scholarly journals Understanding hard-to-reach communities: local perspectives and experiences of trachoma control among the pastoralist Maasai in northern Tanzania

2020 ◽  
pp. 1-20
Author(s):  
Tara B. Mtuy ◽  
Kevin Bardosh ◽  
Jeremiah Ngondi ◽  
Upendo Mwingira ◽  
Janet Seeley ◽  
...  
Keyword(s):  
Health Care Services ◽  
Participant Observation ◽  
Post Partum ◽  
Human Movement ◽  
Ethnographic Study ◽  
Livestock Grazing ◽  
Seasonal Migration ◽  
Care Services ◽  
Lack Of Information ◽  
Effective Delivery

Abstract As progress to eliminate trachoma is made, addressing hard-to-reach communities becomes of greater significance. Areas in Tanzania, inhabited by the Maasai, remain endemic for trachoma. This study assessed the effectiveness of Mass Drug Administration (MDA) through an ethnographic study of trachoma amongst a Maasai community. The MDA experience in the context of the livelihoods of the Maasai in a changing political economy was explored using participant observation and household interviews. Factors influencing MDA effectiveness within five domains were analysed. 1) Terrain of intervention: Human movement hindered MDA, including seasonal migration, domestic chores, grazing and school. Encounters with wildlife were significant. 2) Socio-cultural factors and community agency: Norms around pregnancy led women to accept the drug but hide refusal to swallow the drug. Timing of Community Drug Distributor (CDD) visits conflicted with livestock grazing. Refusals occurred among the ilmurrani age group and older women. Mistrust significantly hindered uptake of drugs. 3) Strategies and motivation of drug distributors: Maa-speaking CDDs were critical to effective drug delivery. Maasai CDDs, whilst motivated, faced challenges of distances, encounters with wildlife and compensation. 4) Socio-materiality of technology: Decreases in side-effects over years have improved trust in the drug. Restrictions to swallowing drugs and/or water were relevant to post-partum women and the ilmurrani. 5) History and health governance: Whilst perceptions of the programme were positive, communities questioned government priorities for resources for hospitals, medicines, clean water and roads. They complained of a lack of information and involvement of community members in health care services. With elimination in sight, hard-to-reach communities are paramount as these are probably the last foci of infection. Effective delivery of MDA programmes in such communities requires a critical understanding of community experiences and responses that can inform tailored approaches to trachoma control. Application of a critical social science perspective should be embedded in planning and evaluation of all NTD programmes.

scholarly journals FIRST-CONTACT ACCESSIBILITY ATTRIBUTE IN PRIMARY HEALTH CARE SERVICES AND CARE PRACTICES: CONTRIBUTIONS TO ACADEMIC EDUCATION FOR NURSES

2016 ◽  
Vol 25 (3) ◽  
Author(s):  
Gabriela Fávero Alberti ◽  
Maria Denise Schimith ◽  
Maria de Lourdes Denardin Budó ◽  
Gabriela Leal Neves ◽  
Laís Fuzer Rosso
Keyword(s):  
Nursing Education ◽  
Health Care Services ◽  
Participant Observation ◽  
Family Health ◽  
Academic Education ◽  
Structured Interviews ◽  
Care Services ◽  
Primary Health Care Services ◽  
Care Practices ◽  
First Contact

ABSTRACT Case study that aimed to identify the care practices of nurses from a Family Health Unit related to the first-contact accessibility attribute and the contributions to academic nursing education. The data is an excerpt from a database, collected from February to July 2012. Semi-structured interviews were conducted with nurses, participant observation of the care practices took place and a document search was undertaken, analyzed according to the operation proposal. The first contact can be initiated by the demand of the user himself or staff meetings based on the cases shared by the community health agents. The nurses' behavior restricts user access and excludes the possibility of welcoming. Academic training should insert and integrate the students into different scenarios and knowledge; foster human understanding based on the opening to new sensibilities and unpredictability, besides instigating the authentic participation of the student in his learning process.

scholarly journals Efecto de la estigmatización del VIH/SIDA en usuarios de drogas intravenosas en el acceso a los servicios sanitarios según género

2010 ◽  
pp. 293
Author(s):  
Elizabeth Mora Torres ◽  
Yina Lizeth García López ◽  
Manuela García de la Hera ◽  
María del Carmen Davó
Keyword(s):  
Health Care ◽  
Health Professionals ◽  
Health Care Services ◽  
Drug Abusers ◽  
Men And Women ◽  
Care Services ◽  
Lack Of Information ◽  
Las Mujeres ◽  
Intravenous Drug Abusers ◽  
Specific Health

