scholarly journals Community based approach to address health disparities among Roma in North Macedonia

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
B Pavlovski ◽  
J Frishchikj
Keyword(s):  
Health Services ◽  
National Level ◽  
Access To Health Services ◽  
Community Members ◽  
Community Based ◽  
Access To Health ◽  
Health Related ◽  
Self Reported Health Status ◽  
Health Rights

Abstract Issue Roma represent vulnerable group regarding health and health outcomes. Most health research and policies perceive Roma as a coherent group, although there are disparities within different subgroups. This is due to social determinants of health and other causes. Perceiving Roma community as monolith group may result in provision of activities for persons that don’t have need and leaving behind the vulnerable. Situation is similar with other marginalized and vulnerable populations. Description In 2016 started community based intervention including social accountability and legal empowerment regarding coverage,quality of health services and health rights violation. Work conducted in ShutoOrizari municipality with estimated 30.000 Roma. In 4 localities where most vulnerable Roma live, each comprised of 200 households. 2 persons from Roma NGOs and 4 community members work as team in 1 locality. Mapping of the community conducted and community inquiry. Findings shared with the community members. Findings used to conduct education of community and toconduct advocacy on local and national level with community participation in 2018for improvement of coverage and quality of services. Results Approach identified disparities among Roma.1256 persons surveyed from 4 localities. 4 localities have high unemployment rate (above 70%),monthly income related to the locality (p < 0.0002). Disparities in health and access to health services among localities noted. Self-reported health status is related to locality(p < 0.002). Coverage with health services also,including having registered gynecologist(p < 0.001),regular gynecological examinations(p < 0.00001),antenatal care(p < 0.0003). Lessons Identifying needs among Roma living in smaller localities enables tailoring of health interventions based on needs. Identification of the problems on micro level is relevant for the community concerned,increasing their involvement in demanding improvement and advocacy. Key messages Working in strictly defined localities/groups from Roma communities provides accurate insight in the health related issues. Working with defined localities/groups enables greater involvement of the community in advocacy for fulfillment of their rights.

scholarly journals Factors associated with access to health services and quality of life in knee osteoarthritis patients: a multilevel cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Siriwan Choojaturo ◽  
Siriorn Sindhu ◽  
Ketsarin Utriyaprasit ◽  
Chukiat Viwatwongkasem
Keyword(s):  
Quality Of Life ◽  
Health Service ◽  
Health Services ◽  
Self Management ◽  
Access To Health Services ◽  
Patient Factors ◽  
Cross Sectional ◽  
Knee Oa ◽  
Access To Health

Abstract Background The main purpose of health service systems is to improve patients’ quality of life (QoL) and to ensure equitable access to health services. However, in reality, nearly half of knee osteoarthritis (OA) patients present to the health system do not have access to health services, and their QoL remains poor. These circumstances raise important questions about what (if any) factors can improve health care accessibility and QoL for knee OA patients. Methods A multicenter, cross-sectional survey was performed with 618 knee OA patients who received care at 16 hospitals in Thailand. Structural equation modeling (SEM) was conducted to investigate the association of health service factors and patient factors with access to health services and QoL. Results The QoL of knee OA patients was very poor (mean score = 33.8). Only 2.1% of the knee OA patients found it easy to obtain medical care when needed. Approximately 39.4% of them were able to access appropriate interventions before being referred for knee replacement. More than 85% of orthopedic health services had implemented chronic disease management (CDM) policy into practice. However, the implementation was basic, with an average score of 5.9. SEM showed that QoL was determined by both health system factors (β = .10, p = .01) and patient factors (β = .29, p = .00 for self-management and β = −.49, p = .00 for disease factors). Access to health services was determined by self-management (β = .10, p = .01), but it was not significantly associated with QoL (β = .00, p = 1.0). Conclusions This study provides compelling information about self-management, access to health services and QoL from the individual and health service system perspectives. Furthermore, it identifies a need to develop health services that are better attuned to the patient’s background, such as socioeconomic status, disease severity, and self-management skills.

