Healthcare accessibility, utilization, and quality of life among internally displaced people during the Sudan war: a cross-sectional study.

IF 3.1 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Hind Elmukashfi ShamsEldin Elobied, Muhannad Bushra Masaad Ahmed, Ahmed Balla M Ahmed, Romaysa Abdelrahman Hassan Salih, Sohaib Mohammed Mokhtar Ahmed, Abdulhadi M A Mahgoub, Abdelmoula Hashim Abdelmagid Mohamed, Eman Hamid Abdallah Elamin, Al-Romaysa M Osman Khalafalla El-Haj, Mohamed Al-Hadi Hamed Abd-Allah, Arwa Yagoub Elmadani Ibrahim, Yousuf Alnoor Younis Mohamed, Arig Elias Shabo
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引用次数: 0

Abstract

Background: The ongoing war in Sudan has triggered a massive displacement crisis, leaving internally displaced people (IDP) struggling to access healthcare services. This study aimed to investigate healthcare access, utilization, and the quality of life among Sudanese IDP during the conflict.

Methods: This cross-sectional study was carried out among Sudanese internally displaced people in six states. Quality of life was assessed using the WHOQOL-Bref questionnaire. Accessibility, utilization, and the consequences of not accessing healthcare were evaluated using an author-designed questionnaire, which was piloted prior to the study. Chi-square tests were used to analyze associations between categorical variables, while ANOVA was applied to assess differences in quality-of-life domains based on displacement duration and living conditions. Multinomial logistic regression identified predictors of healthcare affordability, with significance set at p < 0.05.

Results: Among 612 participants, 40.3% reported facilities being very close, 13.0% faced waits over 2 h, and 54.3% found healthcare unaffordable. Only 33.6% always had access to qualified staff, and 22.8% of IDP visited public healthcare facilities supported by non-governmental organizations. The psychological domain had the highest quality-of-life mean score at 49.7 (18.1). Worsened symptoms (44%) were a common consequence of healthcare inaccessibility, while lack of transport (37.9%) was the most common barrier. Availability of qualified staff significantly increased the likelihood of seeking care (χ² = 11.30, p = 0.022). Quality-of-life domains varied significantly by displacement duration and living situation (p < 0.011).

Conclusion: This study revealed significant variations in healthcare access and utilization among Sudanese IDP, with quality-of-life domains lower than those of IDP in other countries. Interventions should prioritize innovative solutions like telemedicine, targeted support for vulnerable groups, and expanding health insurance coverage to enhance access and long-term health outcomes.

苏丹战争期间国内流离失所者的医疗保健可及性、利用率和生活质量:一项横断面研究
背景:苏丹持续不断的战争引发了大规模的流离失所危机,使国内流离失所者难以获得医疗服务。本研究旨在调查冲突期间苏丹境内流离失所者的医疗保健获取、利用和生活质量。方法:这项横断面研究在苏丹六个州的国内流离失所者中进行。使用whoqol - brief问卷评估生活质量。使用作者设计的问卷对可访问性、利用率和未获得医疗保健的后果进行了评估,该问卷在研究之前进行了试点。卡方检验用于分析分类变量之间的关联,而方差分析用于评估基于流离失所持续时间和生活条件的生活质量领域的差异。多项逻辑回归确定了医疗负担能力的预测因素,显著性设置为p。结果:在612名参与者中,40.3%的人报告设施非常近,13.0%的人面临超过2小时的等待,54.3%的人认为医疗负担不起。只有33.6%的国内流离失所者始终能够获得合格的工作人员,22.8%的国内流离失所者前往非政府组织支助的公共卫生保健设施。心理领域的生活质量平均得分最高,为49.7分(18.1分)。症状恶化(44%)是无法获得医疗服务的常见后果,而交通不便(37.9%)是最常见的障碍。合格工作人员的可用性显著增加了求医的可能性(χ 2 = 11.30, p = 0.022)。生活质量领域因流离失所持续时间和生活状况而显著差异(p结论:本研究揭示了苏丹境内流离失所者在医疗保健获取和利用方面的显著差异,其生活质量领域低于其他国家的境内流离失所者。干预措施应优先考虑创新解决方案,如远程医疗、对弱势群体的有针对性支持,以及扩大医疗保险覆盖面,以提高可及性和长期健康成果。
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来源期刊
Conflict and Health
Conflict and Health Medicine-Public Health, Environmental and Occupational Health
CiteScore
6.10
自引率
5.60%
发文量
57
审稿时长
18 weeks
期刊介绍: Conflict and Health is a highly-accessed, open access journal providing a global platform to disseminate insightful and impactful studies documenting the public health impacts and responses related to armed conflict, humanitarian crises, and forced migration.
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