<p>Se ha elaborado un estudio con enfoque cualitativo basado en encuestas semiestructuradas, en el periodo 2007-2008, de usuarios de drogas intravenosas de los Centros de Información y Prevención del Sida. Los profesionales, que atienden de forma esporádica a pacientes VIH los estigmatizan en mayor medida debido a la desinformación, miedo y falta de empatía. Se detecta diferente comportamiento de uso en ex consumidores de drogas. Las mujeres se ajustan más a las normas y son menos conflictivas, se desenganchan más y recaen menos. A las mujeres se les atiende rápidamente en los servicios sanitarios no específicos. Ambos sexos usan estrategias contra la estigmatización.</p><p>We have performed, in 2007-2008, based upon questionnaires, a qualitative study of intravenous drug abusers from Centres for Information and AIDS prevention. Among health professionals, those who occasionally see AIDS patients do stigmatise them more for lack of information, fear and lack of empathy. Men and women behave differently when they are no longer drug abusers. Women adapt more to the norms, are less conflictive, kick the habit on a larger scale, and relapse less than men. Women are more quickly taken care when accessing non specific health-care services. Both sexes use strategies against stigmatization.<br /><br /><br /></p>

scholarly journals Reactions to institutional violence: patient strategies for facing infringements of the right to health in Brazil

2013 ◽  
Vol 9 (1) ◽  
pp. 11-25
Author(s):  
Sonia Fleury ◽  
Valéria Bicudo ◽  
Gabriela Rangel
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Participant Observation ◽  
Structural Factors ◽  
Public Health Services ◽  
Structured Interviews ◽  
Institutional Violence ◽  
Care Services ◽  
Individual Solution ◽  
The Right

In this article we identify evidences of inequalities, prejudices and discrimination in the access and utilization of public health services belonging to the Brazilian Unified Health Care System, considering them to be institutional violence and a negation of rights, in order to look at the reactions of the subjects victimized by this process. This research study utilized different methodologies, articulating participant observation, semi-structured interviews, focus groups and dramatization. The results highlight the trajectory in seeking health care as the main expression of inequalities, strengthened by structural factors such as the precarious condition of health care services, which potentiate power asymmetries, and the presence of discrimination derived from stigmas and prejudices. Most patients' reactions to the situation of institutional violence seek an individual solution to the problem, often reaffirming the conditions that generate rights violations. Few patients' reactions question the systemic conditions that determine the continued discrimination.

Veterans, Part of the Net: Trends in Community Health Programs

1996 ◽  
Vol 2 (4) ◽  
pp. 25
Author(s):  
Felicity Barr
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Care Services ◽  
Best Practice ◽  
Department Of Veterans Affairs ◽  
Community Based ◽  
Care Services ◽  
Self Help ◽  
Effective Delivery ◽  
Community Health Programs

The Department of Veterans' Affairs (DVA) has moved from being a provider of primary health care, through ownership of Repatriation General Hospitals in each state, to being a major purchaser of community-based health care services. Departmental programs are more outwardly focussed than in the past and are more stringently evaluated to ensure the effective delivery of best practice standard services. DVA is committed to recognising the nation's special debt to the veteran community through appropriate compensation and health care programs. In this paper, the range of Departmental community health care programs, including those which focus on the innovative delivery of services through joint initiatives with community self help organisations, are discussed.

Characterizing the health experience of Tuvaluan migrants in Auckland, New Zealand

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jordan Paul Emont ◽  
Seipua O’Brien ◽  
Vili Nosa ◽  
Elizabeth Terry Toll ◽  
Roberta Goldman
Keyword(s):  
Climate Change ◽  
Health Care ◽  
New Zealand ◽  
Health Care Services ◽  
Participant Observation ◽  
Full Time ◽  
Structured Interviews ◽  
Content Type ◽  
Care Services ◽  
Full Time Employment

Purpose It is predicted that increasing numbers of citizens of the Pacific Island nation of Tuvalu will migrate to New Zealand in the coming decades due to the threat of climate change. Tuvaluans currently living in New Zealand face disparities in income, education and health. This study aims to understand the views of recent Tuvaluan immigrants to Auckland, New Zealand on health behaviors, health care and immigration. Design/methodology/approach The authors conducted semi-structured interviews, key informant interviews and participant observation using a focused ethnography methodology. Findings Participants explained that Tuvaluans in New Zealand do not fully use primary care services, have a poorer diet and physical activity compared to those living in Tuvalu, and struggle to maintain well-paying, full-time employment. Practical implications As Tuvaluan immigration to New Zealand continues, it will be important to educate the Tuvaluan community about the role of primary health-care services and healthy behaviors, facilitate the current process of immigration and provide job training to recent immigrants to improve their opportunities for full-time employment and ensure cultural survival in the face of the threat of climate change. Originality/value This paper contributes to a greater understanding of the challenges to be faced by Tuvaluan environmental migrants in the future and features a high proportion of study participants who migrated due to climate change.

