Faculty of Humanities, North-West University, Mafikeng, South Africa.
Population Studies and Demography, Faculty of Humanities, North-West University, Mafikeng, South Africa.
PLoS One. 2023 Nov 29;18(11):e0293958. doi: 10.1371/journal.pone.0293958. eCollection 2023.
Medical xenophobia of migrant (either in-migrants or immigrants) youths is an ongoing problem in contemporary South African society. Medical mistreatment by healthcare workers and social phobia from migrant youths have been attributed to major obstacles to healthcare utilization as well as health services satisfaction. This study aimed to determine the prevalence and factors contributing to health services satisfaction and medical exclusion among migrant youths in Gauteng province in South Africa.
The Round 5 Gauteng City-Region Observatory (GCRO) Quality of Life (QoL) survey was conducted in 2017‒2018, a nationally representative survey piloted every two years in South Africa, was utilized in this study. A 2-year cohort study of 24,889 respondents aged 18 to 29 and a baseline data consisted of 4,872 respondents, comprising non-migrants, in-migrants and immigrants, from where 2,162 in-migrants and immigrants were utilized as the sample size. The data was analysed using descriptive statistics, Chi-Square analysis and logistic regression.
A total of 2,162 migrants, comprising 35.4% in-migrants and 9.0% of immigrants, from the 4,872 respondents, were included in the analysis. The prevalence of medical exclusion of in-migrant and immigrant youths were 5.5% and 4.2%, and the majority of them reported the use of public health facilities (in-migrants ‒ 84.3% vs. immigrants ‒ 87.1%). At the bivariate level, demographic (age, sex, and population group), economic (employed and any income) and health-related (no medical aid and household member with mental health) factors were significantly associated with medical exclusion (ρ≤0.05). The adjusted odds ratio showed that only female gender (AOR: 1.07, 95% CI: 0.678, 1.705), no medical aid cover (AOR: 1.23, 95% CI: 0.450, 3.362), and neither (AOR: 1.59, 95% CI: 0.606, 4.174) or dissatisfied (AOR: 4.29, 95% CI: 2.528, 7.270) were independent predictors of medical exclusion.
Having no medical aid cover, being a female and dissatisfied, or neither satisfied nor dissatisfied with health services significantly increased the odds of medical exclusion among migrant youths. To increase healthcare utilization and ensuring adequate medical care of migrant youths, opting for medical aid insurance without increasing costs should be guaranteed. Therefore, there should be no consequences for lack of residence status or correct documentation papers when accessing healthcare services among migrant youths in South Africa.
在当代南非社会，对移民（包括境内移民和外国移民）青年的医学仇外心理是一个持续存在的问题。医疗工作者的医疗虐待和移民青年的社会恐惧症被认为是利用医疗保健服务以及对医疗服务满意度的主要障碍。本研究旨在确定在南非豪登省移民青年中，医疗服务满意度和医疗排斥的流行程度及其促成因素。
本研究利用了 2017-2018 年开展的全国代表性调查豪登城市地区观测站（GCRO）第五轮生活质量（QoL）调查的数据。这是一项每两年在南非试点的全国代表性调查。本研究使用了该调查中 24889 名年龄在 18 至 29 岁的受访者的 2 年队列研究和基线数据，其中包括非移民、境内移民和外国移民，其中 4872 名非移民、境内移民和外国移民被用作样本量。使用描述性统计、卡方分析和逻辑回归对数据进行分析。
在来自 4872 名受访者的 2162 名移民中，包括 35.4%的境内移民和 9.0%的外国移民，被纳入分析。境内移民和外国移民青年被医疗排斥的比例分别为 5.5%和 4.2%，其中大多数人报告使用公共卫生设施（境内移民为 84.3%，外国移民为 87.1%）。在单变量水平上，人口统计学（年龄、性别和人群群体）、经济（就业和任何收入）和健康相关因素（无医疗补助和有心理健康问题的家庭成员）与医疗排斥显著相关（ρ≤0.05）。调整后的优势比表明，只有女性（AOR：1.07，95%CI：0.678，1.705）、无医疗补助（AOR：1.23，95%CI：0.450，3.362）、既无也不满意（AOR：1.59，95%CI：0.606，4.174）是医疗排斥的独立预测因素。
没有医疗补助、女性、对医疗服务不满意或既不满意也不满足显著增加了移民青年被医疗排斥的几率。为了增加医疗保健的利用并确保移民青年获得足够的医疗保健，应保障选择不增加成本的医疗补助保险。因此，在南非，移民青年在获得医疗服务时，不应因缺乏居住身份或正确的文件而导致后果。
