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个体和结构性障碍:智利拉美难民和寻求庇护者获取初级和精神保健服务的阻碍:一项定性研究。

Individual and structural barriers to Latin American refugees and asylum seekers' access to primary and mental healthcare in Chile: A qualitative study.

机构信息

Programa de Estudios Sociales en Salud, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (UDD), Santiago, Chile.

出版信息

PLoS One. 2020 Nov 6;15(11):e0241153. doi: 10.1371/journal.pone.0241153. eCollection 2020.


DOI:10.1371/journal.pone.0241153
PMID:33156878
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7647080/
Abstract

BACKGROUND: Since 2010 there has been a growing population of refugees and asylum seekers in Latin America. This study sought to investigate the perceived experiences and healthcare needs of refugees and asylum seekers of Latin American origin in Chile in order to identify main barriers to healthcare and provide guidance on allied challenges for the public healthcare system. METHODS: Descriptive qualitative case study with semi-structured interviews applied to refugees and asylum seekers (n = 8), healthcare workers (n = 4), and members of Non-Governmental Organizations and religious foundations focused on working with refugees and asylum seekers in Chile (n = 2). RESULTS: Although Chilean law guarantees access to all levels of healthcare for the international migrant population, the specific healthcare needs of refugees and asylum seekers were not adequately covered. Primary care and mental healthcare were the most required types of service for participants, yet they appeared to be the most difficult to access. Difficulties in social integration -including access to healthcare, housing, and education- upon arrival and lengthy waiting times for legal status of refugees also presented great barriers to effective healthcare provision and wellbeing. Healthcare workers and members of organizations indicated the need for more information about refugee and asylum-seeking populations, their rights and conditions, as well as more effective and tailored healthcare interventions for them, especially for emergency mental healthcare situations. CONCLUSIONS: All participants perceived that there was disinformation among institutional actors regarding the healthcare needs of refugees and asylum seekers in Chile. They also perceived that there were barriers to access to primary care and mental healthcare, which might lead to overuse of emergency services. This study highlights a sense of urgency to protect the social and healthcare needs of refugees and asylum seekers in Latin America.

摘要

背景:自 2010 年以来,拉丁美洲的难民和寻求庇护者人数不断增加。本研究旨在调查原籍为拉丁美洲的难民和寻求庇护者在智利的所经历和医疗保健需求,以确定医疗保健的主要障碍,并为公共医疗保健系统提供相关挑战的指导。

方法:对难民和寻求庇护者(n=8)、医疗保健工作者(n=4)以及在智利专注于为难民和寻求庇护者提供服务的非政府组织和宗教基金会的成员(n=2)进行描述性定性案例研究,并采用半结构化访谈。

结果:尽管智利法律保障所有国际移民都能获得各级医疗保健服务,但难民和寻求庇护者的具体医疗保健需求并未得到充分满足。初级保健和精神保健是参与者最需要的服务类型,但似乎难以获得。抵达时的社会融入困难,包括获得医疗保健、住房和教育的机会,以及难民法律地位的漫长等待时间,也对有效提供医疗保健和福祉造成了巨大障碍。医疗保健工作者和组织成员表示,需要更多关于难民和寻求庇护者群体、他们的权利和条件的信息,以及为他们提供更有效和量身定制的医疗保健干预措施,特别是在紧急精神保健方面。

结论:所有参与者都认为,机构行为者对智利难民和寻求庇护者的医疗保健需求存在信息误解。他们还认为,获得初级保健和精神保健存在障碍,这可能导致对急诊服务的过度使用。本研究强调了保护拉丁美洲难民和寻求庇护者的社会和医疗保健需求的紧迫性。

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Individual and structural barriers to Latin American refugees and asylum seekers' access to primary and mental healthcare in Chile: A qualitative study.

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引用本文的文献

[1]
Mental health and the healthy immigrant effect in Chile: a comparative cross-sectional study with international migrants and locals.

Front Public Health. 2025-8-14

本文引用的文献

[1]
Access to primary health care for asylum seekers and refugees: a qualitative study of service user experiences in the UK.

Br J Gen Pract. 2019-2-11

[2]
[Illegitimate patients: Undocumented immigrants' access to health care in Chile].

Salud Colect. 2017

[3]
The Social Determinants of Refugee Mental Health in the Post-Migration Context: A Critical Review.

Can J Psychiatry. 2017-12-4

[4]
[Challenges in the health care of international migrants in Chile].

Rev Peru Med Exp Salud Publica. 2017

[5]
The mental health and wellbeing of first generation migrants: a systematic-narrative review of reviews.

Global Health. 2016-8-25

[6]
Sending-country violence and receiving-country discrimination: effects on the health of Colombian refugees in Ecuador.

J Immigr Minor Health. 2014-2

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