Healthcare service delivery to refugee children from the Democratic Republic of Congo living in Durban, South Africa: a caregivers’ perspective

Abstract

BackgroundRefugees are generally considered a vulnerable population, with refugee children (newborn and young children) being particularly so. Access to healthcare for this population remains a challenge. The main purpose of this study was to explore refugee caregivers’ perceptions of their children’s access to quality health service delivery to their young children in Durban, South Africa.MethodsThis study used an explanatory mixed methods design, purposively sampling 120 and 10 participants for the quantitative and qualitative phases, respectively. Participants were administered a self-developed questionnaire that assessed demographic information of participants, socioeconomic status and living standard, medical history of children, satisfaction and experiences with healthcare services and refugees’ networks and social support. A semi-structured interview schedule was developed to elicit in-depth and more detailed information from the participants on the quantitative areas that were investigated. Frequencies were calculated and a χ2 test was used to explore the factors associated with refugees’ satisfaction of the healthcare provided and thematic analysis was used to analyse the qualitative data.ResultsThe majority (89%) of caregivers were women, with over 70% of them aged between 30 and 35 years. Over 74% of caregivers visited public clinics for their children’s healthcare needs. The majority of caregivers (95%) were not satisfied with healthcare services delivery to their children due to the long waiting hours and the negative attitudes and discriminatory behaviours of healthcare workers, particularly in public healthcare facilities.ConclusionThese findings underscore the need to address health professionals’ attitudes when providing healthcare for refugees. Attitudinal change may improve the relationship between service providers and caregivers of refugee children in South Africa, which may improve the health-related outcomes in refugee children.Electronic supplementary materialThe online version of this article (10.1186/s12916-018-1153-0) contains supplementary material, which is available to authorized users.

A Scoping Review of the Health of African Immigrant and Refugee Children

“…Eight of the studies included in this review analyse health care services [ 119 , 123 , 207 , 208 , 209 , 210 , 211 , 212 ]. AMC in the UK indicate not having contact with health care services [ 123 ]; AMC in Israel adopt Western practices and go to the clinic for medical treatment, but if this does not prove satisfactory, they seek out solutions according to familiar patterns from their country of origin for medical, social, or emotional problems [ 207 ]. Similarly, AMC caregivers in South Africa report dissatisfaction with health care services [ 208 ], and AMC in Spain report a sense of pointlessness in seeking out health care services [ 209 ].…”

“…While many of the studies included children as data sources, these were overwhelmingly quantitative. Only 10 studies were qualitative and gathered data from migrant and refugee children from countries in sub-Saharan Africa [ 112 , 116 , 120 , 124 , 125 , 129 , 132 , 150 , 166 , 207 ]. The rest of the qualitative studies gathered data about children from parents or service provider participants.…”

Viewpoints of Other Scientists on Migration, Mental Health and PTSD: Review of Relevant Literature

“…It is substantially documented in the research literature that refugees and migrants are a highly vulnerable population experiencing many difficulties and stressors in their sojourns for a safe haven (Meyer-Weitz, Asante, & Lukobeka, 2018;Idemudia et al 2013;Bustamante et al, 2018). Given that the migration process is accompanied with a myriad of stressors, trauma and psychological difficulties, it is necessary to understand the strategies adopted by migrants to cope with these problems in order to prevent exacerbation of associated mental health problems.…”

Universal health coverage for refugees and migrants in the twenty-first century

“…In a study in Durban, South Africa, Meyer-Weitz et al [ 3 ] explored the health access perception of predominantly female caregivers of Congolese refugee children and concluded that long waiting times, negative attitudes, and discrimination are key sources of dissatisfaction with primary healthcare. By contrast, in Australia, an analysis of longitudinal data to investigate levels of post migration psychological adjustment among refugee children concluded that the majority of resettled children and adolescents was well adjusted, especially those with better physical health and school attendance, although young refugees reported greater peer difficulties [ 4 ].…”