Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
School of Public Health, University of Sydney, Sydney, Australia.
Glob Public Health. 2023 Jan;18(1):2191689. doi: 10.1080/17441692.2023.2191689.
Impeded access to health services is a major factor influencing migrant health. In Uganda, previous research has shown lower utilisation of health services for young rural-urban migrants compared to their non-migrant counterparts. However, access to health services does not start at utilisation, but can be hampered by being able to identify a need for care. Using qualitative methods, we aimed to explore young rural-urban migrants' perceptions of health and patterns of engagement with health services. We analysed, using thematic analysis, a purposive sample of 18 in-depth interviews with 10 young people who had recently migrated within Uganda. Our results are presented through a framework conceptualising access at the intersection between abilities of people and characteristics of services. Participants perceived a need for care mostly through serious crises. Their ability to obtain care was hindered by a lack of resources, as well as the relative social isolation brought by migration. Our study highlights other barriers to accessing care such as the role of social norms and HIV-related stigma in health issues prioritisation, and healthcare workers' attitudes. This knowledge can inform approaches to ensure that community-based services are able to support healthcare access and improved health outcomes for this vulnerable group.
获得卫生服务的机会有限是影响移民健康的一个主要因素。在乌干达，先前的研究表明，与非移民相比，农村到城市的年轻移民利用卫生服务的比例较低。然而，获得卫生服务并不是从利用开始的，而是可能会因为无法确定需要护理而受阻。本研究采用定性方法，旨在探讨年轻农村到城市移民对健康的看法以及他们与卫生服务的互动模式。我们对 18 名最近在乌干达境内迁移的年轻人进行了 10 次深入访谈，通过专题分析对访谈内容进行了分析。我们通过一个框架来呈现研究结果，该框架将服务特点和人们的能力结合起来，以确定获取服务的机会。参与者主要通过严重危机来感知到需要护理。他们获得护理的能力受到资源匮乏的阻碍，以及迁移带来的相对社会孤立。我们的研究还强调了其他获取护理的障碍，例如社会规范和与艾滋病毒相关的污名在健康问题优先排序中的作用，以及医疗保健工作者的态度。这些知识可以为确保社区为基础的服务能够支持这一弱势群体获得医疗服务和改善健康结果的方法提供信息。