Talk to Me, Not at Me: An Ethnographic Study on Health-Related Help-Seeking Behavior Among Socially Marginalized Danish Men

2019 ◽  
Vol 30 (4) ◽  
pp. 598-609 ◽  
Author(s):  
Annette Pedersen ◽  
Helle Haslund-Thomsen ◽  
Tine Curtis ◽  
Mette Grønkjær
Keyword(s):  
Health Care ◽  
Help Seeking ◽  
Health Care Services ◽  
Ethnographic Study ◽  
Public Parks ◽  
Help Seeking Behavior ◽  
Care Services ◽  
Seeking Behavior ◽  
Health Related ◽  
Municipal Health

Research shows that men tend to have delayed health-related help-seeking behavior. In this ethnographic study, we explored influential factors related to health-related help-seeking behavior among socially marginalized men who seem not to benefit from existing municipal health care services in a large Danish municipality. The study included 200 hours of participant observations and 25 ethnographic interviews with men between 45 and 65 years of age in their own homes and in public parks among their peers. In this study, we found that the men had several complex and interacting social- and health-related conditions, which seemed to affect their health-related help-seeking behavior. We conclude that collaborative initiatives between the outreach team who occasionally visits bench sites in the public parks and the municipal health care services in the local areas could lay the groundwork for encouraging men’s health-related help-seeking behavior and aid men in supporting each other.

Perception of hematologists and oncologists about the biosimilars: A prospective Tunisian study based on a survey

2019 ◽  
Vol 26 (1) ◽  
pp. 124-132 ◽  
Author(s):  
Selma Hadoussa ◽  
Mehdi Bouhlel ◽  
Mohamed A Soussi ◽  
Chema Drira ◽  
Myriam Hadoussa ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
General Knowledge ◽  
Public And Private ◽  
Care Services ◽  
Lack Of Information ◽  
Health Authorities ◽  
Access To Health ◽  
Descriptive Survey

Introduction Biosimilar drugs have significantly shaken the global pharmaceutical market through a better access to the health care services. The aim of this study is to establish a state of play in Tunisia based on the knowledge and perceptions of doctors on biosimilars in order to identify the problems related to these drugs and to propose solutions for improvement. Materials and methods In our study, we conducted a prospective, descriptive survey using a questionnaire, destinated to oncologists and hematologists with different grades, from both public and private sectors and from several regions. The questions focused on physicians' general knowledge of biosimilars and their comparison with reference on safety, quality, efficacy, and indication. Finally, we explored the proportion of physicians who are favorable to the policy encouraging biosimilar use. Results One hundred and seven doctors among 150 answered the questionnaire; 57% were oncologists and 43% were hematologists. About one over five physicians defines biosimilar as a chemical drug. About 29% do not differentiate between a biosimilar and a generic one. A percentage of 68 believe that a biosimilar can have all the indications of its reference following complementary clinical studies. On the other side, 68.2% support the policy encouraging these drugs. Last, only 3.7% of the practitioners believe that they are well informed about biosimilars. Discussion Our results are comparable to other surveys described in the literature. However, this is the first study that targets oncologists and hematologists specifically. Conclusion Our study showed a lack of information from oncologists and hematologists about biosimilars in Tunisia. Thus, health authorities should carry out training programs on biosimilars and introduce clear and effective legislation in order to allow better access to health care services.

scholarly journals ‘Keeping up appearances’ – negotiating identities of being fit in older age: a multi-site ethnographic study of daily life in contemporary day centres

2021 ◽  
pp. 1-18
Author(s):  
Christine Øye ◽  
Reidun Norvoll ◽  
Mia Vabø
Keyword(s):  
Participant Observation ◽  
Functional Decline ◽  
Ethnographic Study ◽  
Care Staff ◽  
Cognitive Capacity ◽  
Active Ageing ◽  
Brain Training ◽  
Staff Members ◽  
Care Services ◽  
Social Events

