Views and experiences of family physicians about Syrian refugee patients in Turkey: a qualitative research

Abstract Aim: The aim of this study was to describe the attitudes, views and solution proposals of family physicians (FPs) about primary healthcare problems of Syrian refugee patients. This study would be the very first study for Turkey that evaluates the attitudes, views and solution proposals of FPs about primary healthcare problems of Syrian refugee patients. Background: Following the anti-regime demonstrations that started in March 2011, the developments in Syria created one of the biggest humanitarian crises in the world and the largest number of asylum seekers continue to be hosted in Turkey. There are some studies evaluating asylum seekers’ access to healthcare services in Europe, and the common result is that refugees have free access to primary healthcare services in most countries; however, they face many obstacles when accessing primary healthcare services. While there are studies in the literature evaluating the situation of access to primary healthcare services from the perspective of asylum seekers; there are few studies evaluating the opinions/views of FPs. Methods: A qualitative methodology informed by the grounded theory was used to guide the research. A total of 20 FPs were interviewed face to face through semi-structured interviews, using 12 questions about their lived experience and views caring of refugee population. Interviews were analysed thematically. Finding: The following themes were revealed: Benefiting from Primary Health Care Services, Benefiting from Rights, Differences Between the Approach/Attitudes of Turkish Citizens and Refugees, Barriers to Healthcare Delivery, Training Needs of Physicians, Solution proposals. FPs reported that there is a need for support in primary care and a need for training them and refugees in this regard and they specified refugee healthcare centres are the best healthcare centres for refugees; however, the number of these and provided services should be increased.

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Examining Stakeholder’s Views On Refugee Healthcare Needs, Current Barriers in Accessing Healthcare Services and Future Healthcare Direction in New Zealand: A Qualitative Phenomenological Approach

10.21203/rs.3.rs-877910/v1 ◽

2021 ◽

Author(s):

Bafreen Sherif ◽

Ahmed Awaisu ◽

Nadir Kheir

Keyword(s):

New Zealand ◽

Health Services ◽

Qualitative Methodology ◽

Healthcare Delivery ◽

Healthcare Providers ◽

Healthcare Services ◽

Healthcare Personnel ◽

Structured Interviews ◽

Health Seeking ◽

Healthcare Needs

Abstract Background The annual New Zealand refugee quota was increased to 1500 places from 2020 onwards as a response to the global refugee crisis. The specific healthcare needs of refugees are not clearly understood globally and communication between healthcare providers and refugees remains poor. Methods A phenomenological qualitative methodology was employed to conduct semi-structured interviews among purposively selected stakeholders who work in refugee organisations and relevant bodies in New Zealand. Results The participants indicated the need for a national framework of inclusion, mandating cultural competency training for frontline healthcare and non-healthcare personnel, creation of a national interpretation phone line, and establishing health navigators. Barriers to accessing health services identified included some social determinants of health such as housing and community environment; health-seeking behaviour and health literacy; and social support networks. Future healthcare delivery should focus on capacity building of existing services, including co-design processes, increased funding for refugee-specific health services, and whole government approach. Conclusion Policymakers and refugee organisations and their frontline personnel should seek to address the deficiencies identified in order to provide equitable, timely and cost-effective healthcare services for refugees in New Zealand.

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Patient satisfaction survey: A gateway to quality improvement in primary healthcare in the IAF

Indian Journal of Aerospace Medicine ◽

10.25259/ijasm_29_2021 ◽

2021 ◽

Vol 65 ◽

pp. 105-108

Author(s):

VV Joshi ◽

R Dev ◽

NK Tripathy

Keyword(s):

