PDF(Pubmed)
Abstract：
UNASSIGNED: Transgender and gender diverse (TGD) people face significant challenges in accessing timely, culturally competent, and adequate healthcare due to structural and systemic barriers, yet there is a lack of research exploring the access and utilization of healthcare services within African TGD communities. To address this gap, this systematic review explored: (1) barriers to accessing healthcare services and gender-affirming hormone therapy (GAHT) faced by TGD people, (2) demographic and societal factors correlated with the utilization of healthcare services and GAHT, (3) common healthcare and support services utilized by TGD people, and (4) patterns of accessing healthcare services and GAHT within TGD communities.
UNASSIGNED: A systematic literature search was conducted in PubMed, Embase, and Scopus in September 2023. Eligible studies included peer-reviewed original research, reports, and summaries published in the English language assessing health service accessibility and utilization of TGD people in Africa between January 2016 and December 2023.
UNASSIGNED: From 2072 potentially relevant articles, 159 were assessed for eligibility following duplicate removal, and 49 were included for analysis. Forty-five articles addressed barriers to accessing healthcare services and GAHT, seven focused on demographic and societal factors correlated with the utilization of healthcare services and GAHT, 16 covered common healthcare and support services utilized by TGD people, and seven examined patterns of accessing healthcare services and GAHT. Findings suggested a limited availability of health services, inadequate knowledge of TGD healthcare needs among healthcare providers, a lack of recognition of TGD people in healthcare settings, healthcare-related stigma, and financial constraints within African TGD communities. An absence of studies conducted in Northern and Central Africa was identified.
UNASSIGNED: TGD people in Africa encounter significant barriers when seeking healthcare services, leading to disparity in the utilization of healthcare and resulting in a disproportionate burden of health risks. The implications of these barriers highlight the urgent need for more high-quality evidence to promote health equity for African TGD people.
UNASSIGNED: PROSPERO CRD42024532405.
UNASSIGNED: The online version contains supplementary material available at 10.1186/s44263-024-00073-2.
UNASSIGNED: A systematic literature search was conducted in PubMed, Embase, and Scopus in September 2023. Eligible studies included peer-reviewed original research, reports, and summaries published in the English language assessing health service accessibility and utilization of TGD people in Africa between January 2016 and December 2023.
UNASSIGNED: From 2072 potentially relevant articles, 159 were assessed for eligibility following duplicate removal, and 49 were included for analysis. Forty-five articles addressed barriers to accessing healthcare services and GAHT, seven focused on demographic and societal factors correlated with the utilization of healthcare services and GAHT, 16 covered common healthcare and support services utilized by TGD people, and seven examined patterns of accessing healthcare services and GAHT. Findings suggested a limited availability of health services, inadequate knowledge of TGD healthcare needs among healthcare providers, a lack of recognition of TGD people in healthcare settings, healthcare-related stigma, and financial constraints within African TGD communities. An absence of studies conducted in Northern and Central Africa was identified.
UNASSIGNED: TGD people in Africa encounter significant barriers when seeking healthcare services, leading to disparity in the utilization of healthcare and resulting in a disproportionate burden of health risks. The implications of these barriers highlight the urgent need for more high-quality evidence to promote health equity for African TGD people.
UNASSIGNED: PROSPERO CRD42024532405.
UNASSIGNED: The online version contains supplementary material available at 10.1186/s44263-024-00073-2.
摘要：
■变性人和性别多样化（TGD）的人在及时获取，文化能力强,以及由于结构性和系统性障碍而导致的适当医疗保健，然而，缺乏探索非洲TGD社区内医疗保健服务的获取和利用的研究。为了解决这个差距，本系统综述探讨了：（1）TGD人群面临的获得医疗保健服务和性别确认激素治疗（GAHT）的障碍，(2)与医疗服务利用和GAHT相关的人口和社会因素，(3)TGD人员使用的常见医疗保健和支持服务，(4)TGD社区内获得医疗保健服务和GAHT的模式。
■在PubMed进行了系统的文献检索，Embase,和Scopus在2023年9月。符合条件的研究包括同行评审的原始研究，reports,以及以英语发布的摘要，评估2016年1月至2023年12月非洲TGD人群的卫生服务可及性和利用率。
■来自2072篇潜在相关文章，在重复移除后，对159人进行了资格评估，49例纳入分析.45篇文章讨论了获得医疗保健服务和GAHT的障碍，七个关注与医疗服务和GAHT利用相关的人口和社会因素，16涵盖了TGD人员使用的常见医疗保健和支持服务，和七个检查了访问医疗保健服务和GAHT的模式。调查结果表明，卫生服务的可用性有限，医疗保健提供者对TGD医疗保健需求的了解不足，在医疗机构中缺乏对TGD人员的认可，与医疗保健相关的耻辱，以及非洲TGD社区内的财政限制。发现没有在北非和中非进行研究。
■非洲的TGD人在寻求医疗服务时遇到重大障碍，导致医疗保健利用方面的差距，并导致不成比例的健康风险负担。这些障碍的影响凸显了迫切需要更多高质量的证据来促进非洲TGD人群的健康公平。
■PROSPEROCRD42024532405。
■在线版本包含10.1186/s44263-024-00073-2提供的补充材料。
■在PubMed进行了系统的文献检索，Embase,和Scopus在2023年9月。符合条件的研究包括同行评审的原始研究，reports,以及以英语发布的摘要，评估2016年1月至2023年12月非洲TGD人群的卫生服务可及性和利用率。
■来自2072篇潜在相关文章，在重复移除后，对159人进行了资格评估，49例纳入分析.45篇文章讨论了获得医疗保健服务和GAHT的障碍，七个关注与医疗服务和GAHT利用相关的人口和社会因素，16涵盖了TGD人员使用的常见医疗保健和支持服务，和七个检查了访问医疗保健服务和GAHT的模式。调查结果表明，卫生服务的可用性有限，医疗保健提供者对TGD医疗保健需求的了解不足，在医疗机构中缺乏对TGD人员的认可，与医疗保健相关的耻辱，以及非洲TGD社区内的财政限制。发现没有在北非和中非进行研究。
■非洲的TGD人在寻求医疗服务时遇到重大障碍，导致医疗保健利用方面的差距，并导致不成比例的健康风险负担。这些障碍的影响凸显了迫切需要更多高质量的证据来促进非洲TGD人群的健康公平。
■PROSPEROCRD42024532405。
■在线版本包含10.1186/s44263-024-00073-2提供的补充材料。
