Suchergebnisse

Migrants are especially susceptible to inequitable access to health care services and their access to health care may be further compromised by the tradition of informal patient payments in the Western Balkan countries. As a particularly vulnerable group, this study focused on the asylum-seeking migrants and the role of informal patient payments as an avenue for migrants' health care access in Serbia. Qualitative interviews were conducted in August and September of 2018 with civil servants (intercultural mediators and information workers, n = 8) and asylum-seeking migrants ( n = 6). Data was analyzed using the phenomenological hermeneutical approach. The study showed that intercultural mediators had a pivotal role in shaping better and quicker access to health care services for asylum-seeking migrants in Serbia, which also lowered their exposure to informal patient payments. A commonness in paying informally was found in Serbia, especially due to the high value put into doctors and the lacking resources of the health care system. The asylum-seeking migrants seemed exempted from such payments. Reducing these informal patient payments for health care is highly important to facilitate equity in access to health care

AbstractINTRODUCTIONTo eliminate cervical cancer (CC), access to and quality of prevention and care services must be monitored, particularly for women living with HIV (WLHIV). We assessed implementation practices in HIV clinics across sub‐Saharan Africa (SSA) to identify gaps in the care cascade and used aggregated patient data to populate cascades for WLHIV attending HIV clinics.METHODSOur facility‐based survey was administered between November 2020 and July 2021 in 30 HIV clinics across SSA that participate in the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We performed a qualitative site‐level assessment of CC prevention and care services and analysed data from routine care of WLHIV in SSA.RESULTSHuman papillomavirus (HPV) vaccination was offered in 33% of sites. Referral for CC diagnosis (42%) and treatment (70%) was common, but not free at about 50% of sites. Most sites had electronic health information systems (90%), but data to inform indicators to monitor global targets for CC elimination in WLHIV were not routinely collected in these sites. Data were collected routinely in only 36% of sites that offered HPV vaccination, 33% of sites that offered cervical screening and 20% of sites that offered pre‐cancer and CC treatment.CONCLUSIONSThough CC prevention and care services have long been available in some HIV clinics across SSA, patient and programme monitoring need to be improved. Countries should consider leveraging their existing health information systems and use monitoring tools provided by the World Health Organization to improve CC prevention programmes and access, and to track their progress towards the goal of eliminating CC.