Consumer-Level Perceived Access to Health Services and Its Effects on Vulnerability and Health Outcomes

2020 ◽  
Vol 39 (2) ◽  
pp. 240-255 ◽  
Author(s):  
Emily C. Tanner ◽  
Richard J. Vann ◽  
Elvira Kizilova
Keyword(s):  
Health Services ◽  
Well Being ◽  
Subjective Perception ◽  
Access To Health Services ◽  
Close Link ◽  
Perceived Vulnerability ◽  
Access To Health ◽  
Health Related ◽  
Perceived Access ◽  
The Relationship

Access to health services affects the well-being of millions of consumers. Although the topic of health-related access is regularly featured in popular and academic conversations, these conversations primarily concentrate on objective or situational access factors. This research focuses instead on consumers’ subjective perception of access to better appreciate how personally experienced service availability and ease of access jointly determine consumers’ access perceptions. The authors find that perceived access to health services (PAHS) offers insight into the relationships between access, perceived health vulnerability, and overall health. Through scale development and a series of three theory-testing studies, this work demonstrates the close link between PAHS and perceived vulnerability (Study 1), connects this relationship to overall health (Studies 1–3), and establishes behavioral changes associated with access-vulnerability concerns (Study 2). Moreover, Study 3 finds evidence for a “muting” effect of health system distrust on the relationship between PAHS and perceived vulnerability as well as an “amplifying” effect of health motivation on the relationship between perceived vulnerability and overall health. Together, these studies illustrate PAHS’s relevance for explaining consumer vulnerability and overall health.

scholarly journals Evaluation of a community-based intervention for health and economic empowerment of marginalized women in India

2019 ◽  
Author(s):  
Shantanu Sharma ◽  
Devika Mehra ◽  
Faiyaz Akhtar ◽  
Sunil Mehra
Keyword(s):  
Health Services ◽  
Qualitative Interviews ◽  
Economic Empowerment ◽  
Successful Implementation ◽  
Access To Health Services ◽  
Community Based Interventions ◽  
Post Intervention ◽  
Community Based ◽  
Access To Health ◽  
Four Blocks

Abstract Background Empowered women have improved decision-making capacity and can demand equal access to health services. Community-based interventions (CBI) based on building women’s groups for awareness generation on maternal and child health (MCH) are the best and cost-effective approach in improving their access to health services. The present endeavor evaluates a community-based intervention aimed at improving marginalized women’s health and economic status using the peer-led approach from two districts of India. Methods We used peer educators as mediators of knowledge transfer among women and for creating a supportive environment at the household and community-level. The intervention was implemented in two socially backward districts of Uttar Pradesh, namely Kaushambi and Banda. Two development blocks in each of the two districts were selected randomly, and twenty-four villages in each of the four blocks were selected based on the high percentage of a marginalized population. The evaluation of the intervention involved a non-experimental, pre- and post-research design, using a mixed-method approach. Data were collected at three points in time, including a rapid assessment (quantitative and qualitative interviews) at baseline, qualitative interviews at the end line and tracking data of the intervention population (n=37,324) through an online management information system. Results Most of the women in Banda (90%) and Kaushambi (85%) attended at least 60% of the education sessions. Around 39% of women in Banda and 35% of women in Kaushambi registered for livelihood scheme, and 94% and 80% of them had worked under the scheme. Women during group discussions informed that their awareness about MCH increased post-intervention. The money earned after getting work under livelihood scheme or from daily savings was deposited in the bank account by the women. These savings had helped women investing money at the times of need, such as starting their work, in emergencies for the medical treatment of their family members, education of their children, etc. Conclusion Considering the interlinked plexus of literacy, social status, economic empowerment, and health status of women, interventions targeting anyone of them in silos may not achieve the desired results. The study provides scientific evidence of the successful implementation of peer-led community-based intervention model..

The reported benefits of telehealth for rural Australians

2010 ◽  
Vol 34 (3) ◽  
pp. 276 ◽  
Author(s):  
Jennifer J. Moffatt ◽  
Diann S. Eley
Keyword(s):  
Professional Development ◽  
Cost Effectiveness ◽  
Health Services ◽  
Rural Health ◽  
Health Professionals ◽  
Access To Health Services ◽  
Rural And Remote ◽  
Remote Locations ◽  
Access To Health

