scholarly journals HIV patient access to healthcare services in post-austerity era in Greece

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
George Tsiakalakis ◽  
Christina Golna ◽  
Nikos Dedes ◽  
George Papageorgiou ◽  
Kostas Athanasakis ◽  
...  
Keyword(s):  
Viral Load ◽  
Economic Crisis ◽  
Access To Health Care ◽  
Health Care Services ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Patient Access ◽  
Content Type ◽  
The Past ◽  
The Impact

Purpose The ten-year economic crisis and the ensuing fiscal adjustment that Greece experienced between 2009 and 2018 has had a major impact on patient access to health-care services and resulted in an increase in unmet population health needs. The present study aims to assess the impact of economic crisis and ensuing austerity on HIV patient access to health-care services. Design/methodology/approach A cross-sectional study was carried out between February and April 2019 to assess barriers in access to HIV care faced by people living with HIV. A total of 329 HIV positive individuals participated in the study. An online, self-reporting questionnaire was developed and adapted to the specific clinical and societal characteristics of HIV. Findings A total of 94.2% of respondents were male and 67.80% lived in Athens. Most of them were diagnosed with HIV-1 10 years ago. Out of the total respondents, 37.40% reported obstacles in accessing HIV care over the past year. A total of 24.30% reported they were not tested for viral load in the past six months and received a result. Individuals, who self-evaluate their financial status as very bad or bad, were more likely to be unaware of their viral load (55.60%) than those with better financial status (33.5%) (P < 0.01). Only 33.3% of uninsured participants were aware of their viral load, and this figure rose to 63.30% (P <0.01) amongst insured participants. Originality/value The ten-year economic crisis that Greece experienced in the period 2009–2018 had significant effects on the quality of services of the National Health System. This study attempts to fill the research gap regarding the impact of one of the severest economic crises during the past century with complex social extensions, in one of the most vulnerable patient groups. In this context, the study assesses barriers to access to optimal care of people living with HIV in Greece after a decade of austerity and the variables that impact on such access.

scholarly journals HIV patient access to healthcare services in post-austerity era in Greece

2020 ◽  
Author(s):  
George Tsiakalakis ◽  
Christina Golna ◽  
Nikos Dedes ◽  
Kostas Athanasakis ◽  
Kyriakos Souliotis
Keyword(s):  
Viral Load ◽  
Economic Crisis ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Patient Access ◽  
Financial Status ◽  
Living With Hiv ◽  
Self Reporting Questionnaire

Abstract Background The ten-year economic crisis and the ensuing fiscal adjustment that Greece experienced between 2009 and 2018 has had a major impact on patient access to healthcare services and resulted in an increase in unmet population health needs. The present study assesses the impact of economic crisis and ensuing austerity on HIV patient access to healthcare services. Methods A cross-sectional study was carried out between February and April 2019 to assess barriers in access to HIV care faced by people living with HIV. 329 HIV-positive individuals participated in the study. An online, self-reporting questionnaire was developed on the basis of the HOPE studies tool (2,3,9,10) and adapted to the specific clinical and societal characteristics of HIV. Results 94.2% of respondents were male and 67.80% lived in Athens. Most of them were diagnosed with HIV 1 to 10 years ago. 37,40% of respondents reported obstacles in accessing HIV care over the past year, such as shortages in antiretroviral medicine, restricted opening hours of pharmacies and delays in booking an appointment with physicians. 24,30% reported they were not tested for viral load in the last six months and received a result. Individuals, who self-evaluate their financial status as very bad or bad, were more likely to be unaware of their viral load (55.60%) compared to individuals with better financial status (33,5%) (P<0.01). Only 33.3% of uninsured participants were aware of their viral load, and this figure rose to 63.30% (P <0.01) amongst insured participants. Conclusion Our study suggests that a critical proportion of HIV patients in Greece face significant barriers to receiving optimal HIV care, according to diagnostic and clinical guidelines. Financial and social insurance status are the main variables that impact on access, despite the comprehensive and universal NHS coverage of antiretroviral treatment and HIV monitoring. Reforming and integrating NHS service provision together with addressing social barriers and discrimination are critical to ensuring care is offered as per standards to all people living with HIV in Greece.

