加拿大的性工作者面临不平等的医疗服务:系统思考方法》。

IF 3 Q1 PRIMARY HEALTH CARE
Kaitlyn Squires
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引用次数: 0

摘要

目标:尽管加拿大实行全民医疗保健制度,但全国各地的性工作者在寻求医疗保健服务时面临的障碍之多令人震惊。这导致她们的医疗保健需求得不到满足,健康状况也远不如加拿大普通民众。本研究的目的是采用系统思维方法,深入了解性工作者面临的障碍以及如何改善获得服务的途径:分析采用了系统思维方法,该方法结合了系统工具和探究过程。该方法包括两个探究领域:(1)问题景观;(2)解决方案景观。系统工具和方法,如因果循环图、冰山图和系统映射,对问题景观进行了调查,以了解问题的相互关联性,同时对已发表的文献和灰色文献进行了审查。环境扫描探索了当前的解决方案。这些方法通过系统探究过程连接起来,包括对不同观点、边界判断、相互关系的持续审查和应用;从而确定了差距和变革杠杆:结果:性工作者面临的主要障碍是污名化、定罪、可及性和医疗费用。性工作的污名化源于他者化、家长制、道德主义和基于信仰的信念。性工作所特有的障碍是污名化和犯罪化;两者都表现为对医疗专业人员的回避、厌恶和/或恐惧。我们确定了五种差距,每种差距都有一个改变杠杆,以改善获得服务的机会:(1) 耻辱化--集体化和外部合作,(2) 性工作的犯罪地位--非刑罪化,(3) 缺乏足够的教育--改善医疗保健专业培训和反歧视的医疗保健政策,(4) 缺乏支持--增加基于社区的医疗保健服务,(5) 医疗保健的成本--"二级 "医疗保健组成部分的普遍覆盖:通过减少围绕性工作的污名化、改善性工作者获得的医疗保健服务以及相关各方之间的合作,可以防止性工作者落入加拿大医疗保健系统的夹缝中;减少性工作者面临的健康不平等并改善其健康状况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sex Workers in Canada Face Unequal Access to Healthcare: A Systems Thinking Approach.

Objectives: Despite Canada's universal health system, sex workers across the country face an alarmingly high number of barriers when they seek to healthcare services. This has resulted in unmet healthcare needs and substantially poorer health outcomes than the general Canadian population. The objective of this study was to use a systems thinking approach to gain an in-depth understanding of the barriers sex workers face and how access could be improved.

Methods: The analysis was conducted using a systems thinking methodology, which incorporates systems tools and inquiry processes. The methodology comprised 2 domains of inquiry: (1) Problem Landscape, (2) Solutions Landscape. Systems tools and methods, such as causal loop diagrams, iceberg diagram, and systems mapping, investigated the problem landscape for understanding the interconnected nature of the issue, alongside review of both published and gray literature. An environmental scan explored the current solutions landscape. These methods connected through systemic inquiry processes, including ongoing review and application of diverse perspectives, boundary judgments, interrelationships; enabled gaps and levers of change to be determined.

Results: The main barriers sex workers face are stigma, criminalization, accessibility, and cost of healthcare. The stigma of sex work stems from otherization, paternalism, and moralistic, faith-based beliefs. The barriers unique to sex work are stigma and criminalization; both of which surface as avoidance, dislike, and/or fear of medical professionals. Five gaps each with a lever of change to improve access were identified: (1) Stigma - Collectivization and external collaboration, (2) Criminal status of sex work - Decriminalization, (3) Lack of adequate education - Improved healthcare professional training and anti-discriminatory health policies, (4) Lack of support - Increased community-based healthcare services, (5) Cost of healthcare - Universal coverage of "secondary" healthcare components.

Conclusion: Through reducing the stigma surrounding sex work, making changes that improve the healthcare services that sex workers receive, and collaboration between involved parties, sex workers can be prevented from falling through the cracks of the Canadian healthcare system; lessening the health inequities sex workers face and improving their health outcomes.

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来源期刊
CiteScore
4.80
自引率
2.80%
发文量
183
审稿时长
15 weeks
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