Objective.A literature review was conducted to identify the reported benefits attributed to telehealth for people living and professionals working in rural and remote areas of Australia. Data sources.Scopus and relevant journals and websites were searched using the terms: telemedicine, telehealth, telepsychiatry, teledermatology, teleradiology, Australia, and each state and territory. Publications since 1998 were included. Study selection.The initial search resulted in 176 articles, which was reduced to 143 when research reporting on Australian rural, regional or remote populations was selected. Data synthesis.A narrative review was conducted using an existing ‘benefits’ framework. Patients are reported to have benefited from: lower costs and reduced inconvenience while accessing specialist health services; improved access to services and improved quality of clinical services. Health professionals are reported to have benefited from: access to continuing education and professional development; provision of enhanced local services; experiential learning, networking and collaboration. Discussion.Rural Australians have reportedly benefited from telehealth. The reported improved access and quality of clinical care available to rural Australians through telemedicine and telehealth may contribute to decreasing the urban–rural health disparities. The reported professional development opportunities and support from specialists through the use of telehealth may contribute to improved rural medical workforce recruitment and retention. What is known about the topic?An extensive international literature has reported on the efficacy of telehealth, and to a lesser extent the clinical outcomes and cost-effectiveness of telemedicine. Systematic reviews conclude that the quality of the studies preclude definitive conclusions being drawn about clinical and cost-effectiveness, although there is some evidence of effective clinical outcomes and the potential for cost-benefits. Little attention has been paid to the benefits reported for people who live in rural and remote Australia, despite this being a rationale for the use of telehealth in rural and remote locations. What does this paper add?Patients in rural and remote locations in Australia are reported to benefit from telehealth by increased access to health services and up-skilled health professionals. Health professionals are reported to benefit from telehealth by up-skilling from increased contact with specialists and increased access to professional development. The review findings suggest that one strategy, the increased use of telehealth, has the potential to reduce the inequitable access to health services and the poorer health status that many rural Australians experience, and contribute to addressing the on-going problem of the recruitment and retention of the rural health workforce. What are the implications for practitioners?The use of telehealth appears to be a path to up-skilling for rural and remote practitioners.

scholarly journals Evaluation of a community-based intervention for health and economic empowerment of marginalized women in India

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shantanu Sharma ◽  
Devika Mehra ◽  
Faiyaz Akhtar ◽  
Sunil Mehra
Keyword(s):  
Health Services ◽  
Qualitative Interviews ◽  
Uttar Pradesh ◽  
Access To Health Services ◽  
Community Based Interventions ◽  
Post Intervention ◽  
Community Based ◽  
Access To Health ◽  
Marginalized Women ◽  
Four Blocks

Abstract Background Empowered women have improved decision-making capacity and can demand equal access to health services. Community-based interventions based on building women’s groups for awareness generation on maternal and child health (MCH) are the best and cost-effective approaches in improving their access to health services. The present study evaluated a community-based intervention aimed at improving marginalized women’s awareness and utilization of MCH services, and access to livelihood and savings using the peer-led approach from two districts of India. Methods We used peer educators as mediators of knowledge transfer among women and for creating a supportive environment at the household and community levels. The intervention was implemented in two marginalized districts of Uttar Pradesh, namely Banda and Kaushambi. Two development blocks in each of the two districts were selected randomly, and 24 villages in each of the four blocks were selected based on the high percentage of a marginalized population. The evaluation of the intervention involved a non-experimental, ‘post-test analysis of the project group’ research design, in a mixed-method approach. Data were collected at two points in time, including qualitative interviews at the end line and tracking data of the intervention population (n = 37,324) through an online management information system. Results Most of the women in Banda (90%) and Kaushambi (85%) attended at least 60% of the education sessions. Around 39% of women in Banda and 35% of women in Kaushambi registered for the livelihood scheme, and 94 and 80% of them had worked under the scheme in these two places, respectively. Women’s awareness about MCH seemed to have increased post-intervention. The money earned after getting work under the livelihood scheme or from daily savings was deposited in the bank account by the women. These savings helped the women investing money at times of need, such as starting their work, in emergencies for the medical treatment of their family members, education of their children, etc. Conclusion Peer-led model of intervention can be explored to improve the combined health and economic outcomes of marginalized women.

scholarly journals Access of the black population to health services: integrative review

2020 ◽  
Vol 73 (4) ◽  
Author(s):  
Nelma Nunes da Silva ◽  
Veronica Batista Cambraia Favacho ◽  
Gabriella de Andrade Boska ◽  
Emerson da Costa Andrade ◽  
Neuri Pires das Merces ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Services ◽  
Literature Review ◽  
Black Population ◽  
Limiting Factors ◽  
Structural Factors ◽  
Access To Health Services ◽  
Fundamental Factor ◽  
Access To Health