Right to health and access to health-care services for refugees in Turkey

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
N. Ela Gokalp Aras ◽  
Sertan Kabadayi ◽  
Emir Ozeren ◽  
Erhan Aydin
Keyword(s):  
Public Health ◽  
Health Care ◽  
Institutional Theory ◽  
Access To Health Care ◽  
Health Care Services ◽  
Public Health Care ◽  
Content Type ◽  
Care Services ◽  
Access To Health ◽  
The Impact

Purpose This paper aims to provide a comprehensive understanding of factors that contribute to refugees’ exclusion from health-care services. More specifically, using institutional theory, this paper identifies regulative pillar-, normative pillar- and cultural/cognitive pillar-related challenges that result in refugees having limited or no access to health-care services. Design/methodology/approach The paper draws on both secondary research and empirical insights from two qualitative fieldwork studies totaling 37 semi-structured meso-level interviews, observations and focus groups in three Turkish cities (Izmir, Ankara and Edirne), as well as a total of 42 micro-level, semi-structured interviews with refugees and migrants in one large city (Izmir) in Turkey. Findings This study reveals that systematically stratified legal statuses result in different levels of access to public health-care services for migrants, asylum seekers or refugees based on their fragmented protection statuses. The findings suggest access to health-care is differentiated not only between local citizens and refugees but also among the refugees and migrants based on their legal status as shaped by their country of origin. Originality/value While the role of macro challenges such as laws and government regulations in shaping policies about refugees have been examined in other fields, the impact of such factors on refugee services and well-being has been largely ignored in service literature in general, as well as transformative service research literature in particular. This study is one of the first attempts by explicitly including macro-level factors to contribute to the discussion on the refugees’ access to public health-care services in a host country by relying on the institutional theory by providing a holistic understanding of cognitive, normative and regulative factors in understanding service exclusion problem.

North Korea heads for economic crisis

2018 ◽  
Keyword(s):  
Economic Crisis ◽  
Security Council ◽  
North Korea ◽  
Medium Term ◽  
Content Type ◽  
The Past ◽  
North East ◽  
Un Security Council ◽  
Domestic Instability ◽  
The Impact

Subject The impact of sanctions on North Korea's economy. Significance Successive UN Security Council resolutions over the past year impose the toughest sanctions North Korea has ever faced. If implemented thoroughly, the new sanctions will have much greater impact than earlier measures. The result will be to increase political risk in North-east Asia in the medium term (2018-20). Impacts North Korea's leadership will not even consider denuclearisation, seeing this as tantamount to collective suicide. The threat of domestic instability will push the elite to become more repressive at home. If political collapse or war looked imminent, China would switch back to quietly undermining the sanctions regime.

The Impact of War on Population Health

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Turkan Ahmet
Keyword(s):  
Health Care ◽  
Health Status ◽  
Health Care Services ◽  
Negative Effects ◽  
The Past ◽  
Care Services ◽  
Physical Environments ◽  
The Social ◽  
Personal Experiences ◽  
The Impact

The past few decades of ongoing war in Iraq has had a dramatic impact on the health of Iraq’s population. Wars are known to have negative effects on the social and physical environments of individuals, as well as limit their access to the available health care services. This paper explores the personal experiences of my family members, who were exposed to war, as well as includes information that has been reviewed form many academic sources. The data aided in providing recommendations and developing strategies, on both local and international levels, to improve the health status of the populations exposed to war.

scholarly journals The Impact of Internalized Stigma on LGBT Parenting and the Importance of Health Care Structures: A Qualitative Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5373
Author(s):  
Carolina Alday-Mondaca ◽  
Siu Lay-Lisboa
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Universal Access ◽  
Civil Society Organizations ◽  
Support Network ◽  
Internalized Stigma ◽  
Lgbt People ◽  
Mental Health Programs ◽  
The Impact

