难民与其他移民妇女在避孕护理方面的不平等：荷兰全科医疗的一项回顾性研究。

Inequity in contraceptive care between refugees and other migrant women?: a retrospective study in Dutch general practice.

作者信息

Raben Liselotte A D, van den Muijsenbergh Maria E T C

机构信息

Department of Primary and Community Care, Radboud University Medical Centren, Nijmegen, the Netherlands.

Pharos, Centre of Expertise on Health Disparities, Utrecht, the Netherlands.

出版信息

Fam Pract. 2018 Jul 23;35(4):468-474. doi: 10.1093/fampra/cmx133.

DOI:10.1093/fampra/cmx133

PMID:29351609

Abstract

BACKGROUND

Female refugees are at high risk of reproductive health problems including unmet contraceptive needs. In the Netherlands, the general practitioner (GP) is the main entrance to the healthcare system and plays a vital role in the prescription of contraceptives. Little is known about contraceptive care in female refugees in primary care.

OBJECTIVE

To get insight into GP care related to contraception in refugees and other migrants compared with native Dutch women.

METHODS

A retrospective descriptive study of patient records of refugees, other migrants and native Dutch women was carried out in five general practices in the Netherlands. The prevalence of discussions about contraception and prescriptions of contraceptives over the past 6 years was compared in women of reproductive age (15-49 years).

RESULTS

In total, 104 refugees, 58 other migrants and 162 native Dutch women were included. GPs in our study (2 male, 3 female) discussed contraceptives significantly less often with refugees (51%) and other migrants (66%) than with native Dutch women (84%; P < 0.001 and P = 0.004, respectively). Contraceptives were less often prescribed to refugees (34%) and other migrants (55%) than to native Dutch women (79%; P < 0.001 and P = 0.001). Among refugees from Sub-Saharan Africa, contraception was significantly less often discussed (28.9%) compared with refugees from other regions (67.8%; P < 0.001). More refugees and other migrants had experienced unwanted pregnancies (14% respectively 9%) and induced abortions (12% respectively 7%) than native Dutch women (4% respectively 4%).

CONCLUSION

Contraceptives were significantly less often discussed with and prescribed to refugees and other migrant women compared with native Dutch women. More research is needed to elicit the reproductive health needs and preferences of migrant women regarding GP's care and experiences in discussing these issues. Such insights are vital in order to provide equitable reproductive healthcare to every woman regardless of her background.

摘要

背景

女性难民面临包括未满足的避孕需求在内的生殖健康问题的高风险。在荷兰，全科医生（GP）是医疗保健系统的主要入口，在避孕药具的处方方面发挥着至关重要的作用。关于初级保健中女性难民的避孕护理情况知之甚少。

目的

了解与荷兰本土女性相比，难民及其他移民中与避孕相关的全科医生护理情况。

方法

在荷兰的五个全科诊所对难民、其他移民和荷兰本土女性的患者记录进行了一项回顾性描述性研究。比较了过去6年中育龄（15 - 49岁）女性中关于避孕讨论和避孕药具处方的患病率。

结果

总共纳入了104名难民、58名其他移民和162名荷兰本土女性。我们研究中的全科医生（2名男性，3名女性）与难民（51%）和其他移民（66%）讨论避孕药具的频率显著低于与荷兰本土女性（84%；P < 0.001和P = 0.004）。难民（34%）和其他移民（55%）获得避孕药具处方的频率低于荷兰本土女性（79%；P < 0.001和P = 0.001）。与来自其他地区的难民（67.8%）相比，撒哈拉以南非洲的难民中讨论避孕的频率显著更低（28.9%；P < 0.001）。与荷兰本土女性（分别为4%和4%）相比，更多难民和其他移民经历过意外怀孕（分别为14%和9%）和人工流产（分别为12%和7%）。