scholarly journals Access to healthcare for children with Congenital Zika Syndrome in Brazil: perspectives of mothers and health professionals

2019 ◽  
Vol 34 (7) ◽  
pp. 499-507 ◽  
Author(s):  
Maria S V Albuquerque ◽  
Tereza M Lyra ◽  
Ana P L Melo ◽  
Sandra A Valongueiro ◽  
Thalia V B Araújo ◽  
...  

Abstract The Congenital Zika Syndrome (CZS) epidemic took place in Brazil between 2015 and 2017 and led to the emergence of at least 3194 children born with CZS. We explored access to healthcare services and activities in the Unified Health Service (Sistema Único de Saúde: SUS) from the perspective of mothers of children with CZS and professionals in the Public Healthcare Network. We carried out a qualitative, exploratory study, using semi-structured interviews, in two Brazilian states—Pernambuco, which was the epicentre of the epidemic in Brazil, and Rio de Janeiro, where the epidemic was less intense. The mothers and health professionals reported that healthcare provision was insufficient and fragmented and there were problems with follow-up care. There was a lack of co-ordination and an absence of communication between the various specialized services and between different levels of the health system. We also noted a public–private mixture in access to healthcare services, resulting from a segmented system and related to inequality of access. High reported household expenditure is an expression of the phenomenon of underfunding of the public system. The challenges that mothers and health professionals reported exposes contradictions in the health system which, although universal, does not guarantee equitable and comprehensive care. Other gaps were revealed through the outbreak. The epidemic provided visibility regarding difficulties of access for other children with disabilities determined by other causes. It also made explicit the gender inequalities that had an impact on the lives of mothers and other female caregivers, as well as an absence of the provision of care for these groups. In the face of an epidemic, the Brazilian State reproduced old fashioned forms of action—activities related to the transmitting mosquito and to prevention with an emphasis on the individual and no action related to social determinants.

2019 ◽  
Vol 7 (2) ◽  
pp. 33-43 ◽  
Author(s):  
Hannah Bradby ◽  
Jenny Phillimore ◽  
Beatriz Padilla ◽  
Tilman Brand

Healthcare has long been a gendered enterprise, with women taking responsibility for maintaining health and engaging with service providers. Universal healthcare provision notwithstanding, women nonetheless undertake a range of healthcare work, on their own account and on behalf of others, which remains largely invisible. As part of a multi-method comparative European study that looked at access to healthcare in diverse neighbourhoods from the point of view of people’s own health priorities, the concept of ‘healthcare bricolage’ describes the process of mobilizing resources and overcoming constraints to meet particular health needs. Bricolage mediates between different kinds of resources to meet particular challenges and describing these processes makes visible that work which has been unseen, over-looked and naturalised, as part of a gendered caring role. Drawing on 160 semi-structured interviews and a survey with 1,755 residents of highly diverse neighbourhoods in Germany, UK, Sweden and Portugal, this article illustrates the gendered nature of healthcare bricolage. The complex variations of women’s bricolage within and beyond the public healthcare system show how gendered caring roles intersect with migration status and social class in the context of particular healthcare systems.


2020 ◽  
Vol 8 (4) ◽  
pp. 172-181
Author(s):  
Ephrem Habtemichael Redda ◽  
Jhalukpreya Surujlal

Purpose of study: The purpose of this study was to assess patient satisfaction levels within South African public healthcare facilities. The influence of gender and ethnic grouping (race) perceptions of satisfaction of healthcare services was investigated. Methodology: The study followed a cross-sectional research design and a quantitative research method. The data was collected as part of the General Household Survey in 2018 by Statistics South Africa (the national statistics service of South Africa). Descriptive statistics and cross-tabulation were performed to address the research objectives of the study. Main findings: The results show that the majority of the patients who participated in the survey are satisfied with the public healthcare service they received. The leading provinces that achieved very satisfied patients are Limpopo, the Eastern Cape, Mpumalanga, KwaZulu-Natal, and Gauteng. Applications of the study: The study is important in many ways as it highlights the discrepancies of healthcare provision to the public health decision-makers. For example, the results show that generally, the male patients were slightly more satisfied with the healthcare services than their female counterparts. In terms of ethnic grouping, it appears that white patients are generally more satisfied with the public healthcare services they receive than other race groups. Novelty/originality of study: A study of this nature has not been conducted in South Africa apart from the anecdotal reports of the department of health and Statistics South Africa. The study delved to analyze the public healthcare service in all provinces of the republic and also provided insight into gender and racial perception of healthcare services in the country.