Research on LGBTIQ+ families has focused on the effects of being in a diverse family on the development of children. We seek to show the experience of parenthood from the perspective of LGBTIQ+ people, considering its particularities and the role that health care services play as a potential support network. We used the biographical method through open-ended interviews, participants were LGBT people, and key informants from Chile, Colombia, and Mexico were selected based on a sociostructural sampling. We found that internalized stigma impacts LGBTIQ+ parenting in five ways: the impossibility of thinking of oneself as a parent, fear of violating children’s rights, fear of passing on the stigma, fear of introducing their LGBTIQ+ partner, and the greater discrimination that trans and intersex people suffer. We identified gaps in health care perceptions: the need to guarantee universal access to health care, the need to include a gender perspective and inclusive treatment by health personnel, mental health programs with a community approach, access to assisted fertilization programs, and the generation of collaborative alliances between health services, civil society organizations, and the LGBTIQ+ community. We conclude that the health system is a crucial space from which to enable guarantees for the exercise of rights and overcome internalized stigma.

scholarly journals Free access to antiretroviral treatment and protection against the risk of catastrophic health expenditure in people living with HIV: evidence from Cameroon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marwân-al-Qays Bousmah ◽  
Marie Libérée Nishimwe ◽  
Christopher Kuaban ◽  
Sylvie Boyer
Keyword(s):  
Socioeconomic Status ◽  
Health Expenditure ◽  
Antiretroviral Treatment ◽  
Catastrophic Health Expenditure ◽  
Hiv Care ◽  
Free Access ◽  
People Living With Hiv ◽  
Art Policy ◽  
Living With Hiv ◽  
The Impact

Abstract Background To foster access to care and reduce the burden of health expenditures on people living with HIV (PLHIV), several sub-Saharan African countries, including Cameroon, have adopted a policy of removing HIV-related fees, especially for antiretroviral treatment (ART). We investigate the impact of Cameroon’s free antiretroviral treatment (ART) policy, enacted in May 2007, on catastrophic health expenditure (CHE) risk according to socioeconomic status, in PLHIV enrolled in the country’s treatment access program. Methods Based on primary data from two cross-sectional surveys of PLHIV outpatients in 2006–2007 and 2014 (i.e., before and after the policy’s implementation, respectively), we used inverse propensity score weighting to reduce covariate imbalances between participants in both surveys, combined with probit regressions of CHE incidence. The analysis included participants treated with ART in one of the 11 HIV services common to both surveys (n = 1275). Results The free ART policy was associated with a significantly lower risk of CHE only in the poorest PLHIV while no significant effect was found in lower-middle or upper socioeconomic status PLHIV. Unexpectedly, the risk of CHE was higher in those with middle socioeconomic status after the policy’s implementation. Conclusions Our findings suggest that Cameroon’s free ART policy is pro-poor. As it only benefitted PLHIV with the lowest socioeconomic status, increased comprehensive HIV care coverage is needed to substantially reduce the risk of CHE and the associated risk of impoverishment for all PLHIV.

scholarly journals 482. Impact of COVID-19 Pandemic on Psychosocial and Clinical Factors among people with and without HIV living in Miami

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S308-S308
Author(s):  
Patricia RaccamarichClaudia S Uribe ◽  
Ana S Salazar Zetina ◽  
Emily K Montgomerie ◽  
Douglas Salguero ◽  
Alejandro M Mantero ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Access To Health Care ◽  
People Living With Hiv ◽  
Coping With Stress ◽  
Care Access ◽  
Significant Difference ◽  
Physical Consequences ◽  
The Impact ◽  
Hiv Negative