ABSTRACT Objectives: demonstrate and discuss how the black population’s access to health services occurs Methods: integrative literature review with the following question: How does the black population’s access to health services occur? The search was carried out in the Scholar, LILACS and SciELO databases and used the descriptor “access to health services” and the term “population,” resulting in a sample with twelve articles. Results: studies show that the difficulty of access is a fundamental factor for the quality of life of people, directly compromising preventive services, especially for women’s health and, in addition, it has significant impact on the illness process of the black population within its particularities. Final Considerations: several limiting factors compromise the black population’s access to health services, including institutional and structural factors

scholarly journals Relationship between Financial Factors and Access to Health Care and Quality of Life for HIV / AIDS Patients

2021 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Laila Salma Iklama ◽  
Nursalam Nursalam ◽  
Ni Ketut Alit Armini
Keyword(s):  
Quality Of Life ◽  
Health Services ◽  
Access To Health Care ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Significance Level ◽  
Financial Factors ◽  
Access To Health ◽  
Hiv Aids

Introduction:Patients with HIV-AIDS experience various problems, one of which is related to financial factors and access to health services, this will also affect the patient's quality of life. The purpose of this study was to analyze the relationship between financial factors and access to health services.Method:This was a cross-sectional study with a sample size of 101 respondents who were selected using simple random sampling technique. The independent variable in this study is income and access to services, while the dependent variable in this study is quality of life. The instrument used was a demographic questionnaire and Health-Related Quality of Life, the data were analyzed using chi square with a significance level of p <0.05.Results:The results showed that there was a significant relationship between income (p = 0.044) and the availability of infrastructure (p = 0.003) with the quality of life of HIV-AIDS patients.Conclusion:The financial and access to healthcare factors  are related to the quality of life of clients with HIV-AIDS, so that patients with good quality of life will show that the level of fulfillment of needs and access to health services is also good.

scholarly journals Self-reported health status and access to health services in a sample of prisoners in Italy

2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Carmelo GA Nobile ◽  
Domenico Flotta ◽  
Gaetano Nicotera ◽  
Claudia Pileggi ◽  
Italo F Angelillo
Keyword(s):  
Health Status ◽  
Health Services ◽  
Access To Health Services ◽  
Access To Health ◽  
Reported Health ◽  
Self Reported Health Status

scholarly journals "There's no point in complaining, nothing changes": rural disaffection with complaints as an improvement method

2006 ◽  
Vol 30 (3) ◽  
pp. 322 ◽  
Author(s):  
Judith A Jones ◽  
Terri A Meehan-Andrews ◽  
Karly B Smith ◽  
John S Humphreys ◽  
Lynn Griffin ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Quality Improvement ◽  
Health Services ◽  
Service Improvement ◽  
Access To Health Services ◽  
Access To Health ◽  
Quality Of Health Services ◽  
Rural Consumers ◽  
Lack Of Knowledge

Objective: To validate earlier findings that lack of access to health services is the most likely issue of complaint by rural consumers, and that lack of knowledge about how to make effective complaints and scepticism that responses to complaints bring about service improvement account for the under-representation of complaints from rural consumers. Design: Unaddressed reply-paid mail survey to 100% of households in small communities, and 50%, 20% or 10% in progressively larger communities. Setting: Eight communities in the Loddon-Mallee region of Victoria. Participants: 983 householders most responsible for the health care of household members, responding to a mailed questionnaire. Main outcome measures: Issues of complaints actually made; issues of unsatisfactory situations when a complaint was not made; reasons for not complaining; to whom complaints are made; and plans for dealing with any future complaint. Results: Earlier findings were confirmed. Lack of access to health services was the most important issue, indicated by 54.8% of those who had made a complaint, and 72% of those who wanted to but did not. The most common reason given for not complaining was that it was futile to do so. Lack of knowledge of how to make effective complaints which might contribute to the quality assurance cycle was evident. Conclusions: Rural consumers? disaffection with health complaints as a means to quality improvement poses a significant barrier to consumer engagement in quality assurance processes. Provider practices may need to change to regain community confidence in quality improvement processes. CONSUMER VIEWS ABOUT the quality of health services provide a valuable source of information to those concerned with accountability and quality assurance in service provision.1,2 When such views are expressed as complaints which are responded to in ways which focus on quality improvement rather than allocation of blame, opportunities may arise to improve the quality of health services for all consumers.3,4

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