Structural barriers to treatment for pregnant Coloured women abusing TIK in Cape Town: The experiences of healthcare providers

[摘要] ENGLISH SUMMARY: Despite interventions that aim to address the barriers to healthcare treatment for pregnant Coloured women abusing TIK in Cape Town, the rate of accessing substance abuse treatment and maternal care amongst this population remains dismally low. Recent literature has given attention to highlighting the structural barriers to treatment as experienced from the perspective of pregnant Coloured women; however, little, if any, research has been conducted on these barriers from the healthcare providers' perspective. The present study thus aimed to identify the structural treatment barriers experienced by healthcare providers who treat pregnant Coloured women who abuse TIK. An exploratory qualitative design was utilised whereby 20 healthcare providers were identified through purposive sampling and subsequently interviewed. All participants are involved in the treatment of pregnant Coloured women who abuse TIK. Semi-structured interviews allowed for the documentation of healthcare providers' experiences of the barriers that they encounter when treating Coloured pregnant women who abuse TIK. Thematic analysis was applied in order to generate and analyse themes that emerged from the data collected during the semistructured interviews.Various barriers were identified and were categorised as: overburdened and underresourced healthcare providers, the effect of the work place on healthcare providers' home life, challenges with referral, factors hindering treatment that are outside the healthcare providers' control, miscommunication, and lack of funding.Bronfenbrenner's(1979) Ecological Systems Theory was used to conceptualise each theme on the five levels that constitute his theory. Each theme was discussed as a micro-, meso-, exo- or macro-system level barrier and was linked to current literature on healthcare providers' experiences of barriers to treatment. Although barriers found within the present study are consistent with the barriers found in current literature, novel barriers found within the healthcare referral system have posed as a significant problem specifically regarding the treatment of pregnant Coloured women abusing TIK.Despite the incorporation of substance abuse treatment into various outpatient and primary healthcare facilities in Cape Town, which was aimed at addressing the fragmentation of substance abuse treatment and maternal services, a gap in this system for pregnant Coloured women abusing TIK endures. As Coloured pregnant women that abuse TIK are classified as high risk, outpatient and healthcare providers employed at primary healthcare facilities cannot provide treatment for these women. Healthcare providers are thus forced to refer pregnant Coloured women that abuse TIK to facilities that are equipped to treat high risk patients, such as hospitals, midwife obstetric units and day clinics. Since substance abuse treatment has not been integrated within these facilities, the problem of fragmented services has persisted for Coloured pregnant women that abuse TIK. There is thus a need to investigate how these structural barriers can be addressed in order to make possible access to effective treatment for Coloured pregnant women abusing TIK in Cape Town.Key Words: methamphetamine, tik, pregnancy, Coloured, structural barriers, healthcare

[发布机构] Stellenbosch University