Enumah Zachary Obinna, Rafiq Mohamed Yunus, Juma Omar, Manyama Frank, Ngude Hilary, Stevens Kent, Sakran Joseph
Department of Surgery, Johns Hopkins Global Surgery Initiative (JHGSI), Johns Hopkins Hospital, Tower 110 Doctor's Lounge 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
Department of Anthropology, New York University, Shanghai, Shanghai, China.
J Immigr Minor Health. 2023 Feb;25(1):115-122. doi: 10.1007/s10903-022-01387-9. Epub 2022 Aug 30.
Despite significant advances in the understanding of the global burden of surgical disease, limited research focuses on access to health and surgical services among refugees, especially in east Africa. The goal of this study was to describe patterns of access to transportation to health services among Congolese and Burundian refugees in Tanzania. We utilized cluster random sampling to perform a large, cross-sectional study in Nyarugusu refugee camp, Tanzania using an adapted version of the Surgeon Overseas Assessment Tool (SOSAS). We randomly selected 132 clusters out of 1472 clusters, randomly selected two people from all households in those clusters. Data analysis was performed in STATA (Stata Version 16, College Station, TX). A total of 3560 participants were included in the study including 1863 Congolese refugees and 1697 Burundian refugees. The majority of refugees reported they were generally healthy (n = 2792, 79.3%). The most common period of waiting to be seen at the health center was between three and 5 h (n = 1502, 45.8%), and over half of all refugees waited between 3 and 12 h to be seen. There was heterogeneity in other intra-camp referral networks (e.g. to and from traditional healer and hospital). Finally, a low percentage (3%) of participants reported leaving the refugee camp to seek health care elsewhere, and Congolese refugees were more likely to pursue self-referral in this manner. To our knowledge, this is the largest study focused on access to transportation among refugees in Tanzania and sub-Saharan Africa. Most participants reported financial difficulty always affording transportation costs with significant wait times occurring once arrived at the hospital. Our study does suggest that some independent health care seeking did occur outside of the camp-based services. Future research may focus more specifically on barriers to timely servicing of patients and patterns of self-referral.Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 1 Given name: [Zachary Obinna] Last Name [Enumah] and Author 2 Given name: [Mohamed Yunus] Last Name [Rafiq]. Also, kindly confirm the details in the metadata are correct.Confirmed.
尽管在了解外科疾病的全球负担方面取得了重大进展，但针对难民，尤其是东非难民获得医疗保健和外科服务情况的研究却很有限。本研究的目的是描述坦桑尼亚刚果和布隆迪难民获得医疗服务交通方式的模式。我们采用整群随机抽样方法，在坦桑尼亚的尼亚鲁古苏难民营，使用经改编的海外外科医生评估工具（SOSAS）进行了一项大型横断面研究。我们从1472个群组中随机抽取了132个群组，并从这些群组中的所有家庭中随机选取两人。数据分析在STATA（Stata 16版本，德克萨斯州大学站）中进行。共有3560名参与者纳入研究，其中包括1863名刚果难民和1697名布隆迪难民。大多数难民报告称他们总体健康（n = 2792，79.3%）。在医疗中心等待就诊的最常见时间段是3至5小时（n = 1502，45.8%），超过一半的难民等待3至12小时才得以就诊。营地内其他转诊网络（如往返传统治疗师和医院）存在异质性。最后，只有低比例（3%）的参与者报告离开难民营到其他地方寻求医疗保健，而且刚果难民更有可能以这种方式进行自我转诊。据我们所知，这是针对坦桑尼亚和撒哈拉以南非洲难民获得交通服务情况的最大规模研究。大多数参与者报告称在支付交通费用方面存在经济困难，到达医院后往往要等待很长时间。我们的研究确实表明，在营地外的服务之外确实存在一些独立寻求医疗保健的情况。未来的研究可能会更具体地关注及时为患者提供服务的障碍以及自我转诊模式。请确认作者姓名是否准确呈现且顺序正确（名字、中间名/首字母、姓氏）。作者1名字：[扎卡里·奥宾纳] 姓氏 [埃努马赫]，作者2名字：[穆罕默德·尤努斯] 姓氏 [拉菲克]。另外，请确认元数据中的详细信息是否正确。已确认。
