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获取医疗服务的障碍和促进因素:在喀麦隆和印度的残疾人中进行的定性研究。

Barriers and Facilitators to Accessing Health Services: A Qualitative Study Amongst People with Disabilities in Cameroon and India.

机构信息

Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.

Indian Institute of Public Health, Hyderabad 122002, India.

出版信息

Int J Environ Res Public Health. 2019 Mar 29;16(7):1126. doi: 10.3390/ijerph16071126.

Abstract

: Article 25 of the UNCRPD stipulates the right of people with disabilities to the highest attainable standard of health, and the timely uptake of appropriate health and rehabilitation services. This study seeks to explore the factors which influence access to health care among adults with disabilities in Cameroon and India. : A total of 61 semi-structured interviews were conducted with a purposive sample of adults with vision, hearing or musculoskeletal impairments, using data from an earlier cross-sectional disability survey. In addition, 30 key informants were interviewed to provide contextual information about the local services and context. : Key themes included individual-level factors, understanding and beliefs about an impairment, and the nature of the impairment and interaction with environmental factors. At the community and household level, key themes were family dynamics and attitudes, economic factors, social inclusion and community participation. Intersectionality with gender and age were cross-cutting themes. Trust and acceptability of health service providers in India and poor understanding of referral processes in both countries were key service-level themes. : The interaction of environmental and personal factors with the impairment and their levels of participation and inclusion in community structures, all contributed to the take up of services. This study illustrated the need for a multi-faceted response to improve access to health services for people with disabilities.

摘要

第 25 条联合国残疾人权利公约规定,残疾人有权享有可达到的最高标准的健康,并及时获得适当的保健和康复服务。本研究旨在探讨影响喀麦隆和印度成年残疾人获得医疗保健的因素。

采用目的抽样法,对视力、听力或肌肉骨骼损伤的成年人进行了总共 61 次半结构化访谈,使用了早期的横断面残疾调查数据。此外,还访谈了 30 名关键知情人,以提供有关当地服务和背景的背景信息。

主要主题包括个人层面的因素、对损伤的理解和信念,以及损伤的性质及其与环境因素的相互作用。在社区和家庭层面,主要主题包括家庭动态和态度、经济因素、社会包容和社区参与。性别和年龄的交叉性是贯穿各主题的。印度对卫生服务提供者的信任和可接受性以及两国对转诊过程的理解不足是服务层面的主要主题。

环境和个人因素与损伤及其参与和融入社区结构的程度相互作用,都有助于服务的提供。本研究说明了需要采取多方面的措施来改善残疾人获得医疗服务的机会。

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