Browsing by Author "Macaya, Gustavo"
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Publication Barreras para la utilización de servicios de Atención Primaria de Salud en personas migrantes internacionales(2023) Cabieses, Báltica; Cruz, Consuelo; Macaya, Gustavo; Urzúa, AlfonsoObjetivo: analizar las barreras que enfrentan las personas migrantes internacionales al utilizar los servicios de Atención Primaria de salud en la comuna de Antofagasta, Chile. Método: diseño de investigación cualitativa bajo un enfoque interpretativo fenomenológico-descriptivo. Se utilizó un muestreo por conveniencia y por bola de nieve hasta la saturación del discurso. La muestra se conformó por 42 personas mayores de 18 años (personal funcionario y personas migrantes). Se realizaron entrevistas individuales y grupales semiestructuradas. Para el análisis de los datos se llevó a cabo un análisis reflexivo temático, con codificación abierta para la posterior construcción de categorías. Como criterios de calidad se utilizó la triangulación, la confirmabilidad y la reflexividad. Resultados: desde el personal funcionario de salud se identificaron dimensiones como la aceptabilidad del otro, el idioma y la alteridad racializadora. Desde las personas migrantes internacionales se destacó el idioma, el trato discriminatorio y las dificultades en el acceso relacionadas con los procedimientos administrativos para afiliarse al seguro público de salud. Además, se identificaron barreras en las interacciones diarias entre los equipos de salud y las personas migrantes, en las cuales las interpretaciones mutuas de las acciones desempeñan un papel importante. Conclusiones: las barreras existentes en la utilización de los servicios de la Atención Primaria de Salud presentan componentes del sistema asociado a políticas y normativas que en las prácticas se relaciona a un segundo componente, el individual, en donde el personal funcionario y las personas migrantes estarían plasmados en las interacciones cotidianas durante el proceso de atención. Objective: to analyse the barriers faced by international migrants when using Primary Care services in the commune of Antofagasta, Chile. Method: a qualitative research design with an interpretative phenomenological-descriptive approach. Convenience andsnowball sampling was used until the saturation point was reached. The sample was formed by 42 >18-year-old persons (civil servants and migrants). Semi-structured individual and group interviews were conducted. Reflexive-thematic analysis was used for data analysis, with open coding for subsequent category building. The quality criteria used were triangulation, confirmability and reflectivity. Results: the dimensions identified by the health civil servants were: acceptability of the other, language, and racialization otherness. The international migrants highlighted language, discriminatory treatment, and difficulties for access associated with administrative procedures to enrol in the public health system. Moreover, barriers were detected in the daily interactions between health services and migrants, where mutual interpretations of actions played a major role. Conclusions: the current barriers for the use of Primary Care services presented system components associated with policies and rules which in practice are associated with a second component, the individual one, which would be reflected in the daily interactions by civil servants and migrants during the process of care.Item How Do Health Teams Perceive International Migrant Users of Primary Care?(2022) Cruz, Consuelo; Urzúa, Alfonso; Macaya, Gustavo; Cabieses, BálticaThe following study aims to describe the perception of international migrants who use the primary level of care by health personnel and to explore how this perception can affect the care process in the commune of Antofagasta, north of Chile. Methodology: The methodology was qualitative using a phenomenological descriptive design, through which the discourses of the health personnel of three primary health care centers (n = 14) were explored. Results: The participants presented two thematic categories. The first one related to experiences during delivery of care to migrants and included perceptions and beliefs, factors associated with using services, and reasons for consultation. The second category related to stereotypes towards migrants, including prejudices, beliefs about their lives and reasons for migration. Conclusions: The therapeutic relationship with migrants in primary care depends on the health care personnel's acceptability of this population, hence, allowing the delivery of care based on respect for their culture and rights.Item Meanings and Practices in Intercultural Health for International Migrants(2022) Cruz, Consuelo; Urzúa, Alfonso; Macaya, Gustavo; Cabieses, BálticaAbstract: In this article, meanings and practices in intercultural health for international migrants in health establishments are described from the perspective of health personnel in the city of Antofagasta in northern Chile. Methodology: The methodology was qualitative with a phenomenological descriptive design, through which discourses from health personnel in the public primary and secondary care system were explored (n = 23). Next, meanings and practices in intercultural health for international migrants in health establishments are described from the perspective of health personnel in the northern Chilean city of Antofagasta. Results: The participants presented trees of thematic categories. There were three thematic categories overall: The meaning of interculturality included features of understanding of the concept, with respect for culture being the transversal axis in all discourses. Practices in health care, where voluntariness, references, and the adequacy or non-technicality of the language are fundamental axes. Training in the intercultural approach, where there is often self-knowledge and lack of supply in the health system. Conclusions: The findings show essential elements to consider in the care of international migrants, including the training and awareness of staff about the intercultural approach through strategies following the local reality in which each health establishment exists.