Barriers and facilitators to primary healthcare utilization among immigrants and refugees of low and middle-income countries: a scoping review.

IF 5.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Seyed Mohammad Iman Moezzi, Manal Etemadi, Kamran Bagheri Lankarani, Masoud Behzadifar, Hamidullah Katebzada, Saeed Shahabi
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引用次数: 0

Abstract

Introduction: Primary health care (PHC) is the most common model for providing primary care, and PHC services are the most common points of care that immigrants and refugees attend as a first step. Most immigrants travel to low- and middle-income countries (LMICs), yet only a few studies have examined their health conditions and their access to PHC in these countries. We have attempted to identify the barriers and facilitators that immigrants and refugees encounter when using PHC in these countries.

Methods: We searched PubMed, Scopus, Web of Science, Embase, ProQuest, Google Scholar, Microsoft Academic, and OpenGrey in this scoping review from its inception to the end of October 2023. Moreover, we manually searched key journals, reference lists, and citations from included studies to identify any missed studies. We extracted data from each selected study using a predefined form. Finally, a thematic analysis approach was utilized to synthesize the collected data from the included qualitative studies.

Results: 17 qualitative studies were included in this review, which were from Iran (n = 3), Brazil (n = 3), Kenya (n = 2), Jordan (n = 2), Eastern Sudan (n = 1), Lebanon (n = 1), Bangladesh (n = 1), India (n = 1), Turkey (n = 1), Thailand (n = 1), and Malaysia (n = 1). Among the most common and important reported barriers are language differences, insufficiency of trained carers, unemployment, inability to pay the costs of hospital and medicines, no insurance coverage for immigrants, no clear referral and care system for immigrants, discrimination against women, and improper residence locations. Insurance coverage, awareness programs, and the study of immigrants' needs, along with their social and financial support from family, are among the most essential facilitators.

Conclusion: For LMICs, funding is always a limitation, and increasing PHC utilization is the best choice for improving health. Knowing the challenges and facilitators of PHC utilization from the point of view of each stakeholder is a promising way to decide and make policies that can improve the health of both immigrants and refugees, as well as society as a whole.

中低收入国家移民和难民利用初级医疗保健的障碍和促进因素:范围界定审查。
导言:初级卫生保健(PHC)是提供初级医疗服务的最常见模式,而初级卫生保健服务也是移民和难民最常首先就诊的医疗点。大多数移民前往中低收入国家(LMICs),但只有少数研究考察了他们的健康状况以及在这些国家获得初级卫生保健服务的情况。我们试图找出移民和难民在这些国家使用初级保健服务时遇到的障碍和促进因素:我们搜索了 PubMed、Scopus、Web of Science、Embase、ProQuest、Google Scholar、Microsoft Academic 和 OpenGrey,以进行从开始到 2023 年 10 月底的范围审查。此外,我们还手动搜索了主要期刊、参考文献列表和纳入研究的引文,以确定是否有遗漏的研究。我们使用预定义的表格从每项选定的研究中提取数据。最后,我们采用专题分析方法对所纳入的定性研究中收集到的数据进行了综合:本综述共纳入 17 项定性研究,分别来自伊朗(n = 3)、巴西(n = 3)、肯尼亚(n = 2)、约旦(n = 2)、苏丹东部(n = 1)、黎巴嫩(n = 1)、孟加拉国(n = 1)、印度(n = 1)、土耳其(n = 1)、泰国(n = 1)和马来西亚(n = 1)。所报告的最常见和最重要的障碍包括语言差异、缺乏训练有素的护理人员、失业、无力支付住院和药品费用、没有移民保险、没有明确的移民转诊和护理系统、歧视妇女以及居住地点不当。保险范围、宣传计划、对移民需求的研究,以及来自家庭的社会和经济支持,都是最重要的促进因素:对于低收入和中等收入国家来说,资金始终是一个限制因素,而提高初级保健服务的利用率是改善健康状况的最佳选择。从每个利益相关者的角度了解利用初级保健服务所面临的挑战和促进因素,是决定和制定可改善移民和难民以及整个社会健康状况的政策的有效途径。
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来源期刊
Globalization and Health
Globalization and Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
18.40
自引率
1.90%
发文量
93
期刊介绍: "Globalization and Health" is a pioneering transdisciplinary journal dedicated to situating public health and well-being within the dynamic forces of global development. The journal is committed to publishing high-quality, original research that explores the impact of globalization processes on global public health. This includes examining how globalization influences health systems and the social, economic, commercial, and political determinants of health. The journal welcomes contributions from various disciplines, including policy, health systems, political economy, international relations, and community perspectives. While single-country studies are accepted, they must emphasize global/globalization mechanisms and their relevance to global-level policy discourse and decision-making.
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