Barriers to access, follow-up, and care within the healthcare system in the case of African migrant women requiring healthcare
Gynecological and obstetric healthcare for migrant women from the African continent
A mixed-methods research design will be employed, integrating quantitative and qualitative approaches. The quantitative approach will focus on the collection and analysis of numerical data to address the research hypotheses. To this end, objective, systematic, and rigorous procedures will be used. Data collection will be carried out through Bigan, the Big Data project of the Department of Health of the Government of Aragon, aimed at improving healthcare through the use of routinely generated data from the public healthcare system of Aragon. The variables to be analyzed will include age, nationality, referrals to different care areas, diagnoses, and treatments. In parallel, the qualitative approach will aim to understand the barriers experienced by migrant women within the healthcare system of Aragon, both in terms of access and throughout the different phases of the care process (first contact, consultation development, follow-up, and completion of the intervention) in the fields of Obstetrics and Gynecology, including care provided by midwives. Interviews will be conducted with migrant women and Spanish women in order to identify barriers to accessing and using the healthcare system, as well as to analyze the extent to which these barriers are shared by both groups. In addition, the perspectives of healthcare professionals (medicine and nursing), healthcare administrative staff, and third-sector professionals with experience in supporting migrant women will be included. The qualitative analysis process will be iterative and will include the transcription of the interviews and their subsequent coding. Categories and subcategories will be developed through the identification of higher-level conceptual themes and subthemes. The analysis will follow the phases of open, axial, and selective coding characteristic of grounded theory. For this purpose, NVivo software (demo version) will be used. The principal investigator will follow the COREQ (Consolidated Criteria for Re
Group 1: Healthcare professionals: Specialist nurses in Obstetric and Gynecological nursing (midwives) and primary care nurses, as well as physicians specializing in Obstetrics and Gynecology, primary care, and emergency services. All participants must have a minimum of one year of professional experience in the field. In the case of retired individuals, their retirement must not exceed two years Group 2: Administrative staff within the healthcare system: Administrative professionals working in primary care, emergency services, and specialized units (such as mammography units), who have direct contact with users in tasks related to registration within the healthcare system and the management, assignment, and modification of appointments. All participants must have a minimum of one year of professional experience in the field. In the case of retired individuals, their retirement must not exceed two years Group 3: Third-sector professionals: Professionals from the third sector (social workers from social services, the healthcare system, or private organizations). All participants must have a minimum of one year of professional experience in the field. In the case of retired individuals, they must not have been retired for more than two years. In addition, their professional experience must be linked to care for migrant women, including support functions in accessing medical services Group 4: African women: African women who have had contact with the healthcare system in Aragon regarding matters related to their gynecological health Group 5: Spanish women: Spanish women with experience of contact with the healthcare system in Aragon on issues related to their gynecological health
The exclusion criteria included professionals without direct experience or whose contribution was not relevant to the objectives of the study, as well as individuals with cognitive or sensory factors that prevent them from completing the interview. Likewise, individuals who have not submitted and signed the informed consent will be excluded.