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南非恩富莱尼市移民获取初级医疗保健的经历。

Migrants' Experiences of Accessing Primary Care in Emfuleni Municipality, South Africa.

作者信息

Thulo Reitumetse, Lokotola Christian, Mash Robert

机构信息

Stellenbosch University, Cape Town, South Africa.

出版信息

J Prim Care Community Health. 2025 Jan-Dec;16:21501319251359951. doi: 10.1177/21501319251359951. Epub 2025 Jul 28.

Abstract

INTRODUCTION

Universal health coverage promotes equity of access to essential health care for all, including migrants. Health systems struggle to balance global commitments to health equity with national concerns for sovereignty and security. Migrants therefore often experience inequitable access to primary care.

OBJECTIVES

To explore migrants' experience in accessing public sector primary care services in Emfuleni subdistrict, Gauteng, South Africa.

METHODS

A descriptive exploratory qualitative research study purposefully selected migrants and gathered data using semi-structured interviews in English, French and Portuguese. Data was thematically analysed using the framework method assisted by Atlas-ti.

RESULTS

Fifteen migrants were interviewed. Four main themes were identified. (1) Barriers related to legal status, financial constraints, language issues and misinformation. (2) Coping strategies that included social support, traditional beliefs and alternative practitioners. (3) Healthcare experiences that included good quality care as well as denial of care and delayed care. (4) Psychosocial and emotional effects related to stigmatisation, discrimination and mental health problems.

CONCLUSIONS

This study sheds light on the significant obstacles that migrants have while trying to use government clinics in Gauteng, South Africa. The health system should address these factors through policy, protocols, translation services, training of staff and clear messaging in the migrant community.

摘要

引言

全民健康覆盖促进所有人(包括移民)公平获得基本医疗服务。卫生系统努力在对健康公平的全球承诺与国家对主权和安全的关切之间取得平衡。因此,移民往往难以公平获得初级医疗服务。

目的

探讨南非豪登省恩富莱尼分区移民在获取公共部门初级医疗服务方面的经历。

方法

一项描述性探索性定性研究,有目的地选择移民,并使用英语、法语和葡萄牙语进行半结构化访谈收集数据。数据采用框架法并借助Atlas-ti进行主题分析。

结果

采访了15名移民。确定了四个主要主题。(1)与法律地位、经济限制、语言问题和错误信息相关的障碍。(2)应对策略,包括社会支持、传统信仰和替代医疗从业者。(3)医疗经历,包括高质量护理以及拒绝护理和延迟护理。(4)与污名化、歧视和心理健康问题相关的心理社会和情感影响。

结论

本研究揭示了南非豪登省移民在试图使用政府诊所时面临的重大障碍。卫生系统应通过政策、协议、翻译服务、工作人员培训以及在移民社区传达明确信息来解决这些因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c523/12304633/30d4f4051bdf/10.1177_21501319251359951-fig1.jpg

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