Place, displacement, and health-seeking behaviour among the Ugandan Batwa: A qualitative study.

Autor:	Brubacher LJ; Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada., Berrang-Ford L; School of Earth and Environment, University of Leeds, Leeds, United Kingdom., Clark SN; Environmental and Social Epidemiology Section, Population Health Research Institute, St. George's, University of London, London, United Kingdom., Patterson K; Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada., Lwasa S; Department of Geography, Makerere University, Kampala, Uganda., Namanya D; Ugandan Ministry of Health, Kampala, Uganda.; Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda., Twesigomwe S; Batwa Development Program, The Kellermann Foundation, Kanungu District, Uganda., Harper SL; Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada.; School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2024 Jun 12; Vol. 4 (6), pp. e0003321. Date of Electronic Publication: 2024 Jun 12 (Print Publication: 2024).
DOI:	10.1371/journal.pgph.0003321
Abstrakt:	For many Indigenous Peoples, relationships to the land are inherent in identity and culture, and to all facets of health and wellbeing, physically, emotionally, psychologically, and spiritually. The Batwa are Indigenous Peoples of rural, southwest Uganda who have experienced tremendous social and economic upheaval, due to relatively recent forced displacement and land dispossession. This loss of physical connection to their ancestral lands has significantly impacted Batwa health, and also affected available healthcare options for Batwa. This exploratory study (1) identified and characterized factors that influence Batwa health-seeking behaviour, using acute gastrointestinal illness, a critical public health issue, as a focal point for analysis; and (2) explored possible intersections between the Batwa's connection to place-and displacement-and their health-seeking behaviour for acute gastrointestinal illness. Twenty focus group discussions, stratified by gender, were conducted in ten Batwa settlements in Kanungu District, Uganda and eleven semi-structured interviews were conducted with primary healthcare workers, community health coordinators, clinical officers, and development program coordinators. Qualitative data were thematically analyzed using a constant comparative method. Batwa identified several significant motivators to engage with Indigenous and/or biomedical forms of healthcare, including transition to life outside the forest and their reflections on health in the forest; 'intellectual access' to care and generational knowledge-sharing on the use of Indigenous medicines; and Batwa identity and way of life. These nuanced explanations for health-seeking behaviour underscore the significance of place-and displacement-to Batwa health and wellbeing, and its relationship to their health-seeking behaviour for acute gastrointestinal illness. As such, the results of this study can be used to inform healthcare practice and policy and support the development of a culturally- and contextually-appropriate healthcare system, as well as to reduce the burden of acute gastrointestinal illness among Batwa. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2024 Brubacher et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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