African Journal of Primary Health Care & Family Medicine最新文献

{"title":"The effectiveness of a community-orientated model of primary care for type 2 diabetes compared to standard care.","authors":"Shivani Pillay, Michael K Pather","doi":"10.4102/phcfm.v17i1.4912","DOIUrl":"https://doi.org/10.4102/phcfm.v17i1.4912","url":null,"abstract":"<p><strong>Background: </strong> Non-communicable diseases constitute the primary cause of mortality in South Africa, surpassing infectious diseases. Among these, diabetes mellitus is the second leading cause of death. Although local literature on community-orientated primary care (COPC) remains limited, international evidence supports its effectiveness.</p><p><strong>Aim: </strong> This study aimed to evaluate the effectiveness of a COPC model for adults with type 2 diabetes compared to the standard facility model of care.</p><p><strong>Setting: </strong> The Chiawelo COPC (Chiawelo Community Practice) and Chiawelo Community Health Centre (CHC) in Soweto, South Africa.</p><p><strong>Methods: </strong> A cross-sectional observational study was conducted. File records of adults with type 2 diabetes from both models of care were examined for patients' glycaemic control and clinicians' adherence to evidence-based diabetes standards of care.</p><p><strong>Results: </strong> Chiawelo COPC (CCP) outperformed the CHC over the investigation period. Mean patient HbA1c at Chiawelo COPC (CCP) was lower than the CHC (7.9%, 8.9%; p  0.001). Body mass index (BMI) (75%, 36%; p  0.001), urine tests (74%, 42%; p  0.001) and renal function assessments (95%, 80%; p  0.05) showed superior results at the COPC practice. Differences were observed in examinations of feet (61%, 1%; p  0.001) and eyes (38%, 1%; p  0.001). Adherence discussions were more frequent at COPC (63%, 48%; p  0.05).</p><p><strong>Conclusion: </strong> The COPC model is more effective than the standard facility-based model in managing type 2 diabetes in the Chiawelo community, Soweto.Contribution: This study contributes to understanding the effectiveness of a COPC model for diabetes care in a South African community.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e12"},"PeriodicalIF":1.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of drug-resistant TB outcomes: Body mass index, HIV, and comorbidities.","authors":"Ntandazo Dlatu, Lindiwe M Faye, Ncomeka Sineke, Teke Apalata","doi":"10.4102/phcfm.v17i1.4953","DOIUrl":"https://doi.org/10.4102/phcfm.v17i1.4953","url":null,"abstract":"<p><strong>Background: </strong> The success rates for treating drug-resistant tuberculosis (DR-TB) in programmatic settings have been unsatisfactory. By identifying the factors that predict treatment outcomes, we can implement effective corrective measures that will significantly enhance patient management and improve results for those with DR-TB.</p><p><strong>Aim: </strong> This study aimed to investigate predictive factors influencing treatment outcomes among DR-TB patients, focusing on the combined effects of body mass index (BMI), human immunodeficiency virus (HIV) status, comorbidities, socioeconomic factors, substance use and DR-TB type.</p><p><strong>Setting: </strong> The study was conducted in rural Eastern Cape, South Africa.</p><p><strong>Methods: </strong> This retrospective cohort study was designed to utilise logistic regression models on data from 200 patient medical records. We examined variables including BMI, HIV co-infection, comorbidities (e.g. diabetes, hypertension), income, substance use and DR-TB classifications (multidrug-resistant, rifampicin-resistant, pre-extensively drug-resistant, extensively drug-resistant).</p><p><strong>Results: </strong> Key findings indicate a weak association between lower BMI and reduced treatment success (odds ratio [OR]: 0.92, 95% confidence interval [CI]: 0.81-1.05). HIV-positive status was marginally associated with lower treatment success (OR: 0.89, 95% CI: 0.75-1.12), while income level and substance use emerged as stronger predictors (e.g. substance use OR: 0.72, 95% CI: 0.60-0.88). Among DR-TB types, extensively drug-resistant tuberculosis patients exhibited the poorest outcomes (OR: 0.55, 95% CI: 0.40-0.75). The multivariate model achieved an accuracy of 63.1%, suggesting limited predictive power of BMI and HIV alone and highlighting the significant influence of comorbidities, socioeconomic status and behavioural factors.</p><p><strong>Conclusion: </strong> These findings underscore the importance of a multidimensional approach in improving DR-TB treatment outcomes through tailored clinical and social interventions.Contribution: The study noted limited connections between DR-TB and various comorbidities. It highlights the necessity of managing coexisting conditions in DR-TB patients because of their significant impact on treatment outcomes. Customised interventions are essential for those with severe or complex comorbidities.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e7"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual intimate partner violence among women in sub-Saharan Africa: The Case of Zambia and Zimbabwe.","authors":"Keatlegile M E Mabena, Karabo Mhele, Wandile F Tsabedze","doi":"10.4102/phcfm.v17i1.4921","DOIUrl":"10.4102/phcfm.v17i1.4921","url":null,"abstract":"<p><strong>Background: </strong> Previous research explored the risk factors associated with intimate partner violence (IPV) in the sub-Saharan region, there is a notable paucity of studies addressing cases in which an individual reported experiencing multiple IPV incidents.