The Post-Amputation Rehabilitation Experience of People Living in Rural Settings

2001 ◽  
Vol 7 (1) ◽  
pp. 23-37
Author(s):  
Amanda Young ◽  
Gregory Murphy ◽  
Sandra Kippen ◽  
Peter Foreman
Keyword(s):  
Surgical Intervention ◽  
Health Planning ◽  
Rural Setting ◽  
Access To Health Services ◽  
Counselling Services ◽  
Access To Health ◽  
Rural Settings ◽  
Social Support Services ◽  
Depth Interviews ◽  
Initial Focus

This paper reports the results from a qualitative study aimed at identifying the factors influencing the rehabilitation experience of people living with an amputation in a rural setting. Following the conduct of an initial focus group, 24 rural-based individuals responded to an invitation to participate in the study's in-depth interviews. Fourteen of those interviewed lived in a ‘regional’ setting (the regional group) and the other ten lived in more remote locations (the ‘distant’ group). Consistent with this population's demography, the sample was comprised mainly of older people (mean age of 66.8 years) who had suffered their amputation as a result of vascular disease. While the groups differed with respect to two aspects of their rehabilitation experience (with the distant group reporting more problems with accommodation and access to health services), many common themes emerged from the interviews, including an overall positive acceptance of the surgical intervention, the call for increased post-operative counselling services, and an endorsement of the usefulness of peer-support (and more generally of social support) services. Results are discussed in terms of their implications for service delivery and endorsement is made of the suggestion that rural health planning be more community-focussed.

scholarly journals Assessment of the Utilization of HIV Interventions by Sex Workers in Selected Brothels in Bangladesh: An Exploratory Study

2015 ◽  
Author(s):  
Nafisa Huq ◽  
Mahbub Chowdhury
Keyword(s):  
Sex Workers ◽  
Safe Sex ◽  
Mutual Support ◽  
Access To Health Services ◽  
Group Discussions ◽  
Hiv Interventions ◽  
Hiv Intervention ◽  
Access To Health ◽  
Depth Interviews ◽  
Sex Practices

In this qualitative study of brothel-based Female Sex Workers (FSWs), the authors explored factors that influence safe sex practices of FSWs within an integrated HIV intervention. Qualitative methods, including focus group discussions (FGDs), in-depth interviews and key informant interviews were applied in four brothels in Bangladesh. Young and elderly FSWs, Sordarnis (Madams who own young FSWs and who may be either active or inactive sex workers themselves), program managers and providers were the participants for this study. Findings showed that condom use was high but not consistent among bonded FSWs (those who are under the control of a Sordarni) who have regular clients. The bonded FSWs reported being maltreated by the Sordarnis for refusing to have sex without a condom, and access to health services was hindered by Sordarnis. Implications of the study are that integrated HIV intervention should provide more encouragement to relevant stakeholders to promote mutual support towards safe sex practices for the FSWs.

scholarly journals Vertical Equity in Access to Health Insurance Services: a Qualitative Analysis of Perceptions and Enrollment in the Jirapa Municipality, North-Western Ghana.

2020 ◽  
Author(s):  
Maximillian Kolbe Domapielle ◽  
Constance Awinpoka Akurugu ◽  
Emmanuel Kanchebe Derbile
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Rural Setting ◽  
Northern Ghana ◽  
Vertical Equity ◽  
Access To Health Services ◽  
Rural Residents ◽  
Middle Income ◽  
Strict Adherence ◽  
Access To Health

