Primary Healthcare for Queer Women and Trans People

2019 ◽  
pp. 167-186
Author(s):  
Erin Fredericks ◽  
Kelly Baker
Keyword(s):  
Primary Healthcare ◽  
Structural Changes ◽  
Healthcare Providers ◽  
Healthcare Provision ◽  
Queer Women ◽  
Quality Healthcare ◽  
Healthcare Needs ◽  
Trans People ◽  
Patient Relationships ◽  
Primary Healthcare Providers

This chapter supports primary healthcare providers in understanding and challenging heteronormativity and cisnormativity in their practice. Healthcare provision for queer women and trans people must be approached with an understanding of the way these patients’ healthcare needs are shaped by systematic and historical oppression in the healthcare system. Heteronormativity and cisnormativity are institutionalized in clinic spaces and procedures, including forms, washrooms, brochures, and interactions with healthcare providers and administrative staff. Preemptive structural changes can be made to clinic forms, procedures, spaces, language, and knowledge to address queer women and trans patients’ needs. Changes within the healthcare interaction that focus less on maintaining healthcare providers’ neutrality and comfort, or on the exoticized aspects of queer and trans identities, will further disrupt cisnormativity and heteronormativity within the patient–provider interaction, build trusting provider–patient relationships, and increase access to quality healthcare for this community.

Primary healthcare providers' attitudes and beliefs about the menopause-related care needs of women who have migrated from low- and middle-income countries to Australia

2020 ◽  
Vol 26 (1) ◽  
pp. 88
Author(s):  
Karin A. Stanzel ◽  
Karin Hammarberg ◽  
Jane Fisher
Keyword(s):  
Primary Healthcare ◽  
Online Survey ◽  
Healthcare Providers ◽  
Migrant Women ◽  
Care Needs ◽  
Middle Income ◽  
Structural Support ◽  
Middle Income Countries ◽  
Primary Healthcare Providers ◽  
Low And Middle Income

Health behaviour during midlife is linked to health outcomes in older age. Primary healthcare providers (PHCPs) are ideally placed to provide health-promoting information opportunistically to women in midlife. The aim of this study was to explore PHCPs views about the menopause-related care needs of migrant women from low- and middle-income countries and what they perceive as barriers and enablers for providing this. Of the 139 PHCPs who responded to an anonymous online survey, less than one-third (29.9%) routinely offered menopause-related information during consultations with migrant women. Most agreed that short appointments times (70.8%), lack of culturally and linguistically appropriate menopause information (82.5%) and lack of confidence in providing menopause-related care (32.5%) are barriers for providing comprehensive menopause-related care to migrant women. To overcome these, a menopause-specific Medicare item number and a one-stop website with health information in community languages were suggested. These findings suggest that menopause-related care is not routinely offered by PHCPs to migrant women from low- and middle- income countries and that their capacity to do this may be improved with adequate educational and structural support.

scholarly journals The experiences of clients and healthcare providers regarding the provision of reproductive health services including the prevention of HIV and AIDS in an informal settlement in Tshwane

2016 ◽  
Vol 21 ◽  
pp. 67-76
Author(s):  
M. L.S. Mataboge ◽  
S. Beukes ◽  
A. G.W. Nolte
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Primary Healthcare ◽  
Informal Settlement ◽  
Healthcare Providers ◽  
Hiv And Aids ◽  
Reproductive Health Services ◽  
Healthcare Provision ◽  
Reproductive Healthcare ◽  
Prevention Of Hiv

Globally challenges regarding healthcare provision are sometimes related to a failure to estimate client numbers in peri-urban areas due to rapid population growth. About one-sixth of the world's population live in informal settlements which are mostly characterised by poor healthcare service provision. Poor access to primary healthcare may expose residents of informal settlement more to the human immunodeficiency virus (HIV) and to acquired immunodeficiency syndrome (AIDS) than their rural and urban counterparts due to a lack of access to information on prevention, early diagnosis and treatment. The objective of this study was to explore and describe the experiences of both the reproductive health services' clients and the healthcare providers with regard to the provision of reproductive health services including the prevention of HIV and AIDS in a primary healthcare setting in Tshwane. A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during individual and focus group interviews respectively. Tesch's method for qualitative data analysis was used. Ethical principles guided the study, and certain strategies were followed to ensure trustworthiness. The findings revealed that females who lived in informal settlements were aware of the inability of the PHC setting to provide adequate reproductive healthcare to meet their needs. The HCPs acknowledged that healthcare provision was negatively affected by policies. It was found that the community members could be taught how to coach teenagers and support each other in order to bridge staff shortages and increase health outcomes including HIV/AIDS prevention.

scholarly journals The relationship between primary healthcare providers and their external supervisors in Rwanda

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Michael Schriver ◽  
Vincent K. Cubaka ◽  
Laetitia Nyirazinyoye ◽  
Sylvere Itangishaka ◽  
Per Kallestrup
Keyword(s):  
Primary Healthcare ◽  
Healthcare Providers ◽  
Relationship Building ◽  
Performance Evaluations ◽  
Supervisory Relationship ◽  
Group Discussions ◽  
Healthcare Facilities ◽  
Performance Based Financing ◽  
The Relationship ◽  
Primary Healthcare Providers

