| アブストラクト | BACKGROUND: Evidence on the sexual and reproductive health and rights (SRHR) of migrants is lacking globally. We describe SRHR healthcare resource use and long-acting reversible contraceptives (LARCs) prescriptions for migrant versus non-migrant women attending primary care in England (2009-2018). METHODS: This population-based observational cohort study, using Clinical Practice Research Datalink (CPRD) GOLD, included females living in England aged 15 to 49. Migration was defined using a validated codelist. Rates per 100 person years at risk (pyar) and adjusted rate ratios (RRs) were measured in migrants versus non-migrants for consultations related to all-causes, six exemplar SRHR outcomes, and LARC prescriptions. Proportions of migrants and non-migrants ever prescribed LARC were calculated. FINDINGS: There were 25,112,116 consultations across 1,246,353 eligible individuals. 98,214 (7.9 %) individuals were migrants. All-cause consultation rates were lower in migrants versus non-migrants (509 vs 583/100pyar;RR 0.9;95 %CI 0.9-0.9), as were consultations rates for emergency contraception (RR 0.7;95 %CI 0.7-0.7) and cervical screening (RR 0.96;95 %CI 0.95-0.97). Higher rates of consultations were found in migrants for abortion (RR 1.2;95 %CI 1.1-1.2) and management of fertility problems (RR 1.39;95 %CI 1.08-1.79). No significant difference was observed for chlamydia testing and domestic violence. Of 1,205,258 individuals eligible for contraception, the proportion of non-migrants ever prescribed LARC (12.2 %;135,047/1,107,894) was almost double that of migrants (6.91 %;6,728/97,364). Higher copper intrauterine devices prescription rates were found in migrants (RR 1.53;95 %CI 1.45-1.61), whilst hormonal LARC rates were lower for migrants: levonorgestrel intrauterine device (RR 0.63;95 %CI 0.60-0.66), subdermal implant (RR 0.72;95 %CI 0.69-0.75), and progesterone-only injection (RR 0.35;95 %CI 0.34-0.36). INTERPRETATION: Healthcare resource use differs between migrant and non-migrant women of reproductive age. Opportunities identified for tailored interventions include access to primary care, LARCs, emergency contraception and cervical screening. An inclusive approach to examining health needs is essential to actualise sexual and reproductive health as a human right. |
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| ジャーナル名 | Journal of migration and health |
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| Pubmed追加日 | 2024/2/8 |
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| 投稿者 | Pathak, Neha; Zhang, Claire X; Boukari, Yamina; Burns, Rachel; Menezes, Dee; Hugenholtz, Gregory; French, Rebecca S; Gonzalez-Izquierdo, Arturo; Mathur, Rohini; Denaxas, Spiros; Hayward, Andrew; Sonnenberg, Pam; Aldridge, Robert W |
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| 組織名 | Institute of Health Informatics, University College London, London, NW1 2DA, UK.;Institute for Global Health, University College London, London, WC1E 6JB, UK.;Guy's & St Thomas's NHS Foundation Trust, London, SE1 9RT, UK.;National Perinatal Epidemiology Unit, Nuffield Department of Population Health,;University of Oxford, OX3 7LF, UK.;Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine,;London, UK.;Institute of Applied Health Research, University of Birmingham, Birmingham, B15;2TT, UK.;Wolfson Institute of Population Health, Queen Mary University of London, London,;UK.;BHF Data Science Center, Health Data Research UK, London, NW1 2DA, UK.;Inclusion Health, UK Health Security Agency, London, UK.;Institute of Epidemiology and Healthcare, University College London, London, WC1E;7HB, UK.;Institute for Health Metrics and Evaluation, Seattle, WA, USA. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38327760/ |
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