Health-seeking cultural patterns in the use of available healthcare services among refugee groups in south-central Kentucky

2020 ◽  
Vol 16 (1) ◽  
pp. 12-21
Author(s):  
Chika Ejike ◽  
Grace Lartey ◽  
Randy Capps ◽  
David Ciochetty

Purpose Refugees resettle in the USA every year to escape genocide, famine, civil wars and crises in their countries. The diverse cultural identities of the refugee population in south-central Kentucky make it essential to research into their health-care usage patterns. The purpose of this study is to examine the health-seeking patterns of refugees in relation to their culture and the usage of available health services. Design/methodology/approach This is a descriptive correlational study that culled 110 refugees who completed self-administered or interviewer-administered semi-structured questionnaires. Questionnaires were translated into four different languages. T-tests and ANOVA assessed differences between variables. Findings Findings indicate that a demographic factor such as refugees’ nationality plays a role in both the access and use of health services [F (5, 98) = 4.29, p < 0.001]. Refugees’ beliefs and social factors such as acculturation (t = −2.03, p < 0.04) and having health insurance (t = −3.35, p <0.001) also affect the use of health services. The level of cultural competency of the health-care facility or provider as depicted by the presence of interpreters (t = 1.92, p < 0.05) was associated with increased use of the health services provided. Research limitations/implications The sample of refugees is only representative of the general refugee population in south-central Kentucky; hence, there is inadequate generalization. Originality/value Cultural diversity should be included in the health and policymaking debates that surround the refugee population of south-central Kentucky to ensure their well-being.

Author(s):  
Marina V. Shrestha ◽  
Leela Paudel ◽  
Smriti Pant ◽  
Samikchya Neupane ◽  
Naresh Manandhar

Background: When assessing and monitoring the health of a population, it is important to describe not only classical mortality and morbidity indicators but also, perceived illness, visits to primary health services, and utilization of the healthcare services provided. Objectives of the study were to determine the health status and factors affecting health seeking behaviour of women.Methods: A descriptive study was done at Bhimtar, Sindhupalchowk District in Nepal, involving 147 subjects sampled by purposive sampling. Study population consisted of women. Data was collected by house to house interview with pretested questionnaire during month of September 2016. Data was entered and then analysed using Statistical Package for the Social Sciences (SPSS) 20. Simple measures of statistics like frequency, percentages, means were used to represent the data in tables as a part of descriptive analysis and chi-square test was applied to see the association with dependent variables.Results: Among 80.9% women who had gynaecological problems, the highest prevalence rate of the disease was low back pain (60.5%) followed by lower abdominal pain (35.2%), dysmenorrhea (27.3%) and menstrual irregularities (27.3%). The first approach of seeking health for the reported illness among women was the traditional healer (51%). Regarding attitude towards modern medicine, 47.6% respondents replied that facilities were not available locally. Similarly regarding hindering factors for not utilizing health services, lack of female doctors (43.75%) and far distance of health care centre (37.5%) were the most common ones.Conclusions:Higher percentage of women in Bhimtar sought after the traditional healer as the best way for utilizing health services. Modern health care utilization was less because of the distance to be covered during illness and lack of doctors in the health centre.  


2020 ◽  
Vol 37 (4) ◽  
pp. 465-472
Author(s):  
Hao Zhang ◽  
Wenhua Wang ◽  
Jeannie Haggerty ◽  
Tibor Schuster

