Llanes-Díaz Nathaly, Bojórquez-Chapela Ietza, Odgers-Ortiz Olga
El Colegio de México Ciudad de México México El Colegio de México, Ciudad de México, México.
Rev Panam Salud Publica. 2023 Mar 3;47:e56. doi: 10.26633/RPSP.2023.56. eCollection 2023.
To characterize the sexual and reproductive health (SRH) services on offer to the Central American migrant population residing in shelters in Tijuana, Mexico, and identify barriers and facilitators of access to these services by this population, from the provider perspective.
An observational, mixed, cross-sectional study was conducted. Different information collection techniques-consisting of 16 semi-structured interviews with civil-society providers of SRH services to the migrant population, as well as direct observation in 10 shelters in Tijuana-were employed and triangulated. A two-stage, open, selective coding process was carried out. Content analysis was then performed, using an interpretive approach based on five dimensions: approachability, acceptability, availability, affordability, and appropriateness.
The provision of SRH services is composed of four elements: target population, nature of providing organization (religious or secular), services offered, and venue of care. The main barriers to access involve irregular migrant status, the low priority given to SRH services, and the discrepancy between user preferences and the services offered. Among facilitating elements, lay/secular orientation of providers and inter-institutional coordination stood out.
The provision of SRH services by civil society organizations is wide-ranging and heterogeneous. It ranges from strictly medical attention to other services that affect SRH indirectly, with a view to providing comprehensive care. This represents an opportunity in terms of aspects to facilitate access.
从提供者的角度,描述墨西哥蒂华纳收容所中居住的中美洲移民群体可获得的性与生殖健康(SRH)服务,并确定该群体获得这些服务的障碍和促进因素。
开展了一项观察性、混合性横断面研究。采用了不同的信息收集技术,包括对为移民群体提供SRH服务的民间社会提供者进行16次半结构化访谈,以及在蒂华纳的10个收容所进行直接观察,并对这些数据进行三角互证。进行了两阶段的开放式、选择性编码过程。然后采用基于可及性、可接受性、可用性、可负担性和适宜性五个维度的解释性方法进行内容分析。
SRH服务的提供由四个要素组成:目标人群、提供组织的性质(宗教或世俗)、提供的服务以及护理场所。获得服务的主要障碍包括移民身份不正规、对SRH服务的重视程度低以及用户偏好与提供的服务之间的差异。在促进因素中,提供者的世俗取向和机构间协调较为突出。
民间社会组织提供的SRH服务范围广泛且具有异质性。从严格的医疗护理到间接影响SRH的其他服务,旨在提供全面护理。这在促进服务可及性方面是一个机遇。