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加纳富拉尼族人群获得医疗服务的障碍:在锡萨拉东区的一项定性研究

Access barriers to healthcare services among the Fulani population in Ghana: a qualitative study in the Sissala East Municipality.

作者信息

Bonney Richard Abeiku, Opoku Daniel, Mensah Kofi Akohene, Amuasi John Humphrey, Dassah Ebenezer, Emikpe Benjamin Obukowho, Waitzberg Ruth

机构信息

eHealth Research Partner Group (eHRPG) at the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Department of Health Care Management, Technische Universität Berlin, Berlin, Germany.

出版信息

BMC Health Serv Res. 2025 May 9;25(1):671. doi: 10.1186/s12913-025-12839-x.

Abstract

BACKGROUND

Access to healthcare services is at the center of every health system. Research to understand access to healthcare services for the Fulani in Ghana is limited. Efforts have mainly focused on the confrontations between the Fulani herders and the communities. The study aimed to explore what access barriers exist among the Fulani vulnerable population in Ghana; this will contribute to the understanding of access to healthcare services for a vulnerable population, who are also prone to possible transmission of diseases from human-animal connections, and requiring global health interventions.

METHODS

This is an explorative study using qualitative methods to investigate how the Fulani population access healthcare services in the Sissala East Municipality, Ghana. From 17 to 30 September 2022, interviews were conducted using an interview guide among 11 individuals sampled purposively based on the criteria that, the individual is a Fulani or healthcare professional, resides in and around the study area, and is 18 years or older. Thematic content analysis was used for the analysis.

RESULTS

Contrary to the widely held view of the Fulani population being typically conservative, they displayed positive healthcare-seeking behavior and acceptance of modern healthcare services. And despite their nomadic lifestyle, physical accessibility of healthcare services has not been a challenge given that they can even reach a health facility via mobile phones (mHealth) as well as via other means of transport (e.g., motor bike). However, access barriers to healthcare are influenced mainly by financial constraints and gender roles. They rely on health insurance for healthcare coverage, but co-payments and difficulties in enrollment pose serious healthcare affordability challenges. They require access to health information to improve their knowledge on health-related issues as well.

CONCLUSION

This study reveals that the main barrier to healthcare access among the Fulani is affordability and gender-specific roles. However, they are also utilizing innovative mobile technologies to assist in seeking healthcare against the potential barrier of their nomadic lifestyle. Community engagement and policy measures to improve the coverage of the national health insurance scheme are required to improve healthcare access among the Fulani vulnerable population.

摘要

背景

获得医疗服务是每个卫生系统的核心。关于加纳富拉尼人获得医疗服务情况的研究有限。此前的努力主要集中在富拉尼牧民与社区之间的冲突上。本研究旨在探讨加纳富拉尼弱势群体在获得医疗服务方面存在哪些障碍;这将有助于了解弱势群体获得医疗服务的情况,这些群体也容易因人畜接触而传播疾病,需要全球卫生干预措施。

方法

这是一项探索性研究,采用定性方法调查加纳锡萨拉东区的富拉尼人群如何获得医疗服务。2022年9月17日至30日,使用访谈指南对11名个体进行了访谈,这些个体是根据以下标准有目的地抽取的:个体为富拉尼人或医疗专业人员,居住在研究区域及其周边,年龄在18岁及以上。采用主题内容分析法进行分析。

结果

与普遍认为富拉尼人群通常保守的观点相反,他们表现出积极的就医行为并接受现代医疗服务。尽管他们过着游牧生活方式,但医疗服务的实际可及性并不是问题,因为他们甚至可以通过手机(移动医疗)以及其他交通工具(如摩托车)到达医疗机构。然而,获得医疗服务的障碍主要受经济限制和性别角色的影响。他们依靠医疗保险来支付医疗费用,但自付费用和参保困难带来了严重的医疗费用可负担性挑战。他们也需要获取健康信息以提高对健康相关问题的认识。

结论

本研究表明,富拉尼人获得医疗服务的主要障碍是费用可负担性和特定性别角色。然而,他们也在利用创新的移动技术来克服游牧生活方式可能带来的障碍,以寻求医疗服务。需要社区参与和政策措施来提高国家医疗保险计划的覆盖范围,以改善富拉尼弱势群体的医疗服务可及性。

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