Abstract Background Patient satisfaction is an essential indicator in medical practise and research. To monitor the health and well-being of adult populations and the ageing process, the World Health Organization (WHO) has initiated the Study on Global AGEing and Adult Health (SAGE), compiling longitudinal information in six countries including China as one major data source. Objective The objective of this study was to identify potential predictors for patient satisfaction based on the 2007–10 WHO SAGE China survey. Methods Data were analysed using random forests (RFs) and ordinal logistic regression models based on 5774 responses to predict overall patient satisfaction on their most recent outpatient health services visit over the last 12 months. Potential predictor variables included access to care, costs of care, quality of care, socio-demographic and health care characteristics and health service features. Increase of the mean-squared error (incMSE) due to variable removal was used to assess relative importance of the model variables for accurately predicting patient satisfaction. Results The survey data suggest low frequency of dissatisfaction with outpatient services in China (1.8%). Self-reported treatment outcome of the respective visit of a care facility demonstrated to be the strongest predictor for patient satisfaction (incMSE +15%), followed by patient-rated communication (incMSE +2.0%), and then income, waiting time, residency and patient age. Individual patient satisfaction in the survey population was predicted with 74% accuracy using either logistic regression or RF. Conclusions Patients’ perceived outcomes of health care visits and patient communication with health care professionals are the most important variables associated with patient satisfaction in outpatient health services settings in China.


2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mehmet Korkmaz ◽  
Ilknur Aydın Avci

Purpose This paper aims to determine factors affecting health-care utilization of immigrants living in North of Turkey and make a case assessment about this factors and general health status of immigrants. Design/methodology/approach This study was conducted in accordance with the principles of descriptive research. The data of the study were collected by using questionnaire consisting of 33 questions that include socio-demographic specifications, use of health services and health perception level. Findings This study was conducted with 360 immigrants. Participants, of which 61.9% were female. Immigrants who are young, female, married, have low education, have chronic illnesses, and have been in hospital before, have a better use of health services. Originality/value Immigration experiences of immigrants and their lack of equal opportunities to access health services in the community lead them to use health services at a low level.


2017 ◽  
Vol 13 (2) ◽  
pp. 145-156 ◽  
Author(s):  
Bruce Newbold ◽  
Marie McKeary

Purpose Based on a case study in Hamilton, Ontario, Canada, the purpose of this paper is to explore the difficulties faced by local health care providers in the face of constantly evolving refugee policies, programs, and arrivals. In doing so, it illustrates the complications faced by service providers in providing care to refugee arrivals and how the diversity of arrivals challenges health care provision and ultimately the health and well-being of refugees. Design/methodology/approach A series of semi-structured, in-depth interviews with key service professionals in both the social service and health fields in Hamilton, Ontario, Canada, examined both health and health care issues. Findings Beyond challenges for service providers that have been previously flagged in the literature, including language barriers and the limited time that they have with their clients, analysis revealed that health care providers faced other challenges in providing care, with one challenge reflecting the difficulty of providing care and services to a diverse refugee population. A second challenge reflected the lack of knowledge associated with constantly evolving policies and programs. Both challenges potentially limit the abilities of care providers. Research limitations/implications On-going changes to refugee and health care policy, along with the diversity of refugee arrivals, will continue to challenge providers. The challenge, therefore, for health care providers and policy makers alike is how to ensure adequate service provision for new arrivals. Practical implications The Federal government should do a better job in disseminating the impact of policy changes and should streamline programs. This is particularly relevant given limited budgets and resources, tri-partite government funding, short time-frames to prepare for new arrivals, inadequate background information, barriers/challenges or inequitable criteria for access to health and social services, while addressing an increasingly diverse and complex population. Social implications The research reinforces the complexity of the needs and challenges faced by refugees when health is considered, and the difficulty in providing care to this group. Originality/value While there is a large refugee health literature, there is relatively little attention to the challenges and difficulties faced by service providers in addressing the health needs of the diverse refugee population, a topic that is particularly important given limited funding envelopes, shifting policies and programs, and a focus on clients (refugees). It is this latter piece – the challenges faced by providers in providing care to refugees – which this paper explores.