Abstract Background: Given concerns about the spiralling cost of health services in Low and Middle Income Countries (LMICs), this study draws on a framework for assessing poverty and access to health services to ascertain progress towards achieving vertical equity in the National Health Insurance Scheme (NHIS) in a rural setting in northern Ghana. Rural-urban disparities in financial access to NHIS services are seldom explored in equity-related studies although there is a knowledge gap of progress and challenges of implementing the scheme’s vertical equity objectives to inform social health protection planning and implementation. Methods: A qualitative approach was used to collect and analyse the data. Specifically, in-depth interviews and observation provided the needed data to critically analyse the relationship between location, livelihoods and ability to pay for health insurance services. Results: The article found that flat rate contributions for populations in the informal sector of the economy and lack of flexibility and adaptability of timing premium collections to the needs of rural residents make the cost of membership disproportionately higher for them, and this situation contradicts the vertical equity objectives of the NHIS. Conclusion: The study concludes that the current payment arrangements serve as important deterrence to poor rural residents enrolling in the scheme. Based on this, we advocate strict adherence and implementation of the scheme’s vertical equity measures through the adoption of the Ghana National Household Register (GNHR) as a tool for ensuring that contributions are based on income and also collection is well-timed.

scholarly journals Studi Kualitatif Keberadaan Penyakit Kusta di Desa Dendun Kecamatan Mantang Kabupaten Bintan

2020 ◽  
Vol 11 (2) ◽  
pp. 84-93
Author(s):  
Harvensica Gunnara ◽  
Rian Yuliyana ◽  
Rinaldi Daswito ◽  
Ratna Juwita ◽  
Hendra Dhermawan Sitanggang
Keyword(s):  
Adherence To Treatment ◽  
Access To Health Services ◽  
Case Study Method ◽  
District Health ◽  
Analysis Process ◽  
Access To Health ◽  
History Of ◽  
Level Of Knowledge ◽  
Depth Interviews

Indonesia is in the third position in the world with the most leprosy sufferers after India and Brazil. Leprosy is commonly found in developing countries, as a result of the country's limited ability to provide adequate services in the fields of health, education, and socioeconomic welfare for the community. Dendun Village in Mantang District had the most cases of leprosy, 5 (five) cases in the Bintan Regency area in 2018. The study was used as a qualitative approach with a case study method. Content analysis was used in the analysis process of this research. Testing the results of research used source triangulation by cross-checking data with facts from other sources (informants) and triangulation methods by collecting data through in-depth interviews with informants and reviewing documents. The level of knowledge, negative stigma, adherence to treatment, history of contact with leprosy sufferers, and access to health services were important factors for the existence of leprosy in Dendun Village, Mantang District, Bintan Regency. Patients are expected to comply with the treatment program seriously to prevent transmission, cure, and recovery due to diseases carried out by the Bintan District Health Office and Mantang Puskesmas.

scholarly journals Vertical equity in access to health insurance services: An exploration of perceptions and enrolment in the Jirapa Municipality, north-western Ghana

2021 ◽  
Vol 2 (1) ◽  
pp. 1-12
Author(s):  
Maximillian Kolbe Domapielle ◽  
Constance Awinpoka Akurugu ◽  
Emmanuel Kanchebe Derbile
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Rural Setting ◽  
Northern Ghana ◽  
Vertical Equity ◽  
Access To Health Services ◽  
Rural Residents ◽  
Middle Income ◽  
Strict Adherence ◽  
Access To Health

Given concerns about the spiralling cost of health services in low and middle-income countries (LMICs), this study draws on a framework for assessing poverty and access to health services to ascertain progress towards achieving vertical equity in the National Health Insurance Scheme (NHIS) in a rural setting in northern Ghana. Rural-urban disparities in financial access to NHIS services are seldom explored in equity-related studies although there is a knowledge gap of progress and challenges of implementing the scheme’s vertical equity objectives to inform social health protection planning and implementation. A qualitative approach was used to collect and analyse the data. Specifically, in-depth interviews and observation were deployed to explore participants’ lived experiences, the relationship between location, livelihoods and ability to pay for health insurance services. The article found that flat rate contributions for populations in the informal sector of the economy and lack of flexibility and adaptability of timing premium collections to the needs of rural residents make the cost of membership disproportionately higher for them, and this situation contradicts the vertical equity objectives of the NHIS. The study concludes that the current payment regimes serve as important deterrence to poor rural residents enrolling in the scheme. Based on this, we advocate strict adherence and implementation of the scheme’s vertical equity measures through the adoption of the Ghana National Household Register (GNHR) as a tool for ensuring that contributions are based on income, and collection is well-timed

scholarly journals An Interview Study of Consequences of Early-Career Unemployment in Bulgaria

