Sekoni Adekemi Oluwayemisi, Jolly Kate, Gale Nicola Kay
College of Medicine, University of Lagos, Lagos, Nigeria.
Institute of Applied Health, University of Birmingham, Birmingham, UK.
Glob Public Health. 2022 Jan;17(1):134-149. doi: 10.1080/17441692.2020.1849351. Epub 2020 Dec 8.
Minority population groups are often excluded or marginalised within health systems and in health research and policy. This article argues that theories of intersectionality can help us to understand these issues and develops the concept of 'hidden healthcare populations' - using the case of people who identify as Lesbian, Gay, Bisexual, Transgender Plus (LGBT+) in Nigeria, in sub-Saharan Africa. The findings present original qualitative data from a seldom heard population group about instances of abuse, rejection and marginalisation by healthcare providers working in public and private healthcare facilities, and the attempts of LGBT+ people to resist and survive in that context. We extend theoretical understandings of intersectionality in global public health and explore how the concept relates to the social determinants of health. The article has significant implications for policy and healthcare education and responds to a call from the World Health Organisation to generate context-specific data to guide interventions targeted at minority population groups. Additionally, our discussion has wider significance because it highlights the Western-centric nature of much theory in health policy - and offers analysis and reinterpretation that incorporates queer, postcolonial, African perspectives.
少数族裔群体在卫生系统以及卫生研究与政策中常常被排斥或边缘化。本文认为,交叉性理论有助于我们理解这些问题,并提出了“隐藏的医疗人群”这一概念——以撒哈拉以南非洲地区尼日利亚的女同性恋、男同性恋、双性恋、跨性别及其他(LGBT+)群体为例。研究结果展示了来自一个鲜为人知的人群群体的原始定性数据,内容涉及公立和私立医疗机构的医护人员对他们的虐待、排斥和边缘化情况,以及LGBT+群体在这种背景下的抵抗和生存尝试。我们扩展了对全球公共卫生中交叉性的理论理解,并探讨了这一概念与健康的社会决定因素之间的关系。本文对政策和医疗教育具有重要意义,回应了世界卫生组织提出的生成特定背景数据以指导针对少数族裔群体的干预措施的呼吁。此外,我们的讨论具有更广泛的意义,因为它凸显了卫生政策中许多理论以西方为中心的性质,并提供了纳入酷儿、后殖民、非洲视角的分析和重新诠释。
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