ArticleGlobal health action2024
Contested and nervous spaces: exploring the environment of healthcare provision for international migrants in the Gauteng province of South Africa.
Article in Global health action, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- "Closing the gap in the wrong direction" migration, health policy, and the exclusion of asylum seekers, refugees and undocumented migrants from healthcare access in South Africa.BMC public health · 2025Article
- "Where will we find them?" They are just like droppings : Perceptions of health care workers regarding access to health promotion among urban migrants in Botswana.BMC health services research · 2025Article
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Authors and funding
2 authors.
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Abstract
backgroundNotwithstanding the global goal of inclusive universal health coverage, and the notion of migrant-sensitive health systems, limited healthcare access or the exclusion of migrants from national health systems persists. South Africa has a rights-based constitution, but there is an inability or a failure of the health system to recognise and address the health needs of migrants.
objectiveTo explore the intersection of the environment of healthcare provision for migrants and the everyday practices and behaviours of health workers and patients in the Gauteng province of South Africa.
methodsThe conceptual frameworks of health system responsiveness and social exclusion informed this institutional ethnographic study at 13 healthcare facilities in Gauteng province. We developed an observation guide to explore the intersection of culture and environment and its influence on healthcare provision to patients, especially migrants. Following ethics approval, we observed the facilities for 234 person-days. We used thematic analysis to analyse the data.
resultsBusy, frantic or nervous spaces, and contestations between patients and health workers, and among health workers formed part of the social and cultural environment of healthcare provision. The presence of migrant patients during busy periods served as a detonator for rude or discriminatory remarks, exacerbated by staff shortages and language barriers. Simultaneously, migrants exercised their agency by rebutting or confronting rude health workers. We also observed encouraging examples of kindness, caring and professionalism of health workers.
conclusionThe study has implications for achieving a migrant-sensitive health system in South Africa.
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