RESUMEN
Health disparities within rural communities, notably those affecting migrant and refugee populations, are well-documented. Refugees often grapple with high disease burdens and mortality rates due to limited access to primary healthcare and their vulnerable socio-economic and political situations. This issue is particularly acute in the rural areas around Medellin, Colombia, where the refugee influx exacerbates the existing public health challenges. Studies highlight a substantial gap between community needs and public health policies, resulting in inadequate healthcare access. Our study, utilizing the Delphi technique, aimed to identify common barriers and strategies to enhance rural healthcare for refugees. Through consensus-building with community leaders, we identified six primary barriers to healthcare access and five barriers to healthcare quality. Community leaders endorsed five strategies to address the access barriers and eight strategies to improve healthcare quality. This research provides valuable insights for optimizing resource allocation and designing effective support programs for these vulnerable populations.
Asunto(s)
Refugiados , Humanos , Colombia , Población Rural , Salud Rural , Accesibilidad a los Servicios de SaludRESUMEN
Objetivo: Este estudio pretende explorar como los campesinosno usuarios de plaguicidas difieren en su conocimiento, actitudesy creencias y percepciones de control y confianza en torno aluso de plaguicidas comparado con usuarios de plaguicidas.Metodología: Colectamos 79 cuestionarios con hombresy mujeres adultas que son campesinos agricultores en SanCristóbal, Antioquia, Colombia. Examinamos las percepcionesde estos campesinos sobre el daño de los plaguicidas sobrela salud humana y el medio ambiente. También se exploraronsus creencias, actitudes, percepciones de control y confianzarelacionadas con el uso de los plaguicidas. Resultados:Los hallazgos difieren entre los dos grupos de campesinosmuestreados: usuarios y no usuarios de plaguicidas. Losusuarios de pesticidas experimentaron menores percepcionesdel daño de los plaguicidas sobre la salud humana y el medioambiente, menor percepción del control acerca de parar eluso de plaguicidas (el incremento de una unidad en controldisminuyó el logit de usar pesticidas en un 74%), y menor confianza acerca de parar el uso de pesticidas comparadocon los no usuarios de plaguicidas (el aumento de una unidaden la confianza, disminuyó el logit de usar pesticidas en un64%). Discusión: Varios factores individuales influencian lasalud ocupacional y la salud de los campesinos incluyendola percepción del control y la confianza. Recomendamos quefuturas intervenciones educativas en salud pública aumenten elentrenamiento sobre prácticas seguras y la confianza. Así loscampesinos pueden ganar control en el proceso de implementarcambios en su comportamiento relacionado con la reduccióndel uso de pesticidas...
Objective: this study aims to explore how campesino nonpesticide users differ in their knowledge, attitudes and beliefs,and perceptions of control and confidence surroundingpesticide use compared to pesticide users. Methodology:we collected 79 questionnaires with adult (male and female)rural agricultural campesinos in San Cristobal, Antioquia,Colombia. We examined the campesinosÆ perceptions onpesticidesÆ harm for human health and the environment, aswell as their beliefs, attitudes, perceived control, and perceivedconfidence related to pesticide use. Results: The findingsdiffered between two campesino groups sampled: pesticideusers and agroecological adherents. Pesticide users showedlower perceptions of pesticide harm for human health and theenvironment, lower perceived control about stopping pesticideuse (an increase of one unit in control decreases the logit ofusing pesticides by 74%), and lower confidence about stoppingpesticide use than agroecological adherents (an increase ofone unit in confidence decreases the logit of using pesticidesby 64%). Discussion: Several individual factors influencethe occupational safety and health of campesinos, includingperceived control and confidence. We recommend that futurepublic health and educational interventions should improvesafety training and confidence so campesinos can gain controlof the process for implementing behavioral change related topesticide use reduction...