Health Care Access and Utilization after the 2010 Pakistan Floods

2016 ◽  
Vol 31 (5) ◽  
pp. 485-491 ◽  
Author(s):  
Gabrielle A. Jacquet ◽  
Thomas Kirsch ◽  
Aqsa Durrani ◽  
Lauren Sauer ◽  
Shannon Doocy
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Access ◽  
Access To Health Care ◽  
Survey Method ◽  
Care Providers ◽  
Care Access ◽  
Access To Health ◽  
Residence Location

AbstractIntroductionThe 2010 floods submerged more than one-fifth of Pakistan’s land area and affected more than 20 million people. Over 1.6 million homes were damaged or destroyed and 2,946 direct injuries and 1,985 deaths were reported. Infrastructure damage was widespread, including critical disruptions to the power and transportation networks.HypothesisDamage and loss of critical infrastructure will affect the population’s ability to seek and access adequate health care for years to come. This study sought to evaluate factors associated with access to health care in the aftermath of the 2010 Pakistan floods.MethodsA population-proportional, randomized cluster-sampling survey method with 80 clusters of 20 (1,600) households of the flood-affected population was used. Heads of households were surveyed approximately six months after flood onset. Multivariate analysis was used to determine significance.ResultsA total of 77.8% of households reported needing health services within the first month after the floods. Household characteristics, including rural residence location, large household size, and lower pre- and post-flood income, were significantly associated (P<.05) with inadequate access to health care after the disaster. Households with inadequate access to health care were more likely to have a death or injury in the household. Significantly higher odds of inadequate access to health care were observed in rural populations (adjusted OR 4.26; 95% CI, 1.89-9.61).ConclusionAdequate health care access after the 2010 Pakistani floods was associated with urban residence location, suggesting that locating health care providers in rural areas may be difficult. Access to health services also was associated with post-flood income level, suggesting health resources are not readily available to households suffering great income losses.JacquetGA, KirschT, DurraniA, SauerL, DoocyS. Health care access and utilization after the 2010 Pakistan floods. Prehosp Disaster Med. 2016;31(5):485–491.

scholarly journals “I was trying to speak to their human side” coping responses of Belgium’s undocumented migrants to barriers in health-care access

2020 ◽  
Vol 16 (3) ◽  
pp. 253-267
Author(s):  
Dirk Lafaut ◽  
Gily Coene
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Access ◽  
Access To Health Care ◽  
Undocumented Migrants ◽  
Care Providers ◽  
Content Type ◽  
Coping Responses ◽  
Care Access ◽  
Access To Health

Purpose Undocumented migrants experience major legal constraints in their health-care access. Little is known on how undocumented migrants cope with these limitations in health-care access as individuals. The purpose of this study is to explore the coping responses of undocumented migrants when they experience limited health-care access in face-to-face encounters with health-care providers. Design/methodology/approach The authors conducted multi-site ethnographic observations and 25 semi-structured in-depth interviews with undocumented migrants in Belgium. They combined the “candidacy model” of health-care access with models from coping literature on racism as a framework. The candidacy model allowed them to understand access to health care as a dynamic and interactive negotiation process between health-care workers and undocumented migrants. Findings Responses to impaired health-care access can be divided into four main strategies: (1) individuals can react with a self-protective response withdrawing from seeking further care; (2) they can get around the obstacle; (3) they can influence the health-care worker involved by deploying discursive or performative skills; or (4) they can seek to confront the source of the obstacle. Research limitations/implications These findings point to the importance of care relations and social networks, as well as discursive and performative skills of undocumented migrants when negotiating barriers in access to health care. Originality/value This study refines the candidacy model by highlighting how individuals respond on a micro-level to shifts towards exclusionary health policies and, by doing so dynamically, change provision of health-care services.

scholarly journals Barriers to accessing health care services: A qualitative study of migrant construction workers in a Southwestern Indian city

2020 ◽  
Author(s):  
Maija Santalahti ◽  
Kumar Sumit ◽  
Mikko Perkiö
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Construction Workers ◽  
Access To Health Services ◽  
Care Access ◽  
Care Services ◽  
Access To Health

