From ‘no problem’ to ‘a lot of difficulties’

Barriers to health service utilization among migrants in Rakai, Uganda

Bibliographic Data

ID15127319
AuthorsRuth Young (0000-0002-9234-8690, Johns Hopkins University), Caitlin E Kennedy (0000-0001-6820-063X, Johns Hopkins University, corresponding author), Anita Dam (0000-0001-8793-0515, Johns Hopkins University), Neema Nakyanjo (0000-0002-1908-7957, Rakai Health Sciences Program), William G Ddaaki (0000-0002-2395-7003, Rakai Health Sciences Program), Anne Catherine Kiyingi (Rakai Health Sciences Program), Emmanuel Mukwana (Rakai Health Sciences Program), Abagail Edwards (0000-0002-1714-628X, Johns Hopkins University), Fred Nalugoda (0000-0001-6119-9293, Rakai Health Sciences Program), Larry W Chang (0000-0001-7985-4567, Johns Hopkins University), Maria J Wawer (0000-0002-3601-4469, Johns Hopkins University), Maya Oaks (Johns Hopkins University), Ligia Paina (0000-0002-8403-7825, Johns Hopkins University)
Year2023
Volume38
Issue5
Pages620-630
Publication date2023-05-17
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czad019
PMID37002584
OpenAlexW4362457924
LanguageEN
Citations received6
References cited35

Migration is increasingly common in Africa, especially for employment. Migrants may face additional barriers to accessing health care, including human immunodeficiency virus (HIV) prevention and treatment, compared with long-term residents. Exploring migrants’ experiences with health services can provide insights to inform the design of health programmes. In this study, we used qualitative methods to understand migrants’ barriers to health service utilization in south-central Uganda. This secondary data analysis used data from in-depth semi-structured interviews with 35 migrants and 25 key informants between 2017 and 2021. Interviews were analysed thematically through team debriefings and memos. We constructed three representative migrant journeys to illustrate barriers to accessing health services, reflecting experiences of migrant personas with differing HIV status and wealth. Migrants reported experiencing a range of barriers, which largely depended on the resources they could access, their existing health needs and their ability to form connections and relationships at their destination. Migrants were less familiar with local health services, and sometimes needed more time and resources to access care. Migrants living with HIV faced additional barriers to accessing health services due to anticipated discrimination from community members or health workers and difficulties in continuing antiretroviral therapy when switching health facilities. Despite these barriers, social networks and local connections facilitated access. However, for some migrants, such as those who were poorer or living with HIV, these barriers were more pronounced. Our work highlights how local connections with community members and health workers help migrants access health services. In practice, reducing barriers to health services is likely to benefit both migrants and long-term residents

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