scholarly journals Chronic pain and migration-related factors among Syrian refugees: a cross-sectional study

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
E M Strømme ◽  
J Haj-Younes ◽  
W Hasha ◽  
L T Fadnes ◽  
B Kumar ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Social Relationships ◽  
Access To Health Care ◽  
Trauma Exposure ◽  
Syrian Refugees ◽  
Related Factors ◽  
Cross Sectional ◽  
Poor Access ◽  
Access To Health

Abstract Background Refugees display high rates of chronic pain. However, the relationship between refugee-related exposures introduced along their migration trajectories and the development of chronic pain remains unclear. The aim of this study was to assess the impact of stressors induced at various migration stages on chronic pain in Syrian refugees. Methods This is a cross-sectional survey among adult Syrian refugees in Lebanon and in Norway. We conducted logistic regression to study the associations between chronic pain and migration-related factors experienced prior to or during flight (trauma exposure, migrating alone and detainment) and after arrival in a new country (legal status, social relationships, living conditions and access to health care). Results Altogether 827 Syrians participated (response rate 85%). The mean age was 33 years and 41% were women. The overall prevalence of chronic pain was 30%. The mean WHO Quality of Life (WHOQOL) domain scores for both social relationships (13.4) and environment (10.2) were significantly lower among those reporting chronic pain, with low scores indicating less satisfaction. Regression analyses revealed an association between chronic pain and exposure to trauma (adjusted odds ratio (AOR) 2.5 (1.8; 3.4)), but no clear association between chronic pain and migrating alone or history of detention. Poor social relationships (AOR 1.9 (1.2; 3.1)), poor support from friends (AOR 1.5 (1.0; 2.1)) and poor living place (AOR 1.4 (1.0; 2.0)) were associated with reporting chronic pain, although associations reduced when adjusting for traumatic experiences. The associations between chronic pain and poor economy (AOR 1.6 (1.1; 2.5)) and poor access to health care (AOR 1.5 (1.0; 2.1)) persisted after trauma exposure adjustment. Conclusions We found a strong relationship between trauma exposure and chronic pain. Further, perceived poor economy and poor access to health care were associated with chronic pain regardless of trauma history. Key messages Trauma exposure, perceived poor economy and poor access to health care are associated with chronic pain among Syrian refugees. Public health care interventions should consider the combined impact of risk factors throughout the migration trajectory.

Impact of restricting access to health care services on Syrian refugees in Jordan: evidence from cross-sectional surveys

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ibraheem Khaled Abu Siam ◽  
María Rubio Gómez
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Health Care Cost ◽  
Syrian Refugees ◽  
Cross Sectional ◽  
Content Type ◽  
Care Access ◽  
Care Services

Purpose Access to health-care services for refugees are always impacted by many factors and strongly associated with population profile, nature of crisis and capacities of hosing countries. Throughout refugee’s crisis, the Jordanian Government has adopted several healthcare access policies to meet the health needs of Syrian refugees while maintaining the stability of the health-care system. The adopted health-care provision policies ranged from enabling to restricting and from affordable to unaffordable. The purpose of this paper is to identify the influence of restricted level of access to essential health services among Syrian refugees in Jordan. Design/methodology/approach This paper used findings of a cross-sectional surveys conducted over urban Syrian refugees in Jordan in 2017 and 2018 over two different health-care access policies. The first were inclusive and affordable, whereas the other considered very restricting policy owing to high inflation in health-care cost. Access indicators from four main thematic areas were selected including maternal health, family planning, child health and monthly access of household. A comparison between both years’ access indicators was conducted to understand access barriers and its impact. Findings The comparison between findings of both surveys shows a sudden shift in health-care access and utilization behaviors with increased barriers level thus increased health vulnerabilities. Additionally, the finding during implementation of restricted access policy proves the tendency among some refugees groups to adopt negative adaptation strategies to reduce health-care cost. The participants shifted to use a fragmented health-care, reduced or delayed care seeking and use drugs irrationally weather by self-medication or reduce drug intake. Originality/value Understanding access barriers to health services and its negative short-term and long-term impact on refugees’ health status as well as the extended risks to the host communities will help states that hosting refugees building rational access policy to protect whole community and save public health gains during and post crisis. Additionally, it will support donors to better mobilize resources according to the needs while the humanitarian actors and service providers will better contribute to the public health stability during refugee’s crisis.