Patient Satisfaction ◽

Primary Healthcare ◽

Short Form ◽

Tertiary Care ◽

Healthcare Delivery ◽

Armed Forces ◽

Quality Of Healthcare ◽

Healthcare Services ◽

Important Indicator ◽

Tertiary Healthcare

Patient satisfaction is an important indicator to assess and improve quality of healthcare services. In Armed Forces Medical Services, studies on patient satisfaction are scant and mainly hospital based. Hence, a study was conducted with an objective to assess patient satisfaction in seven Primary Healthcare Delivery Centers (PHDCs) in one of the operational commands in the Indian Air Force (IAF). Patient Satisfaction Questionnaire Short Form 18 (PSQ-18), a simple tool, was used for the survey. The study was unique in the sense that few centers in the survey were remotely located from tertiary care hospitals and the Medical Officers in these PHDCs were relatively inexperienced. The analysis of the survey clearly brought out distinct differences in certain dimensions of patient satisfaction across the PHDCs. In addition, utility of the Hindi translated version of PSQ-18 was ascertained. Based on the results of the study, few important conclusions were drawn; (a) patient satisfaction could be assessed using simple questionnaire such as PSQ-18, (b) the Hindi translated version of PSQ-18 can also be used as a useful tool depending on the participants’ preference, and (c) the observed dimensions affecting patient satisfaction could be addressed through specific interventions. Similar survey is recommended to be conducted across primary, secondary, and tertiary healthcare establishments in the IAF.

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The impact of the Affordable Care Act on patient coverage and access to care: perspectives from FQHC administrators in Arizona, California and Texas

BMC Health Services Research ◽

10.1186/s12913-021-06961-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Angelo Ercia

Keyword(s):

Access To Care ◽

Affordable Care Act ◽

Health Care Services ◽

Healthcare Services ◽

Structured Interviews ◽

Care Services ◽

Healthcare Needs ◽

The Affordable Care Act ◽

Insured Patients ◽

The Impact

Abstract Background The Affordable Care Act (ACA) enabled millions of people to gain coverage that was expected to improve access to healthcare services. However, it is unclear the extent of the policy’s impact on Federally Qualified Health Centers (FQHC) and the patients they served. This study sought to understand FQHC administrators’ views on the ACA’s impact on their patient population and organization. It specifically explores FQHC administrators’ perspective on 1) patients’ experience with gaining coverage 2) their ability to meet patients’ healthcare needs. Methods Twenty-two semi-structured interviews were conducted with administrators from FQHCs in urban counties in 2 Medicaid-expanded states (Arizona and California) and 1 non-expanded state (Texas). An inductive thematic analysis approach was used to analyze the interview data. Results All FQHC administrators reported uninsured patients were more likely to gain coverage from Medicaid than from private health insurance. Insured patients generally experienced an improvement in accessing healthcare services but depended on their plan’s covered services, FQHCs’ capacity to meet demand, and specialist providers’ willingness to accept their coverage type. Conclusion Gaining coverage helped improved newly insured patients’ access to care, but limitations remained. Additional policies are required to better address the gaps in the depth of covered services in Medicaid and the most affordable PHI plans and capacity of providers to meet demand to ensure beneficiaries can fully access the health care services they need.

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Methodological and practical viewpoints of qualitative-driven mixed method design: the case of decentralisation of primary healthcare services in Nepal

Primary Health Care Research & Development ◽

10.1017/s1463423617000597 ◽

2017 ◽

Vol 19 (01) ◽

pp. 64-76

Author(s):

Krishna Regmi

Keyword(s):