</p><p><strong>Aim: </strong> This study aimed to examine the prevalence and sociodemographic factors of dual IPV among women in Zambia and Zimbabwe.</p><p><strong>Setting: </strong> Zimbabwe and Zambia in 2015 and 2018, respectively.</p><p><strong>Methods: </strong> Data for this study were obtained from demographic and health surveys. The study included 11 779 (weighted) women aged 15 to 54 years who were selected for questions on domestic violence. Multinomial regression was used to estimate the relative risk of experiencing physical abuse, emotional abuse or both types of violence compared to experiencing none.</p><p><strong>Results: </strong> While 12% and 9.7% of the respondents reported experiencing only physical and emotional IPV, respectively, almost a quarter (21.7%) were subject to both forms of IPV in the same period. The probability of experiencing both forms of IPV was highest among those whose partners showed controlling behaviour, consumed alcohol, had lower levels of education and had been employed in the past year. The risk of experiencing IPV increased with lower educational attainment among participants, longer relationship duration, number of co-wives, and was higher among those employed.</p><p><strong>Conclusion: </strong> The study recommends counselling interventions, improved access to education and coordinated responses involving key stakeholders. Addressing IPV requires context-specific strategies, the establishment of safe houses and enhanced data systems to monitor its prevalence and trends.Contribution: The study emphasises on the mental healthcare for women who experience IPV.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e11"},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness analysis in primary care research: A practical guide for early-career researchers.","authors":"Akim T Lukwa, Klaus B Von Pressentin, Robert Mash","doi":"10.4102/phcfm.v17i2.5163","DOIUrl":"10.4102/phcfm.v17i2.5163","url":null,"abstract":"<p><p>Cost-effectiveness analysis (CEA) is an important tool for guiding decisions on resource allocation in primary health care (PHC), particularly in low- and middle-income countries that face constrained budgets and competing health priorities. Despite its potential, many early-career primary care researchers struggle with the theoretical and methodological aspects of CEA. This article aims to build capacity in CEA application by providing an accessible guide. It explains fundamental concepts, describes methodological steps, examines quality standards and illustrates real-world applications through detailed case studies from rural settings in Kenya and South Africa. The objective is to equip emerging researchers with the knowledge and skills to embed economic thinking into primary care research and contribute meaningfully to improving the efficiency and equity of health service delivery.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 2","pages":"e1-e6"},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the case for gender-neutral human papillomavirus vaccination in South Africa: Emerging neonatal and ethical considerations.","authors":"Vanessa C Scheepers, Jillian Gardner","doi":"10.4102/phcfm.v17i1.5035","DOIUrl":"10.4102/phcfm.v17i1.5035","url":null,"abstract":"<p><p>Human papillomavirus (HPV) is widely recognised for its role in causing cervical cancer, prompting many countries, including South Africa, to prioritise girls in school-based vaccination programmes. This short report presents an exploratory case for expanding HPV vaccination to adolescent boys as well, drawing on emerging, but still limited evidence of maternal and paternal HPV transmission to neonates. Although current data on neonatal risks are preliminary, the possibility of vertical transmission and associations with respiratory papillomatosis, preterm birth and fertility issues warrant further investigation. Beyond neonatal outcomes, gender-neutral HPV vaccination offers ethical and public health benefits by promoting equitable protection, enhancing herd immunity and addressing transmission dynamics. Recent advances, including the World Health Organization-endorsed single-dose schedules and the availability of affordable vaccines, provide opportunities to revisit cost-effectiveness analyses. We recommend further context-specific research and modelling to quantify the long-term benefits of gender-neutral strategies in South Africa and similar settings.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e3"},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spiritual needs, practices and associated factors among patients with cancer at two teaching hospitals.","authors":"Mpho Ratshikana, Daynia Ballot, Hellen Myezwa, Mary-Lou Galantino, Sonti Pilusa","doi":"10.4102/phcfm.v17i1.5009","DOIUrl":"10.4102/phcfm.v17i1.5009","url":null,"abstract":"<p><strong>Background: </strong> Patients diagnosed with cancer require holistic care that covers the physical, psychosocial and spiritual aspects of wellbeing.</p><p><strong>Aim: </strong> To describe the spiritual needs, practices, association between spirituality, using Traditional Health Practitioners (THPs), ancestral belief, with socio-demographic and clinical characteristics, and examine the association between spiritual interventions and spiritual characteristics.