scholarly journals Health challenges and access to health care among Syrian refugees in Jordan: a review

2018 ◽  
Vol 24 (07) ◽  
pp. 680-686 ◽  
Author(s):  
Wireen Dator ◽  
◽  
Hamzeh Abunab ◽  
Norenia Dao ayen
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Syrian Refugees ◽  
Access To Health

scholarly journals The role of psychosocial determinants in predicting adherence to treatment in patient with hypertension

2018 ◽  
Vol 11 (1) ◽  
pp. 8-16 ◽  
Author(s):  
Mohammad Reza Asgari ◽  
Hamid Bouraghi ◽  
Ali Mohammadpour ◽  
Mina Haghighat ◽  
Raheleh Ghadiri
Keyword(s):  
Social Support ◽  
Health Care ◽  
Self Efficacy ◽  
Access To Health Care ◽  
Perceived Social Support ◽  
Correlation Study ◽  
Adherence To Treatment ◽  
Treatment Access ◽  
Cross Sectional ◽  
Access To Health

Introduction Non-adherence in patients with hypertension directly exacerbates clinical outcomes. The purpose of the present research is to study the recognition of the relationships between the perceived social support and self-efficacy and the satisfaction of health care agents and the interaction of the patient with therapeutic personnel and access to health care and the behaviors of adherence to treatment in the patients who suffer hypertension. Materials and methods This descriptive cross-sectional correlation study recruited 250 patients from a specialized hypertension clinic in Semnan, who completed the following questionnaires: Multidimensional Scale of Perceived Social Support, self-efficacy, adherence to treatment, access to and satisfaction with health care, and the patient’s interaction with treatment personnel. Results An overall statistical description of the sample consists of 89 (35.6%) men and 161 (64.4%) women (SD = 10.41, range = 51.98). Regression coefficient of previous variables (three steps) shows that self-efficacy share, consent form civil services, and job could demonstrate with 99% certainty in the changes of treatment conformity in a meaningful way. Conclusions High self-efficacy, satisfaction with health care, and a favorable job have a high direct effect on adherence to treatment in patients with hypertension and controlling hypertension. Social support and education do not have a significant impact on adherence to treatment.

scholarly journals Health mediator model as a way to access to care and health information for Syrian refugees in Turkey

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
I Kayi ◽  
Z Şimşek2 ◽  
G Yıldırımkaya
Keyword(s):  
Health Care ◽  
Health System ◽  
Access To Health Care ◽  
Health Care Services ◽  
Legal Status ◽  
Healthcare Access ◽  
Syrian Refugees ◽  
Care Services ◽  
Access To Health ◽  
The City

Abstract The number of Syrian refugees residing in Turkey has increased over 200 times since 2012 reaching to 3,621,330 (April 2019). Turkey has granted temporary protection status, including access healthcare in the city of registration. Ministry of Health provides on-site health service in temporary shelters, however more than 90% of the Syrian refugees choose to stay in community settings, which along with language barriers limits their ability to access health care and information. With UNFPA we have designed a health mediator model to improve access to health care and awareness on priority concerns such as mental health, reproductive health, child health, health system in Turkey and legal status provided to Syrian refugees. This study is a participatory operational research to test the health mediator model. Operationalization took place in 3 phases: (1) selection and training of Syrian health mediators and provincial coordinators; (2) household visits and data collection; (3) evaluation and supervision. So far, we have trained 174 health mediators from 24 different Turkish cities. Training took 5 days with up to 30 participants each. UNFPA collaborated with NGOs that work with Syrian refugees for coordination purposes. Health mediators made household visits to reach out to Syrian families, gave health education and where necessary support for access to health care services, and conducted a needs assessment. Data collected has been the subject to weekly supervision meetings by local NGOs, health mediators and coordinators to set priorities for the upcoming week. Health mediator model was effective in reaching out to hard-to-reach groups among Syrian refugees, increased health system and legal awareness, contribute to improved healthcare access and prevention of negative health outcomes such as teenage marriages and pregnancies. Inclusion of refugees in decision-making and guidance during the implementation of the project was key for project success.

