Palattiyil George, Kisaakye Peter, Mwenyango Hadijah, Katongole Simon, Mulekya Francis, Sidhva Dina, Nair Harish, Bukuluki Paul
Department of Social Work, School of Social and Political Science, The University of Edinburgh, United Kingdom.
Department of Population Studies, School of Statistics and Planning, Makerere University, Uganda.
J Migr Health. 2022;5:100098. doi: 10.1016/j.jmh.2022.100098. Epub 2022 Apr 4.
The rapid spread of COVID-19 has overwhelmed the existing health care systems, finding it challenging to provide essential health services besides the COVID-19 response interventions. Refugees are disproportionately affected by the COVID-19 pandemic because of the barriers they face to access health care. However, there is limited research that investigates how access to HIV/AIDS or TB care services by urban refugees is affected during pandemics such as the COVID-19. This study adopted a cross-sectional survey utilizing quantitative (N=229) and qualitative data (26 in-depth interviews and 8 key informant interviews) held among urban refugees living in Kampala, Uganda. Results revealed that more females (75%) than males (25%) were able to access TB or HIV/AIDS services during COVID-19 related lockdowns. A decrease in queues, delivery of drugs through Village Health Teams (VHTs), proximity to health facilities, supply of necessities like food and the reception at the health facilities facilitated access to TB or HIV/AIDS services. On the other hand, restrictions on public transport, high transport costs, unemployment and subsequent poverty were barriers to access to TB or HIV/AIDS services. Results offer major insights into the effect of COVID-19 control measures on disruption of access to services particularly in relation to being able to access service points. The findings suggest that recognizing structural barriers to uninterrupted or continued access to HIV/AIDS or TB services during pandemics such as COVID-19 can go a long way in helping stakeholders to design measures that make it possible for more urban refugees to access HIV/AIDS or TB services.
新冠病毒病（COVID-19）的迅速传播使现有的医疗保健系统不堪重负，除了COVID-19应对干预措施外，提供基本医疗服务也面临挑战。由于难民在获取医疗保健方面面临障碍，他们在COVID-19大流行中受到的影响尤为严重。然而，关于城市难民在COVID-19等大流行期间获得艾滋病毒/艾滋病或结核病护理服务的情况受到何种影响的研究有限。本研究采用横断面调查，利用对乌干达坎帕拉城市难民进行的定量数据（N=229）和定性数据（26次深入访谈和8次关键信息人访谈）。结果显示，在与COVID-19相关的封锁期间，能够获得结核病或艾滋病毒/艾滋病服务的女性（75%）多于男性（25%）。排队人数减少、通过乡村卫生队（VHT）送药、靠近医疗机构、食品等生活必需品的供应以及医疗机构的接待情况都有助于获得结核病或艾滋病毒/艾滋病服务。另一方面，公共交通限制、高昂的交通成本、失业以及随之而来的贫困是获得结核病或艾滋病毒/艾滋病服务的障碍。研究结果为COVID-19控制措施对服务获取中断的影响提供了重要见解，特别是在能否到达服务点方面。研究结果表明，认识到在COVID-19等大流行期间不间断或持续获得艾滋病毒/艾滋病或结核病服务的结构性障碍，对于帮助利益相关者设计措施以使更多城市难民能够获得艾滋病毒/艾滋病或结核病服务大有帮助。