Health Service ◽

Primary Healthcare ◽

Mixed Method ◽

Quantitative Methods ◽

Healthcare Services ◽

Management Program ◽

Future Research ◽

Structured Interviews ◽

Data Set ◽

Mixed Method Design

BackgroundAlthough considerable attention has been paid to the use of quantitative methods in health research, there has been limited focus on decentralisation research using a qualitative-driven mixed method design. Decentralisation presents both a problematic concept and methodological challenges, and is morecontext-specificand is oftenmulti-dimensional. Researchers often consider using more than one method design when researching phenomena is complex in nature.AimTo explore the effects of decentralisation on the provision of primary healthcare services.MethodsQualitative-driven mixed method design, employing three methods of data collections: focus group discussions (FGDs), semi-structured interviews (SSIs) and participant observations under two components, that is, core component and supplementary components were used. Four FGDs with health service practitioners, three FGDs with district stakeholders, 20 SSIs with health service users and 20 SSIs with national stakeholders were carried out. These were conducted sequentially. NVivo10, a data management program, was utilised to code the field data, employing a content analysis method for searching the underlying themes or concepts in the text material.FindingsBoth positive and negative experiences related to access, quality, planning, supplies, coordination and supervision were identified.ConclusionThis study suggests some evidence of the effects of decentralisation on health outcomes in general, as well as filling a gap of understanding and examining healthcare through a qualitative-driven mixed methods approach, in particular. Future research in the area of qualitative in-depth understanding of the problems (why decentralisation, why now and what for) would provoke an important data set that benefits the researchers and policy-makers for planning and implementing effective health services.

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(A194) “Displaced Voices”: Are those Displaced by War Satisfied with the Provision and Quality of Health Care they Received?

Prehospital and Disaster Medicine ◽

10.1017/s1049023x11001907 ◽

2011 ◽

Vol 26 (S1) ◽

pp. s54-s55

Author(s):

K. Wickramage ◽

R. Surentrikumaran

Keyword(s):

Public Health ◽

Health Care ◽

Health Care Services ◽

Qualitative Methodology ◽

Healthcare Services ◽

Internally Displaced ◽

Community Health Volunteers ◽

Care Services ◽

Humanitarian Response ◽

Displaced Children

Research into how war-displaced communities value or prioritize aid response is limited. A clearer conceptualization of what affected populations seek from the international humanitarian response to their needs would be valuable in planning for emergencies.AimExploring internally displaced person's (IDP) experiences and perceptions of the humanitarian response, with a focus on health risks, resources, and health services received during their displacement.MethodA mixed-method approach using both quantitative and qualitative methods was used. This study assessed the perceptions of IDPs on provision of health and other services using an interviewer-administered-questionnaire (survey) using a sample frame that included the entire displaced population of 150,000 IDPs living in 97 camps. Findings from the survey were synthesized with the key themes that emerged through the qualitative methodology. In-depth interviews were conducted with health cluster actors. An innovative child-to-child (CTC) based research methodology was used to ascertain the insights and perceptions of displaced children and adolescents.ResultsThe survey revealed community satisfaction with health care services immediately after displacement (within IDP camps) improved considerably from 63% to 80% (6 months after the acute phase). Significant gains also were registered for shelter (54.2% to 81.4%), and sanitation (47.4% to 62%). Satisfaction of services rendered by primary healthcare workers also were high; 81.7% for public health midwife (who provided maternal and child health care), and 76.8% for public health inspectors (who provided environmental health and disease control). However, CTC workshops revealed inequalities in access to food based on ‘caste’ and occupation. Protection issues relating to violence from community and militant groups were reported.ConclusionsDespite IDP satisfaction with healthcare services, there were gaps in food security and violence/protection activities. Recognizing of the role/impact community health volunteers play in health care is an important factor in enhancing primary health care services in IDP camps.

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THE RELATIONSHIP BETWEEN SYMPTOMS AND HEALTH FACILITY CHOICE IN THE CENTRAL REGION VIETNAM

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.3.8 ◽

2016 ◽

pp. 52-58

Author(s):

Minh Tam Nguyen ◽

Shimamura Yasuharu

Keyword(s):

Health Care Services ◽

Contact Point ◽

Healthcare Delivery ◽

Healthcare Facility ◽

Healthcare Services ◽

Health Seeking ◽

Double Burden ◽

Quality Healthcare ◽

Healthcare Facilities ◽

The Relationship

Background: Patients often have their focus on looking for the high-quality healthcare services while minimizing costs in order to choose the healthcare facilities appropriate to their needs. Moreover, a double burden disease has led to changes in healthcare delivery model and health seeking behavior of patients. However, the relationship between such illness and the utilization of health care services has rarely been empirically assessed. Objective: To clarify how health status and symptoms associated with the healthcare facility choice. Methods: We conducted this survey in 3 provinces (Thua Thien Hue, Quang Tri, and Khanh Hoa), with 6,898 residents in 1,478 households. The International Classification of Primary Care (ICPC-2) was used to classify the symptoms. Results: There were 1,816 people having illness/injury during the last 3 months (26.3) and the majority of them went to CHCs when they got sick. Patients with digestive, neurological and respiratory symptoms were more likely to use CHCs as the first contact point. In contrast, people with musculoskeletal, female genital, and urological diseases were more likely to visit the higher level facilities such as provincial and central hospitals than CHCs. Key words: Healthcare sevices