Abstract Background: This study examined access to health care in an occupational context in an urban city of India. Many people migrate from rural areas to cities, often across Indian states, for employment prospects. The purpose of the study is to explore the barriers to accessing health care among a vulnerable group – internal migrants working in the construction sector in Manipal, Karnataka. Understanding the lay workers’ accounts of access to health services can help to comprehend the diversity of factors that hinder access to health care. Methods: Individual semi-structured interviews involving 15 migrant construction workers were conducted. The study applied theory-guided content analysis to investigate access to health services among the construction workers. The adductive analysis combined deductive and inductive approaches with the aim of verifying the existing barrier theory in a vulnerable context and further developing the health care access barrier theory. Results: This study’s result is a revised version of the health care access barriers model, including the dimension of trust. Three known health care access barriers – financial, cognitive and structural, as well as the new barrier (distrust in public health care services), were identified among migrant construction workers in a city context in Karnataka, India. Conclusions: Further qualitative research on vulnerable groups would produce a more comprehensive account of access to health care. The socioeconomic status behind access to health care, as well as distrust in public health services, forms focal challenges for any policymaker hoping to improve health services to match people’s needs.

Mapping refugees and migrants’ access to health care in Tunisia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Arfa
Keyword(s):  
Health Care ◽  
Civil Society ◽  
Health Services ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Civil Society Organizations ◽  
Care Providers ◽  
Quality Health Care ◽  
Access To Health ◽  
Quality Health

Abstract Objectives of the study carried out under the request of the Office of Family Planning and population are collecting data on refugees and migrants, assessing their social and health needs, mapping health care providers and formulating recommendations to ensure equitable and affordable access to quality health services. The methodology has combined qualitative and quantitative research and focus group discussion scattered over the country, NGOs, ministries, and desk review. Results shown several gaps in relation to access to health care by refugees and migrants including: NGOs provide 55% of servicesVulnerability is increased by lack of official documents for residency and work permitLack of response of public and private providersCultural and linguistic barriersXenophobic and racist attitudes of both population and health care providers Based on gap analysis and inputs from several focus groups several recommendations were made to improve access of refugees and migrants to quality health care including the need: to fill the legal vacuum on refuge and migrationto establish an independent public authority on migrationto establish with support from civil society organizations a space for dialogue and communication with refugees and migrantsto improve health system responsiveness to refugees and migrants. As the issue of migrant's access to quality health care is multi-dimensional there is a need to establish inter sectoral task force involving concerned line ministries (i.e health, interior, migration, social affairs, etc..) national and international civil society organizations and concerned United Nations agencies. The objectives of the paper are to: Map the social, economic and health conditions of refugees and migrants in TunisiaTo assess gaps of health services access of refugees and migrantsTo advocate a right base approach to health of refugees and migrants in Tunisia.

scholarly journals Barriers to accessing health-care services: A qualitative study of migrant construction workers in a Southwestern Indian city

2020 ◽  
Author(s):  
Maija Santalahti ◽  
Kumar Sumit ◽  
Mikko Perkiö
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Construction Workers ◽  
Care Access ◽  
Care Services ◽  
Access To Health ◽  
Health Care Access Barriers

Abstract Background: This study examined access to health care in an occupational context in an urban city of India. Many people migrate from rural areas to cities, often across Indian states, for employment prospects. The purpose of the study is to explore the barriers to accessing health care among a vulnerable group – internal migrants working in the construction sector in Manipal, Karnataka. Understanding the lay workers’ accounts of access to health service can help to comprehend the diversity of factors that hinder access to health care. Methods: Individual semi-structured interviews involving 15 migrant construction workers were conducted. The study applied theory-guided content analysis to investigate access to health services among the construction workers. The adductive analysis combined deductive and inductive approaches with the aim of verifying the existing barrier theory in a vulnerable context and further developing the health-care access barrier theory. Results: This study’s result is a revised version of the health-care access barriers model, including the dimension of trust. Three known health-care access barriers – financial, cognitive and structural, as well as the new barrier (distrust in public health-care services), were identified among migrant construction workers in a city context in Karnataka, India.Conclusions: Further qualitative research on vulnerable groups would produce a more comprehensive account of access to health care. The socioeconomic status behind access to health care, as well as distrust in public health services, forms focal challenges for any policymaker hoping to improve health services to match people’s needs.

scholarly journals Barriers to accessing health care services: A qualitative study of migrant construction workers in a Southwestern Indian city

