FEATURES OF PROVIDING PRIMARY HEALTH CARE TO FOREIGN WORKERS IN RURAL AREAS: BARRIERS AND WAYS TO OVERCOME THEM

The article is devoted to the study of barriers to access to primary health care for foreign workers living in rural areas of the Russian Federation, as well as the development of recommendations for overcoming them. The relevance of the work is due to the intensive migration influx into the country, part of which falls on rural areas, where access to health services is complicated by infrastructural, cultural and legal factors. The purpose of the study was to assess the availability of health care for foreign workers, identify key barriers (legal, financial, cultural) and social determinants of health. During a cross-sectional study (July-October 2024) in the Moscow Region, a survey was conducted among 36 foreign workers and 41 native residents employed in manufacturing, agriculture and trade. The questionnaire covered working conditions, access to insurance, language barriers, morbidity, mental health (PHQ-9, GAD-7 questionnaires) and satisfaction with health services. The results revealed significant differences between the groups: only 8% of foreign workers had compulsory medical insurance (versus 100% of local residents), 80% of respondents noted language and cultural barriers, 75% did not know about the right to free emergency care. The working and living conditions of foreign workers (58% unsatisfactory conditions, 10+ hours of work per day) contributed to the high prevalence of chronic diseases (arterial hypertension - 64%, diabetes - 61%) and mental disorders (depression - 44%, anxiety - 33%). Based on the data, measures were proposed to facilitate foreign workers’ access to medical care: the introduction of mobile medical teams with the participation of cultural mediators, training health workers in intercultural communication, and the creation of multilingual information resources. The need to strengthen preventive work and cooperation with NGOs to overcome social isolation and improve access to services is emphasized. The study contributes to the development of strategies for adapting the healthcare system to the needs of vulnerable groups in rural areas.