Migration, gender and health system responses in South Africa: A focus on the movement of healthcare users and workers

该项目将审查移徙和人口流动如何影响南非卫生系统，卫生系统如何因移徙和人口流动而作出反应和适应，最重要的是，性别问题如何与这些进程相结合。它将采取交叉研究的方法。研究将在南非进行，南非历史上一直面临着高水平的移民-无论是向内移民，还是向外移民，以及国内移民。这项研究的重点是病人和卫生工作者进出南非的流动性以及与公共卫生系统的互动。它将涉及一系列创新的定性和定量研究方法的应用。具体地说，研究将涉及：a)医疗保健用户和工人在南非境内、进出和离开的移民水平；b)移徙、非移徙和流动医疗保健用户以及移徙和非移徙卫生工作者的医疗保健经历；以及c)南非卫生系统如何应对这些用户和/或工人的流动。鉴于人们越来越多地认识到移徙的性别性质和影响，该研究明确探讨了性别以及性别如何影响上述经历。我们将就南非和其他地方的卫生系统如何改善对移民和人口流动的反应提出建议，包括性别方面的建议。其中将包括一种使用社交媒体(WhatsApp)跟踪患者随时间推移的创新方法，该方法将生成有关患者进出南非的流动如何与其卫生系统使用情况互动的新数据。同时，对病人和卫生工作者进出南非的现有数据集进行了新的量化分析。具体而言，这一定量分析包括对南非旅游局边境调查的分析，以及对病人流动情况的首次分析，因为这是南非政府与11个邻国之间的双边协定所规定的。

This project will examine how migration and population mobility affect the South African health system, how the health system responds and adapts as a result of migration and population mobility, and crucially, how gender intersects with these processes. It will adopt an intersectionality approach.The research will be undertaken in South Africa, a country that has historically faced high levels of migration - both inward, outward, and internal. The research focuses on mobility of patients and health workers into and out of South Africa and interactions with the public health system. It will involve the application of a range of innovative qualitative and quantitative research methods.Specifically, the research will involve examining: a) levels of migration of healthcare users and workers within, into, and out of South Africa; b) healthcare experiences of migrant, non-migrant and mobile healthcare users, and migrant and non-migrant health workers; and c) how the South African health system responds to these user and/or worker movements. Given the increasing recognition of the gendered nature and effects of migration, the research explicitly explores gender and how gender shapes the above experiences. We will develop recommendations for how the health system in South Africa, and elsewhere, could improve responses to migration and population mobility including gendered aspects.It will include an innovative method of tracking patient movement over time using social media (WhatsApp), which will generate new data on how movement by patients into and out of South Africa interacts with their health systems use. This is paired with a new quantitative analysis of existing data sets on movement of patients and health workers into and out of South Africa. Specifically, this quantitative analysis includes analysis of the Tourism South Africa border survey, and the first ever analysis of patient mobility as it is regulated under the bilateral agreements between the South African government and 11 neighbouring countries.