</p><p><strong>Setting: </strong> Palliative Care units at two tertiary hospitals in Johannesburg.</p><p><strong>Methods: </strong> An observational retrospective study used routinely collected data of patients older than 18 years, diagnosed with cancer, having complete records on spiritual questions, and enrolled between January 2021 and December 2023. Data were analysed using STATA V18.</p><p><strong>Results: </strong> Most participants (n = 2465) were female (70.5%), with a mean age of 53.6 (s.d.: 22.7). Half were unemployed, 40.1% married/partnered, and 54.4% living with HIV. Many participants were religious (94.1%) and spiritual (96.3%), Christian (84.3%), 11.3% consulted a TPHs, and 20.0% had ancestral beliefs. Most (94.7%) relied on their faith for comfort, their faith grew stronger (84.9%,) and 79.7% needed forgiveness. Receiving spiritual interventions was associated with the need for forgiveness, relying on faith for comfort and receiving support from the faith community.</p><p><strong>Conclusion: </strong> The study confirms that patients with cancer are spiritual and religious; some have ancestral beliefs, need forgiveness, and rely on their faith and faith communities to cope. The study further highlights the need for culturally relevant tools and interventions to address these needs.Contribution: The article highlights the unique spiritual beliefs and practices among patients with cancer that may influence planning for palliative care and cancer programmes.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e9"},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut microbiota of sub-Saharan Africa infants exposed to antiretroviral therapy: Scoping review.","authors":"Taona E Mudhluli, Runyararo Mashingaidze-Mano, Inam Chitsike, Justen Manasa, Lindsay J Hall, Exnevia Gomo, Danai T Zhou","doi":"10.4102/phcfm.v17i1.4939","DOIUrl":"10.4102/phcfm.v17i1.4939","url":null,"abstract":"<p><strong>Background: </strong> Antiretroviral (ARV) exposure influences the early-life gut microbiota in regions with high human immunodeficiency virus (HIV) burdens. Understanding how ARV drugs affect the infant gut microbiota is important for optimising short-term and long-term health outcomes.</p><p><strong>Aim: </strong> This scoping review synthesises current evidence on the gut microbiota of infants born to mothers with HIV (MWH) in sub-Saharan Africa, focusing on the effects of in utero and postnatal ARV exposure. By examining emerging data in this context, we highlight potential implications for infant health and identify key areas for future research.</p><p><strong>Method: </strong> Online databases were systematically searched using comprehensive search strategies. In addition, grey literature was explored. Three authors independently screened titles and abstracts for relevance, evaluated full-text articles for eligibility and performed data extraction.</p><p><strong>Results: </strong> The scoping review highlights differences in gut microbiota because of HIV exposure and ARV drugs in infants born to sub-Saharan African MWH. Of interest is a disturbance in the gut bacterial balance in infants with HIV, who harboured enriched with more diverse and potentially harmful bacteria relative to HIV-exposed uninfected infants. There was agreement from some countries, that is Nigeria and Zimbabwe, that their gut microbiota genomes comprise Bifidobacterium longum subspecies infantis and Enterococcus.</p><p><strong>Conclusion: </strong> Both antiretroviral therapy and HIV influence the gut microbiota in infants born to MWH. Pathogenic overgrowth within the infant gut microbiota for individuals with HIV may impair immune maturation during early-life, with lasting consequences for host health.Contribution: This highlights the need for further research into probiotic interventions for infants in high HIV-burden settings.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e13"},"PeriodicalIF":1.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuing professional development on climate change and primary care in Africa: Qualitative study.","authors":"Robert Mash, Christian Lueme Lokotola","doi":"10.4102/phcfm.v17i1.4916","DOIUrl":"10.4102/phcfm.v17i1.4916","url":null,"abstract":"<p><strong>Background: </strong> Climate change is impacting health and healthcare in Africa. Primary health care can improve community resilience, but only if the workforce is prepared. Pre-service training does not yet address climate change, so continuing professional development (CPD) is needed.</p><p><strong>Aim: </strong> This study aimed to evaluate what primary care providers in sub-Saharan Africa need to know about building climate-resilient facilities and services, and how their learning needs should be addressed.</p><p><strong>Setting: </strong> The Primary Care and Family Medicine (PRIMAFAMED) network in sub-Saharan Africa.</p><p><strong>Methods: </strong> A descriptive exploratory qualitative study purposefully selected members of the network who had published on their experience of climate change. Snowball sampling was used to identify additional informants. Data were analysed with ATLAS.ti and the framework method.