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后《协定》哥伦比亚受害者的健康认知:受武装冲突影响省份的焦点小组。

Health perceptions among victims in post-accord Colombia: Focus groups in a province affected by the armed conflict.

机构信息

School of Medicine, Universidad de los Andes, Bogotá, Colombia.

Alberto Lleras Camargo School of Government, Universidad de los Andes, Bogotá, Colombia.

出版信息

PLoS One. 2022 Mar 2;17(3):e0264684. doi: 10.1371/journal.pone.0264684. eCollection 2022.

Abstract

The peace agreement with the Colombian guerrilla group Fuerzas Armadas Revolucionarias de Colombia-Ejército del Pueblo represented an opportunity for peacebuilding and victims' reparation, rather than the end of the internal armed conflict. In this context, this study aimed to uncover the consequences of conflict on victims' health and on health service provision, and their perceived health status during the post-accord stage in the Meta region, located in the country's eastern plains. Historically, this region has been one of the territories most affected by the presence of conflict-related groups and armed confrontations. Through focus groups, this research explored the health perceptions and experiences of victims of armed conflict. Ten focus groups were conducted with men and women, victims of the armed-conflict, in four municipalities with different degrees of armed conflict intensity. The focus group transcripts were coded using NVivo. The results show that the way women have experienced conflict and the effects of conflict on mental health in general for men, women, and children were recurrent themes in the dialogue of victims. Likewise, it highlights the need to understand the barriers that the current health model imposes on the right to health itself. From the victim's perspective, they experience stigmatization, discrimination, and revictimization when accessing health services. These barriers co-occur along with structural limitations of the health system that affect the general population.

摘要

与哥伦比亚游击队组织“哥伦比亚革命武装力量-人民军”(Fuerzas Armadas Revolucionarias de Colombia-Ejército del Pueblo)达成的和平协议代表了和平建设和受害者赔偿的机会,而不是国内武装冲突的结束。在这种背景下,本研究旨在揭示冲突对受害者健康和卫生服务提供的影响,以及在该国东部平原的梅塔地区(Meta region)的后协议阶段,受害者的感知健康状况。从历史上看,该地区一直是受冲突相关团体和武装冲突影响最严重的地区之一。通过焦点小组,本研究探讨了武装冲突受害者的健康认知和体验。在四个具有不同武装冲突强度的城市中,对十名男性和女性武装冲突受害者进行了焦点小组访谈。使用 NVivo 对焦点小组的转录进行编码。研究结果表明,女性经历冲突的方式以及冲突对男性、女性和儿童心理健康的影响是受害者对话中的反复出现的主题。同样,它强调了需要理解当前卫生模式对健康权本身造成的障碍。从受害者的角度来看,他们在获得卫生服务时会经历污名化、歧视和再次受害。这些障碍与影响整个人口的卫生系统的结构性限制同时存在。

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