2019 ◽  
Vol 10 (2) ◽  
Author(s):  
Veneta Krasteva
Keyword(s):  
Personal Development ◽  
Age Groups ◽  
Early Career ◽  
Point Of View ◽  
Negative Consequences ◽  
Access To Health Services ◽  
Family Ties ◽  
Access To Health ◽  
In The Beginning ◽  
Depth Interviews

The article examines the consequences of prolonged unemployment experienced in the beginning of the career in Bulgaria from a subjective point of view. The analysis is based on information obtained from in-depth interviews with people from three age groups who have entered the labor market in periods with high levels of unemployment. The negative consequences pointed out by the interviewed people include material deprivation, limited access to health services, low self-esteem, interruption of social contacts, postponement of creating a family and living in a home of one’s own, loss of hope for a better future. Along with the negative consequences, some positive ones were also identified, such as strengthening family ties, people’s enhanced motivation to deal with the arising difficulties and their striving for personal development.

scholarly journals Disparities in fruit and vegetable supply: a potential health concern in the greater Québec City area

2009 ◽  
Vol 12 (11) ◽  
pp. 2051-2059 ◽  
Author(s):  
Nathalie Pouliot ◽  
Anne-Marie Hamelin
Keyword(s):  
Spatial Distribution ◽  
Fruits And Vegetables ◽  
Health Planning ◽  
Urban Setting ◽  
Rural Setting ◽  
Health Concern ◽  
Quebec City ◽  
Fruit And Vegetable ◽  
Potential Health ◽  
Rural Settings

AbstractObjectiveThe present study explores the spatial distribution and in-store availability of fresh fruits and vegetables from a socio-environmental perspective in terms of the type of food store, level of deprivation and the setting (urban/rural) where the food outlets are located.DesignSeven types of fresh fruit and vegetable stores (FVS) were identified then visited in six districts (urban setting) and seven communities (rural setting). The quantity and diversity of fresh fruits and vegetables (F&V) were also assessed.SettingQuébec City, Canada.ResultsThe FVS spatial distribution showed differences between the two settings, with accessibility to supermarkets being more limited in rural settings. The quantity and diversity of fresh F&V in-store availability were associated with the type of FVS, but not with setting or its level of deprivation. Greengrocers and supermarkets offered a greater quantity and diversity of fresh F&V than the other FVS.ConclusionsThe results suggest that inequalities in physical access to fresh F&V across the region could have an impact on public health planning considering that supermarkets, which are one of the excellent sources of F&V, are less prevalent in rural settings.

scholarly journals Gestão em saúde: avaliação do acesso ao sistema regional

2019 ◽  
Vol 13 (4) ◽  
pp. 933
Author(s):  
Priscila Balderrama ◽  
Josué Souza Gleriano ◽  
Silvia Helena Henriques ◽  
Janise Braga Barros Ferreira ◽  
Larissa Roberta Alves ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Health Management ◽  
Health Planning ◽  
Study Data ◽  
Access To Health Services ◽  
Microsoft Excel ◽  
Organization Of Care ◽  
Access To Health ◽  
El Sistema ◽  
La Red