</p><p><strong>Results: </strong> Nine respondents from eight countries across Africa identified six major learning needs: (1) awareness of the pathways that link climate change to health and social effects and changes in the management of diseases, (2) management of diseases linked to exposure to extreme heat, (3) development of a community-orientated primary care approach that includes attention to environmental determinants of health, (4) disaster preparedness and management, (5) how to make your facility and services more climate resilient and (6) how to educate patients and communities on climate related health issues. Most respondents supported web-based approaches to CPD in their contexts.</p><p><strong>Conclusion: </strong> Key learning needs were identified and will be further quantified and validated in a cross-sectional survey.Contribution: The findings will inform the development of CPD on planetary health for primary care providers in sub-Saharan Africa.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e7"},"PeriodicalIF":1.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of uncorrected refractive error in low-resource high schools in the Free State, South Africa.","authors":"Xolani Nyathela, Urvashni Nirghin, Naimah Ebrahim Khan","doi":"10.4102/phcfm.v17i1.4967","DOIUrl":"10.4102/phcfm.v17i1.4967","url":null,"abstract":"<p><strong>Background: </strong> The continuous increase in the prevalence of refractive error (RE) globally, with uncorrected refractive error (URE) having been established as the leading cause of visual impairment (VI) in children, is a public health concern. Previous RE studies in South Africa also indicated a growing prevalence, substantiating the burden on schoolchildren.</p><p><strong>Aim: </strong> To determine the prevalence of URE among high school learners.</p><p><strong>Setting: </strong> No-fee-paying high schools in the Free State, South Africa.</p><p><strong>Methods: </strong> A school-based cross-sectional study design was conducted on 13- to 19-year-old learners through a multistage stratified random method. The examination included an unaided logarith of the minimum angle of resolution (LogMAR) visual acuity test, binocular motor alignment tests, ocular health assessment and cycloplegic autorefraction.</p><p><strong>Results: </strong> A total of 868 learners consented to participate in this study, with a mean age of 16.4 ± 1.7 years. Male participants accounted for 34.5% (n = 299), while female participants accounted for 65.6% (n = 569), with the majority being Grade 10 learners. The prevalence of URE stood at 27.1% (n = 233), with astigmatism being the most prevalent ametropia, accounting for 22.3% (192 cases), followed by myopia at 15.1% (n = 130) and hyperopia at 5.4% (n = 46).</p><p><strong>Conclusion: </strong> A high prevalence of URE, especially among older participants, was established, prompting an urgent concerted intervention from all stakeholders to curb the scourge.Contribution: This study accentuates the visual situation of vulnerable learners, that is, older children from disadvantaged backgrounds in the Free State, which until this point had not been established.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e8"},"PeriodicalIF":1.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring barriers to healthcare among internal and international female migrants in The Gambia.","authors":"Aline Vandenbroeck, Els Bekaert, Julia M P Bittner, Ismaila Ceesay, Charlotte Scheerens, Ilse Ruyssen","doi":"10.4102/phcfm.v17i1.4941","DOIUrl":"10.4102/phcfm.v17i1.4941","url":null,"abstract":"<p><strong>Background: </strong> Existing research on female migration and healthcare in sub-Saharan Africa has predominantly focused on internal migration and maternal and child health, often overlooking broader healthcare access issues for (international) migrant women.</p><p><strong>Aim: </strong> This study aimed to quantitatively assess healthcare barriers faced by internal and international migrants relative to non-migrant women.</p><p><strong>Setting: </strong> The setting of this study was The Gambia.</p><p><strong>Methods: </strong> Using the 2019-2020 Gambia Demographic and Health Survey and overlap weighting, we compare healthcare access - based on reported usage and key barriers - between non-migrants and internal or international migrants. We distinguish between recent and settled migrants according to the duration of residence at the destination.</p><p><strong>Results: </strong> Financial barriers are reported by 26.46% - 28.09% of women, geographic barriers by 21.47% - 26.02% and safety barriers by 11.85% - 15.37%. Internal female migrants encounter significantly more geographic (odds ratio [OR] = 1.32, 95% confidence interval [CI] [1.19, 1.45]), permission (OR = 1.43, 95% CI [1.16, 1.76]), safety (OR = 1.16, 95% CI [1.03, 1.30]) and financial (OR = 1.21, 95% CI [1.10, 1.33]) barriers than non-migrants - differences that persist for settled migrants. Conversely, international migrants do not experience more barriers than non-migrants. In addition, migrants who have moved in the past 3 years used health services more than non-migrants, both for internal migrants (OR = 1.14, 95% CI [1.00, 1.31]) and for international migrants (OR = 1.42, 95% CI [1.02, 1.98]), but these differences disappear for settled migrants.</p><p><strong>Conclusion: </strong> Policy interventions should address disparities between internal migrants and non-migrants and improve healthcare access for all women.Contribution: This study highlights internal migration as a key factor shaping healthcare access.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e18"},"PeriodicalIF":1.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}