2020 ◽  
Author(s):  
Maija Santalahti ◽  
Kumar Sumit ◽  
Mikko Perkiö
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Construction Workers ◽  
Care Access ◽  
Care Services ◽  
Access To Health ◽  
Health Care Access Barriers

Abstract Background: This study examined access to health care in an occupational context in an urban city of India. Many people migrate from rural areas to cities, often across Indian states, for employment prospects. The purpose of the study is to explore the barriers to accessing health care among a vulnerable group – internal migrants working in the construction sector in Manipal, Karnataka. Understanding the lay workers’ accounts of access to health service can help to comprehend the diversity of factors that hinder access to health care. Methods: Individual semi-structured interviews involving 15 migrant construction workers were conducted. The study applied theory-guided content analysis to investigate access to health services among the construction workers. The adductive analysis combined deductive and inductive approaches with the aim of verifying the existing barrier theory in a vulnerable context and further developing the health care access barrier theory. Results: This study’s result is a revised version of the health care access barriers model, including the dimension of trust. Three known health care access barriers – financial, cognitive and structural, as well as the new barrier (distrust in public health care services), were identified among migrant construction workers in a city context in Karnataka, India. Conclusions: Further qualitative research on vulnerable groups would produce a more comprehensive account of access to health care. The socioeconomic status behind access to health care, as well as distrust in public health services, forms focal challenges for any policymaker hoping to improve health services to match people’s needs.

scholarly journals Barriers to accessing health care services: A qualitative study of migrant construction workers in a Southwestern Indian city

2020 ◽  
Author(s):  
Maija Santalahti ◽  
Kumar Sumit ◽  
Mikko Perkiö
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Construction Workers ◽  
Access To Health Services ◽  
Care Access ◽  
Care Services ◽  
Access To Health

Abstract Background: This study examined access to health care in an occupational context in an urban city of India. Many people migrate from rural areas to cities, often across Indian states, for employment prospects. The purpose of the study is to explore the barriers to accessing health care among a vulnerable group – internal migrants working in the construction sector in Manipal, Karnataka. Understanding the lay workers’ accounts of access to health services can help to comprehend the diversity of factors that hinder access to health care. Methods: Individual semi-structured interviews involving 15 migrant construction workers were conducted. The study applied theory-guided content analysis to investigate access to health services among the construction workers. The adductive analysis combined deductive and inductive approaches with the aim of verifying the existing barrier theory in a vulnerable context and further developing the health care access barrier theory. Results: This study’s result is a revised version of the health care access barriers model, including the dimension of trust. Three known health care access barriers – financial, cognitive and structural, as well as the new barrier (distrust in public health care services), were identified among migrant construction workers in a city context in Karnataka, India. Conclusions: Further qualitative research on vulnerable groups would produce a more comprehensive account of access to health care. The socioeconomic status behind access to health care, as well as distrust in public health services, forms focal challenges for any policymaker hoping to improve health services to match people’s needs.

scholarly journals Towards Equitable Health Care Access: Community Participatory Research Exploring Unmet Health Care Needs of Homeless Individuals

2021 ◽  
pp. 084456212110321
Author(s):  
Melba Sheila D’Souza ◽  
Noeman Ahmad Mirza
Keyword(s):  
Social Support ◽  
Health Care ◽  
Health Services ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Needs ◽  
Care Needs ◽  
Care Access ◽  
Access To Health ◽  
Unmet Health Care Needs

Community and health services often overlook health care needs of persons experiencing homelessness, which leads to deterioration in health and increased utilization of emergency services. Since homeless people are underrepresented in health service research, little is known about their unmet health care needs, particularly in smaller cities where resources are limited. This community-based participatory research explored the experiences of small-city homeless service users (HSUs) with unmet health care needs and community service providers (CSPs) who work with them to determine barriers to health care access affecting them. Structured interviews were conducted with 65 HSUs and 15 CSPs in interior British Columbia, Canada. These interviews were audio-recorded, and the retrieved data were analyzed thematically. The three themes uncovered included: a lack of access to health care and risk of stigma, a lack of trust and fear of discrimination, and a need for community navigation and social support. The findings indicate that HSUs do not receive equitable care and face challenges in accessing appropriate and timely foot care, which contributes to increased foot-related emergency visits, loss of trust in the health care system, and disabilities due to worsening foot conditions. Various social determinants of health also impact HSUs, such as low socioeconomic status, lack of housing, decreased social support, unhealthy behaviors, and inequitable access to health services. By collaborating with HSUs, community and health services need to develop innovative outreach programs that provide better community resources as the first step toward equitable access to health care.

