“我真的很同情他们”：乌干达坎帕拉卫生工作者为城市难民青少年提供孕产妇保健服务的意愿——一项定性研究
'I really feel pity for them': health workers' readiness to offer maternal health services to urban refugee adolescents in Kampala, Uganda-a qualitative study.
作者信息
Nakisita Olivia, Garimoi-Orach Christopher, Bukenya Justine Nnakate, Bagonza Arthur, Nabiwemba Elizabeth, Kayemba Nalwadda Christine
机构信息
Department of Community Health and Behavioural Sciences, Makerere University College of Health Sciences, Kampala, Uganda.
Makerere University College of Health Sciences, Kampala, Uganda.
出版信息
BMJ Public Health. 2025 Jul 20;3(2):e002611. doi: 10.1136/bmjph-2025-002611. eCollection 2025.
INTRODUCTION
Uganda hosts an estimated 1.6 million refugees and 12.5% are urban refugees living in Kampala. Uganda is implementing an integrated healthcare system where both refugee and host populations use the same healthcare services. Offering adolescent and youth-friendly services can improve access and utilisation of maternal health services. We assessed the readiness of health workers in government health facilities to provide maternal health services to urban refugee adolescents in Kampala, Uganda. In this study, health-worker readiness refers to the continued knowledge training, perceptions, attitudes, practices and prior experiences that enable providers to deliver adolescent-friendly maternal services to urban refugee adolescents.
METHODS
This was a phenomenological study conducted in August 2024 among 12 health workers from six government health centres levels III and IV that offer maternal health services within Kampala city, Uganda. Purposive sampling technique was conducted, and skilled personnel offering antenatal and delivery services were selected and interviewed using an in-depth interview guide. Interviews were audio recorded and transcribed verbatim. Thematic and content analysis was done, and findings are presented in themes and supported with typical quotes.
RESULTS
The health workers felt sympathy for the adolescent urban refugees and were willing to offer services to them. They reported that peer educators and community health workers enabled them to provide the services. However, they had inadequate knowledge about adolescent-friendly services, and they faced challenges like language barrier, lack of essential drugs, supplies and equipment. They recommended training of health workers, separate space for antenatal care and delivery for adolescents and young people with translators for refugees and improvement in the availability of essential drugs, supplies and equipment.
CONCLUSIONS
Health workers in government lower-level facilities are willing to provide maternal health services to adolescent urban refugees. However, they face several challenges that limit their readiness to offer the services. There is an urgent need to improve the readiness of health workers to offer adolescent-friendly maternal health services to refugees.
引言
乌干达约有160万难民，其中12.5%是居住在坎帕拉的城市难民。乌干达正在实施综合医疗体系，难民和当地居民使用相同的医疗服务。提供适合青少年和青年的服务可以提高孕产妇保健服务的可及性和利用率。我们评估了乌干达坎帕拉市政府医疗机构的卫生工作者为城市难民青少年提供孕产妇保健服务的准备情况。在本研究中，卫生工作者的准备情况是指持续的知识培训、认知、态度、实践和既往经验，这些使提供者能够为城市难民青少年提供适合青少年的孕产妇服务。
方法
这是一项现象学研究，于2024年8月对来自乌干达坎帕拉市六个提供孕产妇保健服务的政府三级和四级卫生中心的12名卫生工作者进行。采用目的抽样技术，选择提供产前和分娩服务的技术人员，并使用深入访谈指南进行访谈。访谈进行了录音并逐字转录。进行了主题和内容分析，研究结果以主题呈现并辅以典型引语。
结果
卫生工作者对城市难民青少年表示同情，并愿意为他们提供服务。他们报告说，同伴教育者和社区卫生工作者使他们能够提供这些服务。然而，他们对适合青少年的服务了解不足，并且面临语言障碍、基本药物、用品和设备短缺等挑战。他们建议对卫生工作者进行培训，为青少年和年轻人设立单独的产前护理和分娩空间，并为难民配备翻译，同时改善基本药物、用品和设备的供应情况。
结论
政府基层医疗机构的卫生工作者愿意为城市难民青少年提供孕产妇保健服务。然而，他们面临一些挑战，限制了他们提供这些服务的准备程度。迫切需要提高卫生工作者为难民提供适合青少年的孕产妇保健服务的准备程度。
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