School of Public Health, University of Texas, Health Science Center, Houston, Texas, United States of America.
School of Public Health, University of California Berkeley, Berkeley, California, United States of America.
PLoS One. 2023 Feb 22;18(2):e0282095. doi: 10.1371/journal.pone.0282095. eCollection 2023.
Cross-border use of health services is an important aspect of life in border regions. Little is known about the cross-border use of health services in neighboring low- and middle-income countries. Understanding use of health services in contexts of high cross-border mobility, such as at the Mexico-Guatemala border, is crucial for national health systems planning. This article aims to describe the characteristics of the cross-border use of health care services by transborder populations at the Mexico-Guatemala border, as well as the sociodemographic and health-related variables associated with use.
Between September-November 2021, we conducted a cross-sectional survey using a probability (time-venue) sampling design at the Mexico-Guatemala border. We conducted a descriptive analysis of cross-border use of health services and assessed the association of use with sociodemographic and mobility characteristics by means of logistic regressions.
A total of 6,991 participants were included in this analysis; 82.9% were Guatemalans living in Guatemala, 9.2% were Guatemalans living in Mexico, 7.8% were Mexicans living in Mexico, and 0.16% were Mexicans living in Guatemala. 2.6% of all participants reported having a health problem in the past two weeks, of whom 58.1% received care. Guatemalans living in Guatemala were the only group reporting cross-border use of health services. In multivariate analyses, Guatemalans living in Guatemala working in Mexico (compared to not working in Mexico) (OR 3.45; 95% CI 1.02,11.65), and working in agriculture/cattle, industry, or construction while in Mexico (compared to working in other sectors) (OR 26.67; 95% CI 1.97,360.85), were associated with cross-border use.
Cross-border use of health services in this region is related to transborder work (i.e., circumstantial use of cross-border health services). This points to the importance of considering the health needs of migrant workers in Mexican health policies and developing strategies to facilitate and increase their access to health services.
跨境使用卫生服务是边境地区生活的一个重要方面。对于中低收入邻国的跨境卫生服务使用情况,人们知之甚少。了解在跨境流动性高的情况下(如在墨西哥-危地马拉边境)使用卫生服务的情况,对于国家卫生系统规划至关重要。本文旨在描述墨西哥-危地马拉边境跨境人口使用卫生保健服务的特征,以及与使用相关的社会人口学和健康相关变量。
2021 年 9 月至 11 月期间,我们在墨西哥-危地马拉边境采用概率(时间地点)抽样设计进行了横断面调查。我们对跨境使用卫生服务进行了描述性分析,并通过逻辑回归评估了使用与社会人口学和流动性特征的关联。
本分析共纳入 6991 名参与者;82.9%为居住在危地马拉的危地马拉人,9.2%为居住在墨西哥的危地马拉人,7.8%为居住在墨西哥的墨西哥人,0.16%为居住在危地马拉的墨西哥人。所有参与者中有 2.6%报告在过去两周内有健康问题,其中 58.1%接受了治疗。只有居住在危地马拉的危地马拉人报告跨境使用卫生服务。在多变量分析中,与不在墨西哥工作的人相比,在墨西哥工作的居住在危地马拉的危地马拉人(OR 3.45;95%CI 1.02,11.65),以及在墨西哥从事农业/畜牧业、工业或建筑工作的人(与从事其他行业相比)(OR 26.67;95%CI 1.97,360.85),与跨境使用相关。
该地区跨境使用卫生服务与跨境工作有关(即,临时使用跨境卫生服务)。这表明,在墨西哥卫生政策中考虑移民工人的健康需求并制定促进和增加他们获得卫生服务的机会的战略非常重要。