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Table 2 FARC Healthcare Barrier Categories identified by ETCR healthcare providers and FARC health promoters

From: Healthcare access barriers for FARC ex-combatants in Colombia: qualitative perspectives from healthcare providers and FARC health promoters

Barriers

n

%

Healthcare Needs

 Increased Incidence and complication of disease and trauma

31

96.9%

 Increased Mental Health needs

28

87.5%

 Pregnancy cases, maternal and prenatal care

16

50.0%

Healthcare Desires

 Lack of knowledge of the Colombian health system

30

93.8%

 Transitioning from the FARC Health System

19

59.4%

 Lack of preventive medicine and public health

13

40.6%

 Preference for and ease of accessibility of traditional medicine

11

34.4%

 Patient non-adherence, tendency to skip brigades, appointments, or follow-up

8

25.0%

 Providers are unaccommodating, only motivated financially

2

6.3%

Healthcare Seeking

 Resource insufficiency in rural areas

31

96.9%

 Burdensome geographic distances between communities and nearest hospital

27

84.4%

 Economic barriers

21

65.6%

 No internet nor WiFi, and limited cell phone connectivity

11

34.4%

 Delayed or absent emergency health services

10

31.3%

 Transport barriers

9

28.1%

Healthcare Initiation

 Stigma

29

90.6%

 Health insurance (EPS) and healthcare initiation barriers

29

90.6%

 FARC are slow to trust healthcare providers for fear of mistreatment

17

53.1%

 Confusing bureaucratic processes, lacking information to understand how the healthcare system is constructed

15

46.9%

 Identification associated problems in healthcare initiation

14

43.8%

Healthcare Continuation

 Medical brigades provided to ETCRs and surrounding rural communities

22

68.8%

 FARC health promoters with valuable skills are not utilized as care providers

18

56.3%

 Community providers, ETCR leaders lack communication channels to share common obstacles or create institutional change

12

37.5%

 Wait-times on days of scheduled appointments

12

37.5%

 Lack of clear avenues for FARC and surrounding communities to self-advocate

8

25.0%

 EPS authorization delays cause some to not request them in the first place

7

21.9%

 Loss to follow-up for lack of health system knowledge (labs, diagnostic exams)

7

21.9%

 Migration of FARC community members and their families

6

18.8%

 Inopportune appointment scheduling, compounded by care seeking barriers

4

12.5%

 Non-adherence to medical treatment (taking medicines, vitamins, exercising)

2

6.3%

Other Barriers

 The social determinants of health

29

90.6%

 Breach of the Peace Agreement by the government

18

56.3%

 Education of forgiveness is required for reconciliation and ending cycles of violence

13

40.6%

 Interventions lack holistic health approaches and psychosocial dimensions

6

18.8%

 Research without interventions and uncoordinated care from universities and NGOs has created distrust of external groups among FARC

4

12.5%

  1. This table summarizes the major barriers to FARC healthcare access, categorized according to Frenk’s Domains of Healthcare Access. A full list of barriers with subheadings and frequencies can be found in Additional file 3. Abbreviations: ETCR Espacio Territorial de Capacitación y Reincorporación, ARN Agencia para la Reincorporación y Normalización, EPS Entidad Promotora de Salud, FARC Fuerzas Armadas Revolucionarias de Colombia