RESUMO
Objetivo: Evaluar los determinantes en la financiación del acceso a la atención médica y el papel de una clase particular de financiación informal propia, denminada tontina, para el acceso a la atención médica en la población de migrantes de origen senegalés. Método: Los datos fueron recogidos mediante técnicas cualitativas, entrevistas semiestructuradas (n = 14) y grupo de discusión (n = 10) en una población de migrantes senegaleses residentes en Granada, entre octubre y noviembre de 2019. Los participantes clave provenían de una tontina. Resultados: La falta de trabajo o de recursos económicos, así como la condición de migrante indocumentado, constituyen barreras para la adhesión a los seguros de salud públicos y privados. Asimismo, los participantes consideran que la asistencia sanitaria pública no tiene en cuenta la importancia que puede tener para ellos seguir un tratamiento cerca de sus familiares o tener la alternativa de las medicinas tradicionales. La tontina permite proteger a las personas más vulnerables, como las indocumentadas, y financiar las prácticas de importancia cultural para las personas migrantes senegalesas. Conclusiones: Este estudio es el primero en proporcionar una comprensión de un mecanismo de financiación propio de un colectivo de migrantes bastante desconocido por la sociedad española. Las tontinas continúan una larga tradición en la que las comunidades desfavorecidas y vulnerables resisten múltiples fuentes de discriminación y desigualdad mediante la autoayuda, la confianza y la solidaridad. (AU)
Objective: To evaluate the determinants of healthcare access financing and the role of a particular class of informal financing known as tontine, a community-based health insurance among Senegalese immigrants. Method: Data were retrieved through qualitative techniques, semi-structured interviews (n = 14) and discussion group (n = 10) in a population of Senegalese migrants residing in Granada between October and November 2019. Key participants were from a tontine. Results: The lack of work or economic resources, as well as the condition of undocumented immigrant constitute barriers to adherence to public and private health insurance. Participants consider that public health care does not take into account the importance of following treatment close to their relatives in their country of origin or having the alternative of traditional medicines. The tontine helps to protect the most vulnerable people such as undocumented immigrants and allows financing services of cultural importance. Conclusions: This study was the first to provide an understanding of a financing mechanism typical of an immigrant community quite unknown to Spanish society. Tontines continue a long tradition whereby disadvantaged and vulnerable communities resist multiple sources of discrimination and inequality by self-help, trust and solidarity. (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Acessibilidade aos Serviços de Saúde , Seguro Saúde , Imigrantes Indocumentados , Entrevistas como Assunto , Senegal , Populações VulneráveisRESUMO
OBJECTIVE: To evaluate the determinants of healthcare access financing and the role of a particular class of informal financing known as tontine, a community-based health insurance among Senegalese immigrants. METHOD: Data were retrieved through qualitative techniques, semi-structured interviews (n=14) and discussion group (n=10) in a population of Senegalese migrants residing in Granada between October and November 2019. Key participants were from a tontine. RESULTS: The lack of work or economic resources, as well as the condition of undocumented immigrant constitute barriers to adherence to public and private health insurance. Participants consider that public health care does not take into account the importance of following treatment close to their relatives in their country of origin or having the alternative of traditional medicines. The tontine helps to protect the most vulnerable people such as undocumented immigrants and allows financing services of cultural importance. CONCLUSIONS: This study was the first to provide an understanding of a financing mechanism typical of an immigrant community quite unknown to Spanish society. Tontines continue a long tradition whereby disadvantaged and vulnerable communities resist multiple sources of discrimination and inequality by self-help, trust and solidarity.
