背景:医疗保健准入和公平是人权。全球冲突,暴力,和迫害增加了来自难民或类似难民背景的人数。因为城市地区已经人口稠密,各国政府的目标是增加农村和/或地区地区的难民安置。由于难民的复杂医疗需求,这给医疗服务提供者带来了挑战。因此,确定农村地区获得医疗保健的障碍对于更好地为政策设置和方案提供信息很重要,这些政策和方案将为难民社区提供文化上适当的以患者为中心的护理。
方法:本综述对来自五个国家的2018年至2023年7月之间用英语撰写的22篇论文进行了研究(澳大利亚,新西兰,德国,孟加拉国,和黎巴嫩),以便概述障碍和可能的解决方案,以便利难民获得医疗保健。
结果:综述文献总结了至少3,561名不同难民和259名农村卫生服务提供者和/或管理人员的看法,并确定了主要挑战。其中包括交流(移民国家语言不识字和缺乏合适的口译员),缺乏卫生服务的文化意识,歧视,和进出困难(交通,卫生专家服务的可用性,成本)。因此,人们确定,改善负担得起的住房,通过证书承认就业,能力水平的儿童教育,促进语言培训,和调整健康信息将增加重新安置并鼓励获得医疗保健。
结论:难民在获得和参与医疗服务方面面临重大障碍。这影响了他们融入农村社区,增加了孤独感等心理社会问题的患病率,低自尊,缺乏自主性,缺乏对知情决策的授权,尤其是对女性来说,失业的男人,和老人。这些发现支持需要为难民和医疗保健提供者提供额外支持,以提高语言能力和文化能力。政策制定者需要提高就业的可获得性和可获得性,住房无障碍,和服务流动性。此外,需要更多的研究来评估旨在通过向农村地区的难民社区提供文化上适当的以病人为中心的护理来缩小差距的新兴创新方案的效力。
Healthcare access and equity are human rights. Worldwide conflicts, violence, and persecution have increased the number of people from refugee or refugee-like backgrounds. Because urban areas are already densely populated, governments have aimed to increase refugee resettlement in rural and/or regional areas. Because of the complex healthcare needs of refugees, this creates challenges for healthcare service providers. Identifying barriers to accessing healthcare in rural areas is therefore important to better inform policy settings and programmes that will provide culturally appropriate patient-centred care to the refugee community.
This review scoped 22 papers written in English between 2018 and July 2023 from five countries (Australia, New Zealand, Germany, Bangladesh, and Lebanon) in order to provide an overview of the barriers and possible solutions to facilitate refugees\' access to healthcare.
The reviewed literature summarised the perceptions of at least 3,561 different refugees and 259 rural health service providers and/or administrators and identified major challenges. These include communication (illiteracy in the resettlement country language and lack of a suitable interpreter), lack of cultural awareness of health services, discrimination, and access difficulties (transportation, availability of health specialist services, cost). As a consequence, it was identified that improving access to affordable housing, employment through credential recognition, competence-level education for children, facilitating language training, and adapting health information would increase resettlement and encourage access to healthcare.
Refugees face significant barriers to accessing and engaging with healthcare services. This impacts their integration into rural communities and increases the prevalence of psychosocial issues like feelings of loneliness, low self-esteem, a lack of autonomy, and a lack of empowerment over informed decision-making, especially for women, jobless men, and the elderly. These findings support the need for additional support for refugees and healthcare providers to improve language proficiency and cultural competency. Policymakers need to improve the availability and accessibility of employment, housing accessibility, and service mobility. Additionally, more research is needed to assess the efficacy of emerging innovative programmes that aim to close the gap by delivering culturally appropriate patient-centred care to refugee communities in rural areas.