Abstract As governments adapt to ‘active ageing’ policies, care services are increasingly oriented towards helping older adults to stay active in order to maintain their physiological and cognitive capacity. Day centres for the frail old adults are adding more planned activities to their conventional social programmes. Although evidence indicates that they may benefit from physical fitness sessions and brain training, little is known about the way in which the activation agenda influences social interaction among participants. The article aims to fill this knowledge gap by exploring how staff and participants manoeuvre between the new activation agenda and processes of coming to terms with the functional decline of ageing bodies. We draw on ethnographic data, collected in four day centres in Denmark and Norway, constituting participant observation of 18 days, 19 interviews with older participants and 18 interviews with staff members. With reference to the dramaturgical approach of Erving Goffman, we demonstrate how different fitness identities are negotiated on different social stages. Firstly, we identify a social stage at a crossroad between staff acting as motivators in training sessions and older participants as active contributors. We demonstrate how day-care staff assist participants in keeping up appearances as fit for one's age by recognising their performance and concealing flawed performances. Secondly, we identify a social stage where participants socialise with co-participants around the lunch table and other social events. Here the act of ‘keeping up appearances’ turns into a complex art whereby people strive to retain their fitness identity by comparing themselves with peers. Finally, based on observation ‘backstage’, we reveal how participants distance themselves from the functional decline of old age by claiming that they are fit enough. We conclude that day centres are contested sites for active-ageing policies.

scholarly journals COVID-19 Pandemic and Its Impact on Neurosurgery Practice in Malaysia: Academic Insights, Clinical Experience and Protocols from March till August 2020

2020 ◽  
Vol 27 (5) ◽  
pp. 141-195
Author(s):  
Azman Raffiq ◽  
Liew Boon Seng ◽  
Lim Swee San ◽  
Zaitun Zakaria ◽  
Ang Song Yee ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Recovery Phase ◽  
Public Health Care ◽  
Emergency Rooms ◽  
Care Services ◽  
Care Workers ◽  
Effective Delivery ◽  
Hospital Resources ◽  
Major Shift

The newly discovered coronavirus disease 2019 (COVID-19) is an infectious disease introduced to humans for the first time. Following the pandemic of COVID-19, there is a major shift of practices among surgical departments in response to an unprecedented surge in reducing the transmission of disease. With pooling and outsourcing of more health care workers to emergency rooms, public health care services and medical services, further in-hospital resources are prioritised to those in need. It is imperative to balance the requirements of caring for COVID-19 patients with imminent risk of delay to others who need care. As Malaysia now approaches the recovery phase following the pandemic, the crisis impacted significantly on neurosurgical services throughout the country. Various emergency measures taken at the height of the crisis may remain as the new normal in the provision of neurosurgical services and practices in Malaysia. The crisis has certainly put a strain on the effective delivery of services and as we approach the recovery era, what may have been a strain may prove to be a silver lining in neurosurgical services in Malaysia. The following details are various measures put in place as the new operational protocols for neurosurgical services in Malaysia.

scholarly journals Indigenous nurses: participation of nursing technicians and auxiliary in indigenous health care services

2014 ◽  
Vol 23 (2) ◽  
pp. 451-459 ◽  
Author(s):  
Eliana Elisabeth Diehl ◽  
Helga Bruxel Carvalho Follmann
Keyword(s):  
Health Care ◽  
Indigenous People ◽  
Local Knowledge ◽  
Health Care Services ◽  
Indigenous Health ◽  
Participant Observation ◽  
National Policy ◽  
Health Practices ◽  
Care Services ◽  
Training Courses

The aim of this study was to analyze the participation of Indigenous nursing technicians and aides in Indigenous health care services offered in the Xapecó Reserve, Santa Catarina, Brazil, focusing on the training and activities executed. Data collection (participant observation and interviews) and analysis were based on the ethnographic method. Sixteen key informants were interviewed, including nursing technicians and aides, training instructors, staff nurses and health service users. The training courses contained little or no emphasis on local knowledge and health practices. Other than the role of facilitator and mediator between the health team and community, the activities performed by the Indigenous nursing technicians and aides differed little from those of non-Indigenous people in the same categories. In this context, both the training of these workers and the activities executed by them reinforce the clinical curative model, which hinders articulation with local knowledge and Indigenous health practices, a principle of the National Policy of Health Care for Indigenous People.

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