Determinants of uptake of hepatitis B testing and healthcare access by migrant Chinese in the England: a qualitative study

BMC Public Health

Research Article

Alicia Vedio¹  Jason Horsley²  Andrew Chee Keng Lee³  Amrita Jesurasa³  Eva Zhi Hong Liu³  Sarah Salway³ 

[1] Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK;Public Health Department, Sheffield City Council, Sheffield, UK;Section of Public Health, the School of Health and Related Research, The University of Sheffield, Regent Court, Regent Street, S1 4DA, Sheffield, UK;

关键词: Hepatitis B;    Chinese;    Migrants;    Healthcare access;    Ethnicity;   

DOI  :  10.1186/s12889-017-4796-4

 received in 2016-10-28, accepted in 2017-09-21,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundGlobal migration from hepatitis B endemic countries poses a significant public health challenge in receiving low-prevalence countries. In the UK, Chinese migrants are a high risk group for hepatitis B. However, they are an underserved population that infrequently accesses healthcare. This study sought to increase understanding of the determinants of hepatitis B testing and healthcare access among migrants of Chinese ethnicity living in England.MethodsWe sought to obtain and integrate insights from different key stakeholders in the system. We conducted six focus group discussions and 20 in-depth interviews with community members and patients identifying themselves as ‘Chinese’, and interviewed 21 clinicians and nine health service commissioners. Data were thematically analysed and findings were corroborated through two validation workshops.ResultsThree thematic categories emerged: knowledge and awareness, visibility of the disease, and health service issues. Low disease knowledge and awareness levels among community members contributed to erroneous personal risk perception and suboptimal engagement with services. Limited clinician knowledge led to missed opportunities to test and inaccurate assessments of infection risks in Chinese patients. There was little social discourse and considerable stigma linked to the disease among some sub-sections of the Chinese population. A lack of visibility of the issue and the population within the health system meant that these health needs were not prioritised by clinicians or commissioners. Service accessibility was also affected by the lack of language support. Greater use of community outreach, consultation aids, ‘cultural competency’ training, and locally adapted testing protocols may help.ConclusionsHepatitis B among migrants of Chinese ethnicity in England can be characterised as an invisible disease in an invisible population. Multi-modal solutions are needed to tackle barriers within this population and the health system.

【 授权许可】

CC BY   
© The Author(s). 2017