Use of an Emergency Department in Saint-Laurent du Maroni, French Guiana: Does Being Undocumented Make a Difference?

Jolivet, Anne; Cadot, Emmanuelle; Angénieux, Olivier; Florence, S.; Lesieur, Sophie; Lebas, J.; Chauvin, Pierre

doi:10.1007/s10903-013-9919-0

Cited by 13 publications

(8 citation statements)

References 20 publications

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“…After multivariate analysis, the variables remaining independently associated with renouncing care for financial reasons were classical [23, 28]: women were more likely to renounce, those with a poor perception of their health, those with the lowest incomes, those without a complementary health insurance; the multivariate analysis also showed that those who were retired or students were less likely to renounce for financial reasons. Women may renounce more for individual reasons (often a poorer perception of their health) but in addition to individual reasons, there may be important contextual and cultural reasons, such as the constraints of school schedules, family roles, which may not be necessarily taken into account in the health services’ organization.…”

Section: Discussionmentioning

confidence: 99%

“…Thus undocumented immigrants reported a worse health when compared to others immigrants, and reported health declined over time [18]; immigrants were also diagnosed later for human immunodeficiency virus (HIV) [19], they were more susceptible to interrupt HIV follow-up and treatment [20]; for cancer, immigrants had more advanced stages and a poorer prognosis for cervical cancer [21] and a much lower survival for breast cancer [22]. At the Emergency ward in Saint Laurent du Maroni, the severity and the hospitalization rate were higher among undocumented immigrants [23]. An epidemic of Beriberi was recently reported among illegal gold miners in French Guiana [24].…”

Section: Introductionmentioning

confidence: 99%

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Renouncing care in French Guiana: the national health barometer survey

Melle

Cropet

Parriault

et al. 2019

BMC Health Serv Res

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BackgroundIn French Guiana, health inequalities are patent for a broad range of pathologies for all age groups. The objective of the present study was to quantify the proportion of the population that had renounced care in the past year, to study predictive factors, and to compare results with other French territories.MethodsA two-stage random sample of 2015 individuals aged 15 to 75 years was surveyed by telephone. A descriptive analysis of variables relative to renouncing care, use of health care, screening, and vaccination was initially performed. Multivariate analysis was then used to determine variables associated with renouncing care for financial reasons and renouncing for reasons linked to time were directly estimated using a Poisson model on weighted data. Variables with a significance level < 0.2 in the bivariate analysis were included in the full multivariate model.ResultsIn French Guiana, during the past 12 months, 30.9% of surveyed persons renounced care whatever the type for financial reasons. Results of the multivariate analysis showed that gender, perceived financial situation, perceived health and complementary insurance status were independent predictive factors of care renouncement for financial reasons. Overall, 24% of the surveyed population declared having renounced to care for time-related motives. The independent predictors for time-related renouncing were different than those for renouncing care for financial reasons: a higher education level and a poor perceived health were independently associated with time-related renouncement; retired persons and students were found to renounce care less frequently than persons with a job.ConclusionsRenouncing for financial reasons, a major target of the 2016 health law, represented a public health problem in French Guiana. Renouncing for lack of time was an important motive for renouncing, which is aggravated by the insufficient number of health professionals, but may benefit from organizational solutions. There are avenues for improvement of health for the most vulnerable: promote health, act on risk factors, and facilitate the readability and accessibility of the health system. Recent reforms to stabilize health insurance may however have some adverse consequences for migrants.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Renouncing care in French Guiana: the national health barometer survey

Melle

Cropet

Parriault

et al. 2019

BMC Health Serv Res

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“…Of note, illnesses are also the most frequent reason for calling prehospital emergency medical services in similar settings, 12 and fever is the most common symptom reported upon admission at the emergency department of the French Guiana referral hospital in Cayenne (unpublished data) as well as at Saint-Laurent du Maroni, the referral hospital at the Suriname border. 7 Malaria is a major public health problem in French Guiana, with an incidence estimated at 3000 to 4500 cases each year, one third being caused by Plasmodium falciparum . 13,14 Even in malaria-free areas, migration of gold miners from endemic areas may lead to the re-emergence of malaria due to the presence of competent Anopheles vector, as has been documented in Brazil.…”

Section: Discussionmentioning

confidence: 99%

Prehospital Emergencies in Illegal Gold Mining Sites in French Guiana

Egmann¹,

Tattevin

Palancade³

et al. 2018

Wilderness & Environmental Medicine

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“…This is mainly attributed to the lack of the intercultural-competency of health personnel. The language barrier could also lead to miscommunication and such bitter experiences of abandonment and isolation (27) other countries (28)(29)(30). It could limit the access to the appropriate health care among illegal migrants and refugees.…”

Section: Legal and Immigration Issuesmentioning

confidence: 99%

“It is good, but I can’t afford it…” potential barriers to adequate prenatal care among Afghan women in Iran: a qualitative study in south Tehran

Dadras

Taghizade

Dadras

et al. 2020

Preprint

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Background: An estimated 96% of registered refugees in Iran are Afghan. Almost half of them are young women at the reproductive age. The adequate maternity care is crucial for healthy pregnancy. There is limited knowledge regarding the access and adequacy of maternity care among Afghan women in Iran. The reports from ministry of health (MOH) implicates higher prevalence of perinatal complication in Afghan population. This mainly attributed to the inadequate prenatal care in during pregnancy. Therefore, this paper explores the access and potential barriers to prenatal care among Afghan women in Iran.Methods: Using purposive convenient sampling, thirty pregnant Afghan women were recruited at three community health centers with the highest number of Afghan visitors in Tehran, the capital city of Iran. Data were collected through face-to-face interviews in Persian language using an interview guide. The interviewers were two bilingual Afghan graduate midwifery students. Each interview lasted for an hour. The interviews were transcribed into original language (Persian) and analyzed using content analysis. The MAXQD v.10 software was used in data analysis. The main themes were extracted grouping the similar codes and categories after careful consideration and consensus between the researchers.Results: The financial constraints and lack of affordable health insurance with adequate coverage of prenatal care services, particularly the diagnostic and screening tests, were the most frequent reported obstacles by Afghan women. In addition, personnel behavior, transportation issues, stigma and discrimination, cultural concerns, legal and immigration issues were also mentioned as the source of disappointment and inadequate utilization of such services.Conclusions: The findings of present study emphasize the necessity of available and most importantly, affordable prenatal care for Afghan women in Iran. Providing an affordable health insurance with adequate coverage of prenatal and delivery services, could reduce the financial burden, facilitate the access, and ensure the maternal and child health in this vulnerable population. The issues of fear and concern of deportation must be removed for at least illegal Afghan mothers to ensure their access to maternity care and improve the health of both mother and offspring.

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Use of an Emergency Department in Saint-Laurent du Maroni, French Guiana: Does Being Undocumented Make a Difference?

Cited by 13 publications

References 20 publications

Renouncing care in French Guiana: the national health barometer survey

Renouncing care in French Guiana: the national health barometer survey

Prehospital Emergencies in Illegal Gold Mining Sites in French Guiana

“It is good, but I can’t afford it…” potential barriers to adequate prenatal care among Afghan women in Iran: a qualitative study in south Tehran

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