Healthcare infrastructure development in rural India: a critical analysis of its status and future challenges

2019 ◽  
Vol 25 (12) ◽  
pp. 1-9
Author(s):  
Nenavath Sreenu
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Access To Health Care ◽  
Health Care Facilities ◽  
Rural India ◽  
Infrastructure Development ◽  
Poor Access ◽  
Access To Health ◽  
Future Challenges

At present, the development of healthcare infrastructure in India is poor and needs fundamental reforms in order to deal with emerging challenges. This study surveys the growth of the healthcare infrastructure. The development of infrastructure and health care facilities, the position of the workforce, and the quality of service delivery are important challenges that are confronting healthcare centres in rural India. This article critically analyses the future challenges of Indian healthcare infrastructure development in rural areas, discussing the burden of disease, widespread financial deficiency, the vaccination policy and poor access to health care as some of the main issues. Life expectancy, literacy and per capita income are further considerations.

scholarly journals Patient-physician communication about financial problems: A cross-sectional study among over-indebted individuals

2019 ◽  
Author(s):  
Jacqueline Warth ◽  
Marie-Therese Puth ◽  
Ulrike Zier ◽  
Niklas Beckmann ◽  
Johannes Porz ◽  
...  
Keyword(s):  
Health Care ◽  
Health Status ◽  
General Practitioner ◽  
Educational Level ◽  
Financial Distress ◽  
Access To Health Care ◽  
Physician Communication ◽  
Financial Problems ◽  
Cross Sectional ◽  
Access To Health

Abstract Background About every tenth household across Europe is unable to meet payment obligations and living expenses on an ongoing basis and is thus considered over-indebted. Previous research suggests that over-indebtedness reflects a potential cause and consequence of psychosomatic health problems and limited access to health care. However, it is unclear whether those affected discuss their financial problems with general practitioners that often serve as patients’ initial medical contact. Therefore, this study examined patient-physician communication about financial problems in general practice among over-indebted individuals. Methods We conducted a cross-sectional survey among clients of 70 debt advice agencies in North Rhine-Westphalia, Germany, in 2017. We assessed the prevalence of patient-physician communication about financial problems and its association with patient characteristics using descriptive statistics and logistic regression analysis. Of 699 individuals who returned the questionnaire (response rate: 50.2%), we included 598 respondents enrolled in statutory health insurance with complete outcome data in the analyses. Results Less than one fourth of respondents had ever discussed financial problems with their general practitioner (n=135; 22.6%). Individuals with a high educational level were less likely to communicate about financial problems compared to those with medium educational level (aOR 0.11; 95% CI 0.01-0.83) after adjustment for other sociodemographic characteristics, health status and measures of financial distress. Those without a migrant background (aOR 2.09; 95% CI 1.32-3.32), the chronically ill (aOR 1.90; 95% CI 1.16-3.13) and individuals who reported high financial distress (aOR 2.15; 95% CI 1.22-3.78) and cutting on necessities to pay for medications (aOR 1.86; 95% CI 1.12-3.09) were more likely to report communication than their counterparts after adjustment. Conclusions Few over-indebted individuals discussed financial problems with their general practitioner. The findings suggest that patients’ health status, coping strategies and perception of financial distress might contribute to variations in disclosure of financial problems. Thus, enhancing communication and screening by routine assessment of financial problems in clinical practice can help to identify vulnerable patients and promote access to health care and social services and well-being for all.

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