Bruyere Research Institute, Family Medicine, University of Ottawa, Ottawa, Canada.
Global Health. 2012 Jul 2;8:21. doi: 10.1186/1744-8603-8-21.
The purpose of the research was to assess access to sexual and reproductive health services for migrant women who work as beer promoters. This mixed methods research was conducted in Phnom Penh, Cambodia, Bangkok, Thailand, Vientiane, Laos, and Hanoi, Vietnam during 2010 to 2011.
Focus groups were held with beer promoters and separate focus groups or interviews with key informants to explore the factors affecting beer promoters' access to health care institutions for reproductive health care. The findings of the focus groups were used to develop a survey for beer promoters. This survey was conducted in popular health institutions for these women in each of the four Asian cities.
Several common themes were evident. Work demands prevented beer promoters from accessing health care. Institutional factors affecting care included cost, location, environmental factors (e.g. waiting times, cleanliness and confidentiality) and service factors (e.g. staff attitudes, clinic hours, and availability of medications). Personal factors affecting access were shyness and fear, lack of knowledge, and support from family and friends.The survey of the beer promoters confirmed that cost, location and both environmental and service factors impact on access to health care services for beer promoters. Many beer promoters are sexually active, and a significant proportion of those surveyed rely on sex work to supplement their income. Many also drink with their clients. Despite a few differences amongst the surveyed population, the findings were remarkably similar across the four research sites.
Recommendations from the research include the provision of evening and weekend clinic hours to facilitate access, free or low cost clinics, and health insurance through employer or government plans which are easy to access for migrants. Other improvements that would facilitate the access of beer promoters to these services include increased funding to hire more staff (reducing waiting times) and to stock more needed medications, mobile clinics to come to the workplace or free transportation for beer promoters to the clinics, improved training to reduce health care provider stigma against beer promoters, and public education about the importance of reproductive health care, including preventative services.
本研究旨在评估在柬埔寨金边、泰国曼谷、老挝万象和越南河内工作的啤酒促销员获取性与生殖健康服务的途径。本混合方法研究于 2010 年至 2011 年在上述四个亚洲城市进行。
我们与啤酒促销员一起开展焦点小组讨论，并对主要知情人进行单独的焦点小组讨论或访谈，以探讨影响啤酒促销员获得生殖健康护理的医疗机构的因素。根据焦点小组的结果，我们为啤酒促销员开发了一份调查。在这四个亚洲城市中，该调查在这些女性经常光顾的一些医疗机构中进行。
有几个共同的主题很明显。工作需求使啤酒促销员无法获得医疗保健。影响护理的机构因素包括费用、位置、环境因素（如等待时间、清洁度和保密性）以及服务因素（如工作人员态度、诊所时间和药物供应）。影响获得护理的个人因素包括害羞和恐惧、缺乏知识以及来自家人和朋友的支持。对啤酒促销员的调查证实，费用、位置以及环境和服务因素都影响啤酒促销员获得医疗保健服务。许多啤酒促销员都有性行为，接受调查的人中相当一部分人依靠性工作来补充收入。他们中的许多人还与客户一起喝酒。尽管在被调查人群中存在一些差异，但四个研究地点的调查结果非常相似。
本研究提出的建议包括提供晚上和周末诊所时间以方便获得服务、提供免费或低价诊所、以及通过雇主或政府计划为移民提供易于获得的医疗保险。其他可以方便啤酒促销员获得这些服务的改进措施包括增加资金以雇佣更多的员工（减少等待时间）和储备更多所需药物、为工作场所提供流动诊所或为啤酒促销员提供免费交通服务、加强对卫生保健提供者的培训以减少针对啤酒促销员的污名化、以及开展关于生殖健康护理重要性的公共教育，包括预防服务。
