利用模型，使用 MAXQDA 软件进行。
对卫生系统的了解和感知质量、对疾病的认识、家庭和社区支持、社区举措以及社会支持的可用性是获得卫生系统的主要促进因素。荷兰语困难和对医疗保健提供者的不信任是获得医疗保健的主要障碍。
获得医疗保健主要是通过对荷兰医疗保健系统的了解和感知效率和质量来促进的。然而，荷兰语水平差和对医疗保健提供者的不信任似乎是获得医疗保健的重要障碍。本研究确定的促进因素和障碍为促进该研究和类似的撒哈拉以南非洲社区获得医疗保健提供了有用的信息。
