Ankara İli Birinci Basamak Sağlık Kuruluşlarında Göçmen Çocuklara Sağlık Hizmeti Sunumunda Karşılaşılan Engellerin Belirlenmesi
Özet
Özyürek D, Determining the Barriers Encountered in Providing Health Services to
Migrant Children in Primary Health Care Institutions in Ankara, Hacettepe
University Faculty of Medicine, Department of Public Health, Public Health
Specialty Thesis, Ankara, 2022.Migration has a direct impact on the health through
individual life characteristics, social and community effects, living and working
conditions, socioeconomic, cultural and environmental conditions. Children are
among the vulnerable groups affected by migration. In this research, it is aimed to
learn the views of family health physicians and family health workers working in
family health centers in six districts of Ankara about the health status of immigrant
children and the conveniences and barriers experienced in accessing health services;
and identify factors associated with self-assessment of cultural competency and the
difficulty they face in service delivery. In Ankara, 224 family health centers were
reached at Altındağ, Çankaya, Keçiören, Mamak, Yenimahalle and Sincan districts,
224 family physicians and 250 family health workers voluntarily participated in the
research. The mean age of the participants was 42.6 ± 9.2 (ss), the median age was
42, the age was ranging between 23-75, and 76.3% were women. 23.5% (n=52) of the
family physicians participating in the study received specialty training. 53.9% (n=255)
of the participants knew a foreign language and 7.0% (n=33) were abroad for more
than one month. 92.4% of the participants stated that they did not take theoretical
courses on immigrant health in the post-graduation period; however, 17.4% (n=83)
had migrant health service experience before working in this unit. Frequent phone
and address changes was identified as a significant problem by 75% of the
participants for accessing migrant families. 57.8% of the participants stated that they
had difficulties in pregnancy follow-up and 55.9% in breastfeeding education. In
childhood screenings, 59.3% of the participants stated that they had difficulties.
While the mean score of the cultural competency scale of the family physicians
participating in the study was 59.4±15.9 (sd), the median value was 60.0, and the
scores were between 20.0 and 100.0; The mean score of the cultural competency
scale of family health workers is 62.67±15.7 (sd), the median value is 63.0, and the
scores are between 20.0 and 100.0. Knowing a foreign language and taking immigrant
health courses before graduation were associated with higher cultural competency
scale scores than the other participants (p<0.05). The cultural competency scale score
of the participants who stated that they had a low level of difficulty in serving
immigrant patients was 1.083 times (CI 1,051-1,115) (p<0.001) compared to those
who had a high level of disability; participants who stated that they had moderate
difficulty in serving immigrant patients were 1.049 times (CI 1,030-1,069) higher
(p<0.001). It is recommended that interventions that reduce the barriers experienced
in the health service delivery process, increase positive communication and respond
to different cultures, support health service delivery at the level of health
professionals, immigrant individuals and the health system. Keywords: immigrant,
child health, health service delivery; Ankara, family health center, family doctor,
family health worker, cultural competency, healthcare service barriers