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Perspectives of rural and remote primary healthcare services on the meaning and goals of clinical governance

Australian Journal of Primary Health ◽

10.1071/py16168 ◽

2017 ◽

Vol 23 (5) ◽

pp. 451 ◽

Cited By ~ 3

Author(s):

Ruyamuro K. Kwedza ◽

Sarah Larkins ◽

Julie K. Johnson ◽

Nicholas Zwar

Keyword(s):

Primary Healthcare ◽

Participant Observation ◽

Health Centre ◽

Document Analysis ◽

Healthcare Services ◽

Clinical Governance ◽

Rural And Remote ◽

Structured Interviews ◽

Frontline Staff ◽

Rural And Remote Areas

Definitions of clinical governance are varied and there is no one agreed model. This paper explored the perspectives of rural and remote primary healthcare services, located in North Queensland, Australia, on the meaning and goals of clinical governance. The study followed an embedded multiple case study design with semi-structured interviews, document analysis and non-participant observation. Participants included clinicians, non-clinical support staff, managers and executives. Similarities and differences in the understanding of clinical governance between health centre and committee case studies were evident. Almost one-third of participants were unfamiliar with the term or were unsure of its meaning; alongside limited documentation of a definition. Although most cases linked the concept of clinical governance to key terms, many lacked a comprehensive understanding. Similarities between cases included viewing clinical governance as a management and administrative function. Differences included committee members’ alignment of clinical governance with corporate governance and frontline staff associating clinical governance with staff safety. Document analysis offered further insight into these perspectives. Clinical governance is well-documented as an expected organisational requirement, including in rural and remote areas where geographic, workforce and demographic factors pose additional challenges to quality and safety. However, in reality, it is not clearly, similarly or comprehensively understood by all participants.

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Building capacity in primary health care to respond to the needs of asylum seekers and refugees in Melbourne, Australia: the 'GP Engagement' initiative

Australian Journal of Primary Health ◽

10.1071/py18190 ◽

2020 ◽

Vol 26 (1) ◽

pp. 10

Author(s):

Mark Timlin ◽

Alana Russo ◽

Jacquie McBride

Keyword(s):

Health Care ◽

Primary Health Care ◽

Primary Healthcare ◽

Asylum Seekers ◽

Healthcare Services ◽

Collaborative Problem Solving ◽

Eastern Region ◽

Record Keeping ◽

Primary Health ◽

Asylum Seekers And Refugees

Asylum seekers and refugees experience poorer health than the broader Australian population. Universal primary healthcare services play an integral role in supporting and optimising the health and wellbeing of these communities. However, clinical-level issues frequently compromise the quality of care provided to these groups. The ‘GP Engagement’ initiative, implemented in the south-eastern region of Melbourne, aimed to build capacity within universal primary health care to respond to the needs of asylum seekers and refugees. This involved engaging general practice clinics, resourcing them with tools and frameworks, and undertaking collaborative problem-solving on refugee issues. Evaluation methods included: rigorous record keeping; pre- and post-practice assessments guided by a self-reported ‘12-Point Checklist’; and participant feedback. Findings from 57 participating health professionals indicated changes in the way that GPs work with asylum seekers and refugees. ‘GP Engagement’ suggests that it is possible to build primary healthcare responsiveness to asylum seekers and refugees through a strategic regional approach that is firmly grounded in evidence-based practice and considerate of the requirements and constraints of GPs.

