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Lived Experience of Afghan Refugees in Iran Concerning Primary Health Care Delivery

Published online by Cambridge University Press:  10 June 2019

Nemat Azizi
Affiliation:
Iran University of Medical Sciences, School of Health Management and Information Sciences, Tehran, Iran
Bahram Delgoshaei*
Affiliation:
Department of Health Sciences Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
Aidin Aryankhesal
Affiliation:
Department of Health Sciences Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
*
Correspondence and reprint requests to Bahram Delgoshaei, School of Health Management and Information Sciences, Rashid Yasemi St., Vali-e Asr Ave., Tehran, Iran (e-mail: Bdelgoshaei@yahoo.com).

Abstract

Objective:

Access to primary health care (PHC) is very important for refugees. The aim of this study was to illuminate lived experience of Afghan refugees in Iran regarding PHC delivery.

Methods:

This qualitative study was conducted in 2016–2017 by using the content analysis technique. Data were collected through individual deep interviews with Afghan refugees who lived in Iran. The data were analyzed by using a method by Graneheim and Lundman.

Results:

Four main categories and 12 subcategories were emerged, including (1) challenges before PHC delivery: large number of children, high service cost, not having medical insurance, access to health centers, appointment to get services, simultaneity of breastfeeding, and pregnancy; (2) challenges during PHC delivery: understanding Iranian words, health care provider’s behavior, delay in getting service in PHC centers; (3) challenges after delivery PHC: referral patient, high costs of paraclinics; and (4) free and good services.

Conclusion:

Our results showed that Afghan refugees have several challenges in every stage of PHC delivery. Awareness of such problems can help medical personnel improve delivery of service to Afghan refugees, as well as using trained Afghani nurses to serve the refugees.

Type
Original Research
Copyright
Copyright © 2019 Society for Disaster Medicine and Public Health, Inc. 