RESUMOObjetivo: avaliar o acesso ao sistema regional de saúde a partir das ações de atenção aos agravos cardiovasculares. Método: trata-se de um estudo misto, descritivo. Coletaram-se dados a partir dos Sistemas de Informação Ambulatorial e Hospitalar do SUS, armazenados em planilhas Microsoft Excel e analisados utilizando-se estatística descritiva. Posteriormente, selecionaram-se 41 participanetes (gestores e reguladores) para responderem um questionário semiestruturado sobre acesso em cardiologia na rede regional. Optou-se pela Análise Temática de Conteúdo para análise dos dados qualitativos. Resultados: registrou-se o incremento da produção de consultas e exames, indicando a ampliação da oferta de serviços, a redução das internações clínicas e o crescimento das internações cirúrgicas em Cardiologia. Revelaram-se, em entrevistas, aspectos da organização da atenção no sistema regional que favorecem o acesso à atenção integral em Cardiologia. Conclusão: conclui-se que houve uma melhoria do acesso à atenção cardiovascular. Aponta-se que a coordenação do cuidado e a melhoria da resolubilidade da Atenção Básica favorecem o acesso à saúde, que também requer a implantação de estruturas sólidas de gestão, envolvendo planejamento, controle, regulação e avaliação. Descritores: Acesso aos Serviços de Saúde; Avaliação em Saúde; Doenças Cardiovasculares; Gestão em Saúde; Planejamento em Saúde; Regionalização.ABSTRACTObjective: to evaluate the access to the regional health system from the actions of attention to cardiovascular diseases. Method: this is a mixed, descriptive study. Data were collected from UHS Ambulatory and Hospital Information Systems, stored in Microsoft Excel spreadsheets and analyzed using descriptive statistics. Subsequently, 41 participanetes (managers and regulators) were selected to answer a semi-structured questionnaire about access in cardiology in the regional network. The Thematic Content Analysis was used to analyze the qualitative data. Results: there was an increase in the production of consultations and examinations, indicating the expansion of the service offer, the reduction of clinical hospitalizations and the increase of surgical hospitalizations in Cardiology. In interviews, aspects of the organization of care in the regional system that favor access to comprehensive care in Cardiology were revealed. Conclusion: it was concluded that there was an improvement in access to cardiovascular care. It is pointed out that the coordination of care and the improvement of the resolubility of Primary Care favor access to health, which also requires the implementation of solid management structures, involving planning, control, regulation and evaluation. Descriptors: Access to Health Services; Health Evaluation; Cardiovascular diseases; Health Management; Health Planning; Regionalization.RESUMENObjetivo: evaluar el acceso al sistema regional de salud a partir de las acciones de atención a los agravios cardiovasculares. Método: se trata de un estudio mixto, descriptivo. Se recolectó datos a partir de los Sistemas de Información Ambulatoria y Hospitalaria del SUS, almacenados en hojas de cálculo de Microsoft Excel y analizados utilizando estadística descriptiva. Posteriormente, se seleccionaron 41 participantes (gestores y reguladores) para responder un cuestionario semiestructurado sobre acceso en cardiología en la red regional. Se optó por el Análisis Temático de Contenido para el análisis de los datos cualitativos. Resultados: se registró el incremento de la producción de consultas y exámenes, indicando la ampliación de la oferta de servicios, la reducción de las internaciones clínicas y el crecimiento de las internaciones quirúrgicas en Cardiología. Se revelaron, en entrevistas, aspectos de la organización de la atención en el sistema regional que favorecen el acceso a la atención integral en Cardiología. Conclusion: se concluye que hubo una mejora del acceso a la atención cardiovascular. Se señala que la coordinación del cuidado y la mejora de la resolución de la Atención Básica favorecen el acceso a la salud, que también requiere la implantación de estructuras sólidas de gestión, involucrando planificación, control, regulación y evaluación. Descriptores: Accesibilidad a los Servicios de Salud; Evaluación en Salud; Enfermedades Cardiovasculares; Gestión en Salud; Planificación en Salud; Regionalización.

