从卫生工作者的视角看申根边境移民的医疗服务提供：定性研究
Through health workers' eyes: a qualitative study of health service provision for migrants at Schengen border.
机构信息
Medical faculty, Department of family medicine, Poljanski nasip 58, 1000, Ljubljana, Slovenia.
University of Applied Health Sciences Zagreb, Mlinarska cesta 38, 10 000, Zagreb, Croatia.
出版信息
Int J Equity Health. 2019 Jul 29;18(1):117. doi: 10.1186/s12939-019-1022-2.
BACKGROUND
Croatia and Slovenia were the transit countries on the Balkan route for migrants and refugees from Middle East countries in 2015 and 2016. They had to optimize health care delivery in the special circumstances in refugee camps and transit centres. Little is known about health care provision in border camps where a large number of migrants stay for only couple of hours. Previous studies emphasize that language barriers and cultural differences play a central part in the relationship between health workers and migrants inside the transit zone. The aim of the study was to identify specific characteristics of health care provision experienced by primary healthcare providers in order to prepare solutions on how to organise health care in refugee settings.
METHODS
Twelve thematic interviews were conducted in the middle of the most intense migration movements to the North-West Europe between November and December 2015 with health workers from Croatia and Slovenia. Interview transcripts were read, coded, reviewed, and labelled. We used qualitative content analysis.
RESULTS
Four themes about the health service provision for refugees at Schengen border were identified. The circumstance when mutual understanding is poor and the consultation not successful, cultural differences represent a central barrier. Participants highlighted that the importance of respecting human dignity is crucial for the provision of basic medical care for migrants in transit.
CONCLUSION
Successful overcoming language barriers, respecting cultural differences, humanity, susceptibility to social deprivation and traumatic experiences are the key factors important for organisation of health care in transit centers and camps. This article gives some useful tips for healthcare workers and policy makers who are participating in health services provision for migrants and other refugees. Health workers should be prepared to work in special working conditions with a lack of resources. Their work would require timely planning and reflection on the organization of more transit camps.
TRIAL REGISTRATION
Ethical Committee of the Republic of Slovenia approved the study as a project number 112/02/16.
背景
克罗地亚和斯洛文尼亚是 2015 年和 2016 年从中东国家移民和难民前往巴尔干路线的过境国。他们必须在难民营和过境中心的特殊情况下优化医疗服务。在边境营地，大量移民仅停留几个小时，那里的医疗服务提供情况知之甚少。先前的研究强调，语言障碍和文化差异在过境区卫生工作者与移民之间的关系中起着核心作用。本研究的目的是确定初级保健提供者在提供医疗服务方面所经历的具体特征，以便就如何在难民环境中组织医疗保健制定解决方案。
方法
2015 年 11 月至 12 月期间，在向西北欧最激烈的移民潮期间，在克罗地亚和斯洛文尼亚的卫生工作者中进行了 12 次主题访谈。阅读、编码、审查和标记访谈记录。我们使用定性内容分析。
结果
确定了在申根边境为难民提供卫生服务的四个主题。当相互理解不佳且咨询不成功时，文化差异是一个主要障碍。参与者强调，尊重人的尊严对于为过境移民提供基本医疗保健至关重要。
结论
成功克服语言障碍、尊重文化差异、人性、对社会剥夺和创伤经历的敏感性是过境中心和营地医疗保健组织的重要因素。本文为参与移民和其他难民医疗服务的医疗工作者和政策制定者提供了一些有用的提示。卫生工作者应准备好在资源匮乏的特殊工作条件下工作。他们的工作将需要及时规划和反思组织更多过境营地。
注册
斯洛文尼亚共和国伦理委员会批准该研究作为项目编号 112/02/16。
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