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References

REFERENCES

Otoukesh, S, Mojtahedzadeh, M, Figlin, RA, et al. Literature review and profile of cancer diseases among Afghan refugees in Iran: referrals in six years of displacement. Med Sci Monit. 2015;21:36223628.CrossRefGoogle ScholarPubMed
Eckstein, B. Primary care for refugees. Am Fam Physician. 2011;83(4):429436.Google ScholarPubMed
Adam, B. Treating refugees from Syria and beyond: a moral and professional responsibility. J Am Acad Child Adolesc Psychiatry. 2017;56(10):803.CrossRefGoogle ScholarPubMed
Ashrafi, A, Moghissi, H. Afghans in Iran: asylum fatigue overshadows Islamic Brotherhood. Global Dialogue. 2002;4(4):89.Google Scholar
Otoukesh, S, Mojtahedzadeh, M, Cooper, CJ, et al. Lessons from the profile of kidney diseases among Afghan refugees. Med Sci Monit. 2014;20:1621.Google ScholarPubMed
Zarghani, H, Gholami, U, Ghanbari, M, et al. An analysis of the spatial distribution of Afghan refugees in Khorasan Razavi province during the years 2003–2013. J Manage Sys. 2017;7(27):127146.Google Scholar
Joshi, C, Russell, G, Cheng, I-H, et al. A narrative synthesis of the impact of primary health care delivery models for refugees in resettlement countries on access, quality and coordination. Int J Equity Health. 2013;12(1):88.CrossRefGoogle ScholarPubMed
Harris, MF, Telfer, BL. The health needs of asylum seekers living in the community. Med J Aust. 2001;175(11–12):589592.CrossRefGoogle ScholarPubMed
Rakhshani, F, Moghadam, AA, Hor, A. Knowledge, attitude and practice of Afghan refugee women residing in Zahedan about family planning. J Reprod Infertil. 2002;3(4):4754.Google Scholar
Refugees UNHCR. Global appeal South-West Asia. Report. Published December 2014. https://reliefweb.int/report/afghanistan/unhcr-global-appeal-2015-update-south-west-asia-subregional-overview. Accessed April 10, 2018.Google Scholar
Pottie, K, Batista, R, Mayhew, M, et al. Improving delivery of primary care for vulnerable migrants: Delphi consensus to prioritize innovative practice strategies. Can Fam Physician. 2014;60(1):e32e40.Google ScholarPubMed
Malterud, K. Qualitative research: standards, challenges, and guidelines. Lancet. 2001;358(9280):483488.CrossRefGoogle ScholarPubMed
Elo, S, Kyngäs, H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107115.CrossRefGoogle ScholarPubMed
Graneheim, UH, Lundman, B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today.2004;24(2):105112.CrossRefGoogle ScholarPubMed
Iranmanesh, S, Banazadeh, M, Forozy, MA. The relationship between nurses’ perception of barriers magnitude and their demographic characteristics. Imanagers J Nurs. 2015;5(1):1122.Google Scholar
Mehrdad, R. Health system in Iran. JMAJ. 2009;52(1):6973.Google Scholar
Barzegar, MA, Djazayery, A. Evaluation of rural primary health care services in Iran: report on vital statistics in West Azarbaijan. Am J Public Health. 1981;71(7):739742.CrossRefGoogle ScholarPubMed
Couper, I. Medicine in Iran: a brief overview: open forum. S Afr Fam Pract. 2004;46(5):57.Google Scholar
Hami, M, Taghavi Jelodar, M. Effect of economic growth on total fertility rate in Iran (1984–2013). IJOGI. 2016;19(14):2028.Google Scholar
Carvalho, N, Goldie, S, Salehi, AS. The value of family planning for improving maternal health in rural Afghanistan. Afghan J Public Health. 2017;1(1):12–19.Google Scholar
Center, IS. Iran statistical yearbook of 2011. Tehran, Iran: Statistical Center of Iran; 2011.Google Scholar
Sohrabi, M-R, Albalushi, RM. Clients’ satisfaction with primary health care in Tehran: a cross-sectional study on Iranian health centers. J Res Med Sci. 2011;16(6):756.Google ScholarPubMed
Motamedi, MHK, Saghafinia, M, Bafarani, AH, Panahi, F. A reassessment and review of the Bam earthquake five years onward: what was done wrong? Prehosp Disaster Med. 2009;24(05):453460.CrossRefGoogle ScholarPubMed
Polit, DF, Beck, CT. Nursing research: principles and methods. Philadelphia: Lippincott Williams & Wilkins; 2004.Google Scholar
Streubert Speziale, H, Carpenter, D. Qualitative research in nursing. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2007.Google Scholar
Tober, DM, Taghdisi, MH, Jalali, M. “Fewer children, better life” or “As many as God wants”? Med Anthropol Q. 2006;20(1):5071.CrossRefGoogle ScholarPubMed
Rakhshani, F, Ansari Moghadam, A, Hor, A. Knowledge, attitudes and behavior of Afghan refugee women residing in Zahedan City regarding family planning. J Reprod Infertil. 2002;3(4):4754.Google Scholar
Keasley, J, Blickwedel, J, Quenby, S. Adverse effects of exposure to armed conflict on pregnancy: a systematic review. BMJ Global Health. 2017;2(4):e000377.CrossRefGoogle ScholarPubMed
Poureslami, IM, MacLean, DR, Spiegel, J, Yassi, A. Sociocultural, environmental, and health challenges facing women and children living near the borders between Afghanistan, Iran, and Pakistan (AIP region). MedGenMed. 2004;6(3):2033.Google Scholar
Mohammadi, A. To live on the margins: a closer look at the social and economic situation of illegal Afghan migrants in Iran. World Acad Sci Eng Technol Int J Human Soc Sci. 2015;2(7):322341.Google Scholar
Divkolaye, NSH, Burkle, FM Jr. The enduring health challenges of Afghan immigrants and refugees in Iran: a systematic review. PLoS Curr. 2011;9. doi: 10.1371/currents.dis.449b4c549951e359363a90a7f4cf8fc4.CrossRefGoogle Scholar
Krause, J, ed. Afghan languages (Dari and Pashto) as a source of unity rather than division. Conference on Central Asian Languages and Linguistics. Pennsylvania State University: CiteSeer; 2014:154.Google Scholar
Lebrun-Harris, LA, Baggett, TP, Jenkins, DM, et al. Health status and health care experiences among homeless patients in federally supported health centers: findings from the 2009 patient survey. Health Serv Res. 2013;48(3):9921017.CrossRefGoogle ScholarPubMed
Prentice, JC, Pizer, SD. Delayed access to health care and mortality. Health Serv Res. 2007;42(2):644662.CrossRefGoogle ScholarPubMed