Evidence map›Paper›PMID 33419406›Full record

ArticleBMC public health2021

Healthcare access barriers for FARC ex-combatants in Colombia: qualitative perspectives from healthcare providers and FARC health promoters.

Christopher W Reynolds, Leonar G Aguiar, Christian Arbelaez, Carlos Gómez Restrepo, Andres Patiño, Heidy Carranza, Lindsey Pileika, Andrés Duarte

Abstract read
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Article in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Christopher W ReynoldsUniversity of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA. chriswreynolds18@gmail.com.ORCID 0000-0001-6634-391X
Leonar G AguiarPontificia Universidad Javeriana, Hospital Universitario San Ignacio, Cra. 7 #No. 40 -62, Bogotá, Colombia.
Christian ArbelaezPontificia Universidad Javeriana, Hospital Universitario San Ignacio, Cra. 7 #No. 40 -62, Bogotá, Colombia.
Carlos Gómez RestrepoPontificia Universidad Javeriana, Hospital Universitario San Ignacio, Cra. 7 #No. 40 -62, Bogotá, Colombia.
Andres PatiñoEmory University School of Medicine, 550 Peachtree St. NE, Atlanta, GA, 30308, USA.
Heidy CarranzaPontificia Universidad Javeriana, Hospital Universitario San Ignacio, Cra. 7 #No. 40 -62, Bogotá, Colombia.
Lindsey PileikaWarren Alpert Medical School of Brown University, 222 Richmond St, Providence, RI, 02903, USA.
Andrés DuartePontificia Universidad Javeriana, Hospital Universitario San Ignacio, Cra. 7 #No. 40 -62, Bogotá, Colombia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFollowing the 2016 Peace Agreement with the Fuerzas Armadas Revolucionarias de Colombia (FARC), Colombia promised to reincorporate more than 13,000 guerrilla fighters into its healthcare system. Despite a subsidized healthcare insurance program and the establishment of 24 Espacios Territoriales de Capacitación y Reincorporación (ETCRs-Territorial Spaces for Training and Reintegration) to facilitate this transition, data has shown that FARC ex-combatants access care at disproportionately lower rates, and face barriers to healthcare services.

methodsSemi-structured interviews were conducted with FARC health promoters and healthcare providers working in ETCRs to determine healthcare access barriers for FARC ex-combatants. Analysis was completed with a qualitative team-based coding method and barriers were categorized according to Julio Frenk's Domains of Healthcare Access framework.

resultsAmong 32 participants, 25 were healthcare providers and 7 self-identified as FARC health promoters. The sample was majority female (71.9%) and worked with the FARC for an average of 12 months in hospital, health center, medical brigade, and ETCR settings. Our sample had experiences with FARC across 16 ETCRs in 13 Departments of Colombia. Participants identified a total of 141 healthcare access barriers affecting FARC ex-combatants, which affected healthcare needs, desires, seeking, initiation and continuation. Significant barriers were related to a lack of resources in rural areas, limited knowledge of the Colombian health system, the health insurance program, perceived stigma, and transition process from the FARC health system.

conclusionsFARC ex-combatants face significant healthcare access barriers, some of which are unique from other low-resource populations in Colombia. Potential solutions to these barriers included health insurance provider partnerships with health centers close to ETCRs, and training and contracting FARC health promoters to be primary healthcare providers in ETCRs. Future studies are needed to quantify the healthcare barriers affecting FARC ex-combatants, in order to implement targeted interventions to improve healthcare access.

Indexed as

Health PersonnelHealth Services AccessibilityCognitionColombiaFemaleHumansInsurance, HealthQualitative ResearchArmed conflictColombiaFARC ex-combatantGlobal healthHealthcare access barriersReintegration

Identifiers

PMID33419406
PMCPMC7792039

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.