Author(s):  
Matic Kavčič ◽  
Majda Pahor

This article starts with background information on the Slovenian healthcare system and the description of the evolutionary process and privatisation reforms that bring a mix of public and private healthcare services. The authors' aim is to conceptualise existing modes of public and private healthcare provision and discuss possible implications for user choice and accessibility of services. A descriptive and exploratory case study approach was employed. Literature and document analysis was complemented by secondary data and semi-structured interviews. The results demonstrate four modes of healthcare services in relation to public-private delivery. The ‘public non-profit' type refers to publicly financed and delivered services. The ‘private within public' type addresses services provided within and by the public sector for patients who pay out-of-pocket. The ‘private for public' type deals with services provided by private entities with concessions. The ‘private for-profit' type refers to completely private provision (without concession) of self-pay services. The strengths and weaknesses of each mode with respect to choice, space-time accessibility, financial accessibility and quality of services are critically discussed. The results of the study show that private healthcare services significantly complement and compete with public sector. In addition, there is a risk that uncontrolled mixing of public and private modes of practice may bring about unethical behaviour and corruption.


2020 ◽  
Vol 18 (2) ◽  
pp. 149
Author(s):  
Mohammed Mustapha Namadi

Corruption is pervasive in Nigeria at all levels. Thus, despite recent gains in healthcare provision, the health sector faces numerous corruption related challenges. This study aims at examining areas of corruption in the health sector with specific focus on its types and nature. A sample size of 480 respondents aged 18 years and above was drawn from the eight Metropolitan Local Government Areas of Kano State, using the multistage sampling technique. The results revealed evidence of corrupt practices including those related to unnecessary-absenteeism, diversion of patients from the public health facilities to the private sector, diverting money meant for the purchase of equipment, fuel and diesel, bribery, stealing of medications, fraud, misappropriation of medications and unjustifiable reimbursement claims. In order to resolve the problem of corrupt practices in the healthcare sector, the study recommended the need for enforcement of appropriate code of ethics guiding the conduct of the health professionals, adoption of anti-corruption strategies, and strengthening the government monitoring system to check corruption in public health sector in order to ensure equitable access to healthcare services among the under-privileged people in the society.


2020 ◽  
Vol 16 ◽  
pp. 45-76
Author(s):  
Richard Pankomera ◽  
Darelle Van Greunen

Although Information and Communication Technologies (ICTs) in the healthcare sector are extensively deployed globally, they are not used effectively in developing countries. Many resource poor countries face numerous challenges in implementing the ICT interventions. For instance, many health applications that have been deployed are not user-centric. As a result, such ICT interventions do not benefit many health consumers. The lack of an ICT framework to support patient-centric healthcare services in Malawi renders the e-health and mhealth interventions less sustainable and less cost effective. The aim of the study was therefore to develop an ICT Framework that could support patient-centric healthcare services in the public health sector in Malawi. The comprehensive literature review and semi-structured interviews highlighted many challenges underlying ICT development in Malawi. An ICT framework for patient-centric healthcare services is therefore proposed to ensure that eHealth and mobile health interventions are more sustainable and cost effective. The framework was validated by five experts selected from different areas of expertise including mhealth application developers, ICT policy makers and public health practitioners. Results show that the framework is relevant, useful and applicable within the setting of Malawi. The framework can also be implemented in various countries with similar settings.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sanghamitra Das ◽  
Samhita Das

Media reports of the COVID-19 pandemic in India have highlighted the important role that India’s female community health workers, the Accredited Social Health Activists (ASHAs), have played in managing COVID infections in India. This paper explores the epistemic basis of ASHA work to understand the significance of their role. Through a discourse analysis of textual media articles, we show that the ASHAs’ routine and COVID-related caregiving practices are a form of embodied, intimate labor rooted in their situated, community-oriented knowledge. This labor is devalued as emotional and feminized care work, which denies the ASHAs professional status in the public healthcare system of India and, in turn, reflects a hierarchy among health practitioners that stems from the status of objectivity/disembodiment in biomedicine. We find that, despite their low status in the public health system, ASHA workers develop a self-concept that enables them to self-identify as healthcare professionals, motivating them to continue providing essential healthcare services during the pandemic. We argue that an official recognition of the epistemic value of ASHA work would help to overcome the age-old nature/culture dichotomy that informs what counts as valuable, legitimate, formal medical knowledge. Furthermore, our analysis provides a critique of the gendered devaluation of care work within a political economy of health increasingly dictated by a neoliberal logic.


Author(s):  
Jussi S. Jauhiainen ◽  
Miriam Tedeschi

AbstractFinnish authorities provide undocumented migrants with at least emergency healthcare services, but very few (if any) undocumented migrants use these or other public healthcare services. There are challenges to accessing healthcare, including language, culture or communication, inadequate information, difficult opening times, lack of specialised services, fear of using such services, and lack of networks relating to social and healthcare services. The provision of wider healthcare services and prevention of illnesses is actually less expensive for countries than providing undocumented migrants with only emergency healthcare.This chapter discusses the undocumented migrants’ access to healthcare and their use of healthcare services. The Constitution of Finland guarantees emergency healthcare services for everyone staying in Finland, including undocumented migrants; however, the actual provision of healthcare (emergency or otherwise) for undocumented migrants varies greatly among local municipalities. Furthermore, few migrants use these available services. The majority turn to unofficial services, with some risk for themselves and the local community. The chapter highlights issues regarding the mental and physical health of undocumented migrants, who often suffer from trauma, which is not properly treated. It also discusses the effect of the COVID-19 pandemic on undocumented migrants in Finland.


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