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

Human rights-based conceptions of deservingness: health and precarity

2020 ◽  
Vol 16 (3) ◽  
pp. 279-292
Author(s):  
Sarah Marshall
Keyword(s):  
Health Care ◽  
Human Rights ◽  
Health Care Providers ◽  
Health Care Access ◽  
Migrant Health ◽  
Dominant Negative ◽  
Care Providers ◽  
Content Type ◽  
Care Access ◽  
Health Related

Purpose Ideas of health-related deservingness in theory and practise have largely been attached to humanitarian notions of compassion and care for vulnerable persons, in contrast to rights-based approaches involving a moral-legal obligation to care based on universal citizenship principles. This paper aims to provide an alternative to these frames, seeking to explore ideas of a human rights-based deservingness framework to understand health care access and entitlement amongst precarious status persons in Canada. Design/methodology/approach Drawing from theoretical conceptualizations of deservingness, this paper aims to bring deservingness frameworks into the language of human rights discourses as these ideas relate to inequalities based on noncitizenship. Findings Deservingness frameworks have been used in public discourses to both perpetuate and diminish health-related inequalities around access and entitlement. Although, movements based on human rights have the potential to be co-opted and used to re-frame precarious status migrants as “undeserving”, movements driven by frames of human rights-based deservingness can subvert these dominant, negative discourses. Originality/value To date, deservingness theory has primarily been used to speak to issues relating to deservingness to welfare services. In relation to deservingness and precarious status migrants, much of the literature focuses on humanitarian notions of the “deserving” migrant. Health-related deservingness based on human rights has been under-theorized in the literature and the authors can learn from activist movements, precarious status migrants and health care providers that have taken on this approach to mobilize for rights based on being “human”.

scholarly journals A Study Protocol for Increasing Access to Smoking Cessation Treatments for Low-Income Minority Smokers

2021 ◽  
Vol 9 ◽  
Author(s):  
Alicia K. Matthews ◽  
Karriem S. Watson ◽  
Cherdsak Duang ◽  
Alana Steffen ◽  
Robert Winn
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Health Care Providers ◽  
Low Income ◽  
Access To Health Care ◽  
Social Determinant ◽  
Evidence Based ◽  
Patient Portal ◽  
Care Providers ◽  
Access To Health

Background: Smoking rates among low-income patients are double those of the general population. Access to health care is an essential social determinant of health. Federally qualified health care centers (FQHC) are government-supported and community-based centers to increase access to health care for non-insured and underinsured patients. However, barriers to implementation impact adherence and sustainability of evidence-based smoking cessation within FQHC settings. To address this implementation barrier, our multi-disciplinary team proposes Mi QUIT CARE (Mile Square QUITCommunity-Access-Referral-Expansion) to establish the acceptability, feasibility, and capacity of an FQHC system to deliver an evidence-based and multi-level intervention to increase patient engagement with a state tobacco quitline.Methods: A mixed-method approach, rooted in an implementation science framework of RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance), will be used in this hybrid effectiveness-implementation design. We aim to evaluate the efficacy of a novel delivery system (patient portal) for increasing access to smoking cessation treatment. In preparation for a future randomized clinical trial of Mi QUIT CARE, we will conduct the following developmental research: (1) Examine the burden of tobacco among patient populations served by our partner FQHC, (2) Evaluate among FQHC patients and health care providers, knowledge, attitudes, barriers, and facilitators related to smoking cessation and our intervention components, (3) Evaluate the use of tailored communication strategies and patient navigation to increase patient portal uptake among patients, and (4) To test the acceptability, feasibility, and capacity of the partner FQHC to deliver Mi QUIT CARE.Discussion: This study provides a model for developing and implementing smoking and other health promotion interventions for low-income patients delivered via patient health portals. If successful, the intervention has important implications for addressing a critical social determinant of cancer and other tobacco-related morbidities.Trial Registration: U.S. National Institutes of Health Clinical Trials, NCT04827420, https://clinicaltrials.gov/ct2/show/NCT04827420.

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