Abstract Background As the COronaVIrus Disease 2019 (COVID-19) continues to unfold, drastic changes in daily life pose significant challenges on mental and clinical health. While public health interventions such as national lockdowns and social distancing are enforced to reduce the spread of COVID-19, the psychosocial and physical consequences have yet to be determined that may disproportionately affect people living with HIV (PLWH). Methods To evaluate the impact of COVID-related stress on mental and clinical health, we conducted a 20-minute questionnaire eliciting sociodemographic information, clinical and psychological factors from people living in Miami, Fl. All individuals &gt;18 years with or without a history of COVID-19 were included. Participating PLWH were recruited from an existing HIV registry and HIV uninfected participants from community flyers and word of mouth. Results A total of 135 participants were recruited from 05/2020-06/2020. The mean age was 50 years old, 73/135 (54%) were female, and 102/135 (75%) were PLWH. Among participating PLWH, 60/102 (58.8%) self-identified as African American, and 9/102 (8.8%) were positive for COVID-19 by a commercially approved test. Among HIV-negative participants, 15/33 (45.5%) self-identified as White and 11/33 (33%) were positive for COVID-19. Both PLWH and HIV-negative participants described significant disruptions in health care access (47%), difficulty paying basic needs (41%), and feelings of anxiety and depression (48%); there was no statistically significant difference by HIV status. However, HIV negative participants were less likely to experience job loss and income disruption compared to PLWH during the pandemic (70% for HIV-negative vs 48% for PLWH; OR 0.40, p=0.03). Conclusion The impact of COVID-19 on emotional and clinical health is significant in both PLWH and HIV-negative groups. These findings highlight the need for providing mental and physical health care during the pandemic, especially for coping with stress and anxiety during these difficult times and ensuring adequate access to health care. Disclosures All Authors: No reported disclosures

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.

COVID-19 may hit less resilient EU eastern areas more

2021 ◽  
Keyword(s):  
Significant Development ◽  
Content Type ◽  
Capital Cities ◽  
Left Behind ◽  
The Past ◽  
Standards Of Living ◽  
Slow Progress ◽  
Economic Slowdown ◽  
Clear Cases ◽  
The Impact

Significance At least in the EU’s eleven eastern member states (EU-11), there has been significant if slow progress in lifting standards of living across the board in the past decade. However, progress is uneven and the impact of the economic slowdown due to lockdowns in the past year may well have affected disproportionately already poorer regions. Impacts Some governments, notably Hungary’s, will put political loyalty above need in directing recovery funds to the localities. People in ‘left-behind’ regions may seek a better life in relatively prosperous capital cities or abroad. There is scope for countries and regions to learn from each other given clear cases of significant development in the past decade.

The impact of within-country and within-firm factors on Japanese foreign subsidiary performance during economic crisis

2017 ◽  
Vol 9 (3) ◽  
pp. 190-205 ◽  
Author(s):  
Matheus Baldo Cordeiro ◽  
Mario Henrique Ogasavara ◽  
Gilmar Masiero
Keyword(s):  
Economic Crisis ◽  
Fixed Effects ◽  
Multinational Firms ◽  
Negative Impact ◽  
Foreign Subsidiaries ◽  
Productivity Measurement ◽  
Subsidiary Performance ◽  
Content Type ◽  
Subsidiary Management ◽  
The Impact

Purpose The purpose of this paper is to analyze the relevant aspects that influence foreign subsidiary’s performance and remain how they retain competitiveness in international markets during economic crisis. To investigate this effect, this research analyzes the behavior of Japanese subsidiaries located in European countries during the pre- and post-crisis periods that started in the USA in 2008 and spread all over the world. Design/methodology/approach This is a quantitative study with an analysis based on longitudinal data of foreign subsidiaries of Japanese multinational firms during the period 2006-2013. It applies a multiple linear regression with panel data using fixed effects models. Findings The findings show that within-firm factors related to local experiential knowledge, market entry through joint ventures with partners from the same nationality, and subsidiary management with a team of expatriates all have a positive impact on subsidiary performance during times of economic crisis. Moreover, within-country factors involving macroeconomic aspects related to inflation rate and population income indicators show a negative impact on performance. Finally, the results confirm that subsidiary performance is higher in the pre-crisis period, showing the importance of considering economic crisis aspects in longitudinal studies. Practical implications The result has implications for managers of multinational firms to understand which factors most impact the success of their foreign subsidiaries during times of economic crisis. In this way, managers can, with greater confidence, decide to reach the most important performance indicator in subsidiary management. Originality/value The majority of studies on economic crisis is based on an economic perspective and mostly investigates Asian and Argentinean crises. When considering a firm-level perspective, most research studies conducted on a subsidiary level are cross-sectional or use survival as a measure of performance. This paper applies a longitudinal study using subsidiary-level data and analyzes performance by sales and productivity measurement. In addition, it investigates whether or not within-country and within-firm factors impacted subsidiary performance during the 2008 economic crisis.

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