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Protocol for a systematic review of barriers, facilitators and outcomes in primary healthcare services for women in Pakistan

BMJ Open ◽

10.1136/bmjopen-2020-043715 ◽

2021 ◽

Vol 11 (3) ◽

pp. e043715

Author(s):

Sara Rizvi Jafree ◽

Qaisar Khalid Mahmood ◽

Ain ul Momina ◽

Florian Fischer ◽

Jane Barlow

Keyword(s):

Systematic Review ◽

Health Outcomes ◽

Primary Healthcare ◽

Healthcare Delivery ◽

Synthesis Method ◽

Healthcare Services ◽

Barriers And Facilitators ◽

Cochrane Library ◽

Health Coverage ◽

The Government

IntroductionThe lack of universal health coverage and high poverty rates among the majority of women in Pakistan makes it essential to understand the quality and effectiveness of primary healthcare services. The aim of this project is to systematically review the available literature for interventions for primary healthcare services for women in order to provide the basis for future healthcare policy. The primary objective is to identify the effectiveness of the intervention in terms of how successful it was in improving health of women; whereas the secondary aim is to identify barriers and facilitators for delivery of primary healthcare services.Methods and analysisA systematic review using a narrative synthesis will be undertaken, including qualitative, quantitative and mixed methods studies from January to June 2021. Electronic databases will be used including PubMed, BMC, Medline, CINAHL and Cochrane Library. The search will be conducted in English and no date restrictions will be applied. A thematic synthesis method will be used for data synthesis involving three steps: (1) the identification, coding and initial theme generation for effectiveness of primary healthcare interventions in Pakistan for women, (2) identification and grouping of overarching themes, and related subthemes, to develop descriptive themes for barriers and facilitators for primary healthcare delivery, and (3) generation of general analytical themes in order to present recommendations in terms of improved health outcomes for women.Ethics and disseminationEthics approval for this study was obtained from the Institutional Review Board, Forman Christian College University. Results will be disseminated via publications in international peer-reviewed journals. In addition, conference proceedings will be used to inform the government, researchers, donors, non-governmental organisations and other stakeholders. This study will result in a systematic identification and synthesis of barriers and facilitators for women’s health outcomes that will help inform future primary health policies.PROSPERO registration numberCRD42020203472.

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Enablers and Barriers to Accessing Healthcare Services for Aboriginal People in New South Wales, Australia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18063014 ◽

2021 ◽

Vol 18 (6) ◽

pp. 3014

Author(s):

Davida Nolan-Isles ◽

Rona Macniven ◽

Kate Hunter ◽

Josephine Gwynn ◽

Michelle Lincoln ◽

...

Keyword(s):

Healthcare System ◽

Aboriginal People ◽

Healthcare Delivery ◽

Healthcare Services ◽

Cultural Safety ◽

Healthcare Outcomes ◽

Snowball Sampling ◽

Structured Interviews ◽

Barriers And Enablers ◽

Sustainable Services

Background: Australia’s healthcare system is complex and fragmented which can create challenges in healthcare, particularly in rural and remote areas. Aboriginal people experience inequalities in healthcare treatment and outcomes. This study aimed to investigate barriers and enablers to accessing healthcare services for Aboriginal people living in regional and remote Australia. Methods: Semi-structured interviews were conducted with healthcare delivery staff and stakeholders recruited through snowball sampling. Three communities were selected for their high proportion of Aboriginal people and diverse regional and remote locations. Thematic analysis identified barriers and enablers. Results: Thirty-one interviews were conducted in the three communities (n = 5 coastal, n = 13 remote, and n = 13 border) and six themes identified: (1) Improved coordination of healthcare services; (2) Better communication between services and patients; (3) Trust in services and cultural safety; (4) Importance of prioritizing health services by Aboriginal people; (5) Importance of reliable, affordable and sustainable services; (6) Distance and transport availability. These themes were often present as both barriers and enablers to healthcare access for Aboriginal people. They were also present across the healthcare system and within all three communities. Conclusions: This study describes a pathway to better healthcare outcomes for Aboriginal Australians by providing insights into ways to improve access.

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