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From 'no problem' to 'a lot of difficulties': barriers to health service utilization among migrants in Rakai, Uganda.
Young, Ruth; Kennedy, Caitlin E; Dam, Anita; Nakyanjo, Neema; Ddaaki, William; Kiyingi, Anne Catherine; Mukwana, Emmanuel; Edwards, Abagail; Nalugoda, Fred; Chang, Larry W; Wawer, Maria J; Oaks, Maya; Paina, Ligia.
Afiliação
  • Young R; Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, United States.
  • Kennedy CE; Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, United States.
  • Dam A; Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, United States.
  • Nakyanjo N; Rakai Health Sciences Program, P.O Box 279, Kalisizo, Uganda.
  • Ddaaki W; Rakai Health Sciences Program, P.O Box 279, Kalisizo, Uganda.
  • Kiyingi AC; Rakai Health Sciences Program, P.O Box 279, Kalisizo, Uganda.
  • Mukwana E; Rakai Health Sciences Program, P.O Box 279, Kalisizo, Uganda.
  • Edwards A; Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, United States.
  • Nalugoda F; Rakai Health Sciences Program, P.O Box 279, Kalisizo, Uganda.
  • Chang LW; School of Medicine, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, United States.
  • Wawer MJ; Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, United States.
  • Oaks M; Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, United States.
  • Paina L; Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, United States.
Health Policy Plan ; 38(5): 620-630, 2023 May 17.
Article em En | MEDLINE | ID: mdl-37002584
Migration is increasingly common in Africa, especially for employment. Migrants may face additional barriers to accessing health care, including human immunodeficiency virus (HIV) prevention and treatment, compared with long-term residents. Exploring migrants' experiences with health services can provide insights to inform the design of health programmes. In this study, we used qualitative methods to understand migrants' barriers to health service utilization in south-central Uganda. This secondary data analysis used data from in-depth semi-structured interviews with 35 migrants and 25 key informants between 2017 and 2021. Interviews were analysed thematically through team debriefings and memos. We constructed three representative migrant journeys to illustrate barriers to accessing health services, reflecting experiences of migrant personas with differing HIV status and wealth. Migrants reported experiencing a range of barriers, which largely depended on the resources they could access, their existing health needs and their ability to form connections and relationships at their destination. Migrants were less familiar with local health services, and sometimes needed more time and resources to access care. Migrants living with HIV faced additional barriers to accessing health services due to anticipated discrimination from community members or health workers and difficulties in continuing antiretroviral therapy when switching health facilities. Despite these barriers, social networks and local connections facilitated access. However, for some migrants, such as those who were poorer or living with HIV, these barriers were more pronounced. Our work highlights how local connections with community members and health workers help migrants access health services. In practice, reducing barriers to health services is likely to benefit both migrants and long-term residents.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Migrantes / Infecções por HIV Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Migrantes / Infecções por HIV Idioma: En Ano de publicação: 2023 Tipo de documento: Article