Access to, and experiences of, healthcare services by trafficked people: findings from a mixed-methods study in England.
BACKGROUND
Physical and psychological morbidity is high in trafficked people but little is known about their experiences of accessing and using healthcare services while, or after, being trafficked.


OBJECTIVE
To explore trafficked people's access to, and use of, health care during and after trafficking.


METHODS
A mixed-methods study - a cross-sectional survey comprising a structured interview schedule and open-ended questions - was undertaken in trafficked people's accommodation or support service offices across England.


METHODS
Participants were asked open-ended questions regarding their use of healthcare services during and after trafficking. Interviews were conducted with professionally qualified interpreters where required. Thematic analysis was used to analyse the data.


RESULTS
In total, 136 trafficked people (from 160 contacted) participated in the open-ended interviews of whom 91 (67%) were female and 45 (33%) male. Participants reported being trafficked for domestic servitude (n = 40; 29%), sexual exploitation (n = 41; 30%), and labour exploitation (for example, agriculture or factory work) (n = 52; 38%). Many responders reported that traffickers restricted access to services, accompanied them, or interpreted for them during consultations. Requirements to present identity documents to register for care, along with poor access to interpreters, were barriers to care during and after trafficking. Advocacy and assistance from support workers were critical to health service access for people who have been trafficked.


CONCLUSIONS
Trafficked people access health services during and after the time they are exploited, but encounter significant barriers. GPs and other practitioners would benefit from guidance on how these people can be supported to access care, especially if they lack official documentation.
University of Stirling, Stirling.
Joanne
J
Westwood
Institute of Psychiatry, King's College London, London.
Louise M
LM
Howard
School of Social Work, Care and Community, University of Central Lancashire, Preston.
Nicky
N
Stanley
London School of Hygiene and Tropical Medicine, London.
Cathy
C
Zimmerman
NHS Practitioner Health Programme, Riverside Medical Centre, London.
Clare
C
Gerada
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London.
Siân
S
Oram
D000293:Adolescent; D000328:Adult; D019548:Crime Victims; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D030881:Disclosure; D004739:England; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000706:statistics & numerical data; D045809:Human Rights Abuses; D064410:Human Trafficking; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010818:Practice Patterns, Physicians'; D055815:Young Adult
health services accessibility; immigration; minority groups; primary health care; qualitative; trafficking in human beings
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