Desigualdade social em doentes renais crônicos/ Social inequality in chronic renal patients

1970 ◽  
Vol 1 (1) ◽  
pp. 44-49
Author(s):  
Beatriz Bertolaccini Martínez ◽  
Fernanda Marcelino Da Silva ◽  
Vinícius Tavares Veiga ◽  
Rodrigo Pereira Custódio ◽  
José Vítor Da Silva
Keyword(s):  
Social Inequality ◽  
Access To Health Care ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Access To Health Services ◽  
Access To Treatment ◽  
Cross Sectional ◽  
Economic Class ◽  
Access To Health ◽  
Clinical Background

Introdução: A pobreza influencia na evolução dos pacientes com doenças crônicas, porque contribui para o seu agravamento e dificulta o acesso à assistência médica. O objetivo deste trabalho foi avaliar os aspectos relacionados à desigualdade social de pacientes em hemodiálise. Métodos: Estudo transversal com 123 pacientes em hemodiálise no Hospital Samuel Libânio – Pouso Alegre, MG, divididos, de acordo com a classe econômica, em 3 grupos: AB (n=23), C (n=60) e DE (n=40),. Foram coletados dados sociodemográficos e econômicos, antecedentes clínicos e informações sobre o acesso a serviços de saúde. Para a análise dos resultados, foi utilizada estatística analítica e descritiva. Adotou-se p £ 0,05. Resultados: O grupo AB apresentou um menor número de pacientes jovens (4,3% em AB vs 40% em C e 25% em DE, p < 0,05), um maior número de indivíduos com mais anos de escolaridade (65,3% em AB vs 18,3% em C e 2,5% em DE; p < 0,05), predomínio de pacientes com menos de um ano em tratamento de hemodiálise (65,2% em AB vs 10% em C e 5% em DE, p < 0,05), menor número de usuários do SUS (40% em C e 25% em DE vs 4,3% em AB; p < 0,05) e maior acesso ao tratamento com nefrologista (73,9% em AB vs 46,7% em C e 52,5 em DE; p < 0,05). Conclusão: Classes economicamente desfavorecidas agregam indivíduos mais jovens, com menor escolaridade, usuários do SUS, com maior tempo em hemodiálise e pior acesso ao tratamento com nefrologista.Introduction: The poverty influence on the evolution of patients with chronic diseases because it contributes to your aggravation and hinders access to health care. Our goal was to evaluate the aspects related to social inequality on hemodialysis patients. Methods: cross-sectional study with 123 patients on hemodialysis in Samuel Libânio Hospital – Pouso Alegre, MG, divided according to the economic class, into 3 groups: AB (n = 23), C (n = 60) and DE (n = 40). Were collected socio-demographic and economic data, clinical background and information about access to health services. For analysis of the results has been used statistical analytical and descriptive. We take p £ 0,05.  Results: The AB group has fewer young patients (4,3% in AB vs 40% in C and 25% in DE, p< 0,05), a greater number of individuals with more years of schooling (65,3% in AB vs 18,3% in C and 2,5% in DE; p< 0,05), predominance of patients with less than a year on haemodialysis treatment (65,2% in AB vs 10% in C and 5% in DE, p< 0,05), smaller number of users of SUS (40% in C and 25% in DE vs 4,3% in AB; p< 0,05), greater access to treatment with nephrologist (73,9% in AB vs 46,7% in C and 52,5% in DE; p< 0,05). Conclusion: Economically disadvantaged classes bring younger patients, with less schooling, users of SUS, patients with greater time on hemodialysis and worse access to treatment with nephrologist. 

scholarly journals Tackling Rural Health, Energy, … and Technological Issues All at Once: A Call for a Global Interdisciplinary Platform for Strengthening Rural Setting Amid the COVID-19 Pandemic

Challenges ◽  
2021 ◽  
Vol 12 (2) ◽  
pp. 16
Author(s):  
Farshad Amiraslani
Keyword(s):  
Rural Communities ◽  
Rural Health ◽  
Rural Areas ◽  
Rural Setting ◽  
Global Challenges ◽  
Rural Settings ◽  
Research Studies

The recent COVID-19 pandemic has revealed flaws in rural settings where most people live without the necessary tools, income, and knowledge to tackle such unprecedented global challenges. Here, I argue that despite the research studies conducted on rural areas, these have not solved rising rural issues, notably poverty and illiteracy. I propound a global institute to be formed by governments that provides a platform for empowering rural communities through better training, skills, and competencies. Such global endeavour will ensure the remaining rural communities withstand future pandemics if they occur.

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