Background: External supervision of Rwandan primary healthcare facilities unfolds as an interaction between supervisors and healthcare providers. Their relationship has not been thoroughly studied in Rwanda, and rarely in Africa.Aim: To explore perceived characteristics and effects of the relationship between providers in public primary healthcare facilities and their external supervisors in Rwanda.Setting: We conducted three focus group discussions with primary healthcare providers (n = 16), three with external supervisors (n = 15) and one mixed (n = 5).Methods: Focus groups were facilitated under low-moderator involvement. Findings were extracted thematically and discussed with participating and non-participating providers and supervisors.Results: While external supervision is intended as a source of motivation and professional development in addition to its managerial purpose, it appeared linked to excessive evaluation anxiety among Rwandan primary healthcare providers. Supervisors related this mainly to inescapable evaluations within performance-based financing, whereas providers additionally related it to communication problems.Conclusion: External supervision appeared driven by systematic performance evaluations, which may prompt a strongly asymmetric supervisory power relation and challenge intentions to explore providers’ experienced work problems. There is a risk that this may harm provider motivation, calling for careful attention to factors that influence the supervisory relationship. It is a dilemma that providers most in need of supervision to improve performance may be most unlikely to benefit from it. This study reveals a need for provider-oriented supportive supervision including constructive attention on providers who have performance difficulties, effective relationship building and communication, objective and diligent evaluation and two-way feedback channels.

scholarly journals Childhood Cancer Early Detection Training Program for Primary Healthcare Providers

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 135s-135s ◽  
Author(s):  
B. Ntacyabukura
Keyword(s):  
Early Detection ◽  
Health Care Providers ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Signs And Symptoms ◽  
Health Centers ◽  
Childhood Cancers ◽  
Care Providers ◽  
Train The Trainer ◽  
Primary Healthcare Providers

Background and context: Over 250,000 new pediatric cancer cases are diagnosed yearly worldwide. Health care providers (mainly nurses) at health centers (HC) level are the children´s first opportunity for correctly recognizing and responding to early signs and symptoms of childhood cancers by appropriately referring them to district hospitals but studies show that 83% of nurses did not receive training on pediatric cancers. Insufficient knowledge about the warning signs and symptoms of pediatric cancer usually leads to improper diagnosis or delay to diagnosis and hence loss of many lives of these children. After realizing that majority in our community lack information on childhood cancers, our efforts since 2017 has been concentrated on training primary healthcare providers to recognize early signs and symptoms of childhood cancers. Aim: Improve survival of children with cancer by early detection of symptoms and signs and prompt referral by nurses at health centers. Strategy/Tactics: The program is consisted of trainings in selected regions of Rwanda. The first step is a “train the trainer workshop” where volunteering medical students and doctors are trained to train the nurses and community health workers. A two days workshop is organized subsequently in each province bringing together at least with one nurse from each selected health center. These trained nurses go back with materials to train their colleagues. They are followed up every three months with a survey to assess how much they retain the learned knowledge and the impact made. Prior to trainings, RCCR and pediatric oncologists develop training materials that include training curriculum for both the trainers and for the trainees (nurses), educational and awareness material (posters, fliers, brochures). Trained nurses are kept in RCCR database for their follow-up and track any case of a childhood cancer at their health facilities. Program/Policy process: The program is run in 4 phases, Phase 1: Develop training materials materials Phase 2: Recruitment and train the trainer phase Phase 3: Selection of health center and recruitment of healthcare providers Phase 4: The execution phase. Trainings are carried out in selected health centers. Phase 5: Post training follow-up. Outcomes: In 2017, the program was conducted in 4 health centers and around 90 health care providers were trained with more than 800 posters, 950 brochures and 300 flyers distributed. According to reports, after the training, the number of referrals from health centers increased and the posttraining showed how accurate nurses were in stating their differential diagnoses. What was learned: Childhood cancers are curable when detected and treated early, there is a need to build strong partnerships with private and public sectors to address the challenge of early detection and late presentation at the hospital because the program of training primary healthcare providers showed a good impact.

“We Had to Keep Pushing”: Caregivers' Perspectives on Autism Screening and Referral Practices of Black Children in Primary Care

2018 ◽  
Vol 56 (5) ◽  
pp. 321-336 ◽  
Author(s):  
Sarah Dababnah ◽  
Wendy E. Shaia ◽  
Karen Campion ◽  
Helen M. Nichols
Keyword(s):  
Primary Care ◽  
Primary Healthcare ◽  
Racial Bias ◽  
Healthcare Providers ◽  
Black Children ◽  
Autism Spectrum ◽  
Theory Approach ◽  
Early Intervention Services ◽  
Primary Healthcare Providers

Abstract Black children with autism spectrum disorder (ASD) are diagnosed later than their White peers, are more likely to be misdiagnosed, and are less likely to receive early intervention services or a developmental evaluation by three years old. Using a grounded theory approach, we solicited the perspectives of parents and other primary caregivers of Black children with ASD on barriers and facilitators to ASD screening and referrals in primary care. A socioeconomically diverse sample of 22 female caregivers participated. Four themes emerged. First, while some caregivers noted their child's primary healthcare providers facilitated a timely ASD diagnosis, other participants reported these providers ignored early concerns about child developmental delays. Second, many participants felt racial bias negatively impacted caregiver-primary healthcare provider interactions. Third, legal/custodial issues slowed caregivers' abilities to follow up on referrals from their primary healthcare providers. Finally, caregivers described denial, shame, and stigma relating to ASD in the Black community as possible factors for delayed follow up to referrals. Differences based on socioeconomic status are discussed. Efforts to improve family-centered, culturally relevant care for all Black caregivers raising children with or at-risk for ASD are needed, particularly for those families experiencing the multiple effects of poverty.

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