Fernández-Niño Julián Alfredo, Chavarro Lud Magdy, Vásquez-Rodríguez Ana Beatriz, Rojas-Botero Maylen Liseth, Hernández-Neuta Ginna Esmeralda, Peñuela-Poveda Ana Maria, Rodríguez David Alejandro
Department of Public Health, Universidad del Norte, Barranquilla, Colombia.
Migration and Health programme, International Organization for Migration, Bogotá, Colombia.
F1000Res. 2019 Dec 23;8:2140. doi: 10.12688/f1000research.21375.2. eCollection 2019.
: The signing of the peace accords in Colombia created challenges that are inherent to post-conflict transitions. One of those is the process of reintegrating ex-combatants into society, in which ensuring their rights to health is a particularly significant challenge in rural areas affected by armed conflict. These areas, known as Territorial Spaces for Training and ReintegrationReincorporation (ETCR, in Spanish), are geographically dispersed throughout 24 municipalities and 13 departments in Colombia. This study aimed to describe how ex-combatants in ETCR regions perceived access to health services one year after the signing of the peace accords. A descriptive, cross-sectional study was performed between September and October 2018. It included 591 adults and their families, from 23 ETCRs. The study was designed, culturally validated, and piloted. Interviewers were trained and a structured survey was administered containing five dimensions that characterized the perception of effective access to health services. : The majority of interviewees were women, heads of household, young adults, ex-combatants, and residents in an ETCR. In total of 96.4% were enrolled in Colombia's subsidized health system, and 20.8% indicated that a member of their household required emergency health services. The regional health center provided the majority of the services. Most of those surveyed (96.0%) reported that they did not have to pay for the services, and that they received respectful (91.6%) and good quality (66.6%) care. There were few referrals to disease prevention and health promotion activities, and only 19.0% of households reported having been visited by extramural health care teams, whose activities were highly valued (80%). Lastly, there was little knowledge about community health activities. : While residents of ETCR regions have a favorable perception of their access to health services, they need to be made aware of extramural and public health activities.
哥伦比亚和平协议的签署带来了冲突后过渡时期固有的挑战。其中之一是前战斗人员重新融入社会的进程，在受武装冲突影响的农村地区，确保他们的健康权是一项特别重大的挑战。这些地区被称为培训与重新融入/重返社会领土空间（西班牙语为ETCR），在地理上分散在哥伦比亚的24个市和13个省。本研究旨在描述和平协议签署一年后，ETCR地区的前战斗人员如何看待获得卫生服务的情况。2018年9月至10月进行了一项描述性横断面研究。研究对象包括来自23个ETCR的591名成年人及其家庭。该研究经过设计、文化验证和预试验。对访谈者进行了培训，并实施了一项结构化调查，该调查包含五个维度，用于描述对有效获得卫生服务的认知。大多数受访者为女性、户主、年轻人、前战斗人员以及ETCR的居民。总共96.4%的人加入了哥伦比亚的补贴卫生系统，20.8%的人表示其家庭成员需要紧急卫生服务。大多数服务由地区卫生中心提供。大多数受访者（96.0%）报告称他们无需为服务付费，并且他们得到了尊重（91.6%）且质量良好（66.6%）的护理。很少有转介到疾病预防和健康促进活动的情况，只有19.0%的家庭报告有校外卫生保健团队来访，这些团队的活动受到高度评价（80%）。最后，对社区卫生活动的了解很少。虽然ETCR地区的居民对获得卫生服务的情况看法良好，但需要让他们了解校外和公共卫生活动。