2016 ◽  
Vol 8 (2(J)) ◽  
pp. 65-78
Author(s):  
Charles Mulindabigwi Ruhara ◽  
Josue Mbonigaba

The purpose of this paper is to investigate the role of economic factors in choosing alternative service providers and to recommend suitable measures that could be taken to improve the use of health services in Rwanda. The study uses a multinomial logit framework and employs the Integrated Household Living Conditions Survey (EICV2) conducted in 2005 by the National Institute of Statistics of Rwanda (NISR). To handle the problem of endogeneity, we estimate a structural model. The results indicate that health insurance is an important factor in the choice of health facilities. User fees are major financial barriers to health care access in Rwanda. The results suggest that as household income increases, patients shift from public to private health facilities where quality is assumed to be high. A number of policy recommendations emerge from these findings. First, as insurance is an important factor in choosing a health care facility, policies that reduce health care costs to patients would substantially increase the use of health services. Second, since an increase in income allows the patient to shift to private facilities, the government should consider subsidizing private health facilities to enable access to care in private sector facilities by low-income households. Finally, since distance affects access to health care in Rwanda, there is a need to improve geographical accessibility to health facilities across regions by upgrading and expanding transportation and health infrastructures.


Author(s):  
Manisha Arora ◽  
George Koshy ◽  
Vandana Gangadharan

Background: Health care in India is a complex amalgam involving various stakeholders. For decades it has been a neglected area with reluctance in increasing the inputs such as finance or infrastructure required to drive this system. Utilization and access to this health system is a key indicator and major determinant of health seeking behaviour.Methods: This community based cross sectional study was conducted from January-February 2016 in, the urban slum located in a metro city using a pretested, semi-structured questionnaire. The data was analyzed using SPSS 22.Results: More than half of the participants preferred to seek treatment from a public health care facility compared to a private. One of the most predominant determining factors on choosing a particular health facility was affordability. Main barriers perceived in utilization of health services were long waiting time at the health facility and expenditure on treatment.Conclusions: The key for ensuring adequate and appropriate utilization of health care services is in having an efficient government health care delivery system which can offer quality and affordable medical care to one and all. 


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F R Rab ◽  
S S Stranges ◽  
A D Thind ◽  
S S Sohani

Abstract Background Over 34 million people in Afghanistan have suffered from death and devastation for the last four decades as a result of conflict. Women and children have borne the brunt of this devastation. Afghanistan has some of the poorest health indicators in the world for women and children. In the midst of armed conflict, providing essential healthcare in remote regions in the throws of conflict remains a challenge, which is being addressed the Mobile Health Teams through Afghan Red Crescent (ARCS). To overcome socio-cultural barriers, ARCS MHTs have used local knowledge to hire female staff as part of the MHTs along with their male relatives as part of MHT staff. The present study was conducted to explore the impact of engaging female health workers as part of MHTs in conflict zones within Afghanistan on access, availability and utilization of maternal and child health care. Methods Quantitative descriptive and time-trend analysis were used to evaluate impact of introduction of female health workers. Qualitative data is being analyzed to assess the possibilities and implications of engaging female health workers in the delivery of health services. Results Preliminary results show a 96% increase in uptake of services for expectant mothers over the last four years. Average of 18 thousand services provided each month by MHTs, 70% for women and children. Service delivery for women and children significantly increased over time (p &lt; 0.05) after inclusion of female health workers in MHTs. Delivery of maternity care services showed a more significant increase (p &lt; 0.001). Time trend and qualitative analyses is ongoing. Conclusions Introduction of female health workers significantly improved uptake of health care services for women and children especially in extremely isolated areas controlled by armed groups in Afghanistan. Engaging with local stakeholders is essential for delivery of health services for vulnerable populations in fragile settings like Afghanistan. Key messages Understanding cultural norms results in socially acceptable solutions to barriers in delivery of healthcare services and leads to improvements in access for women and children in fragile settings. Building local partnerships and capacities and using local resources result in safe, efficient and sustainable delivery of healthcare services for vulnerable populations in fragile settings.


2017 ◽  
Vol 25 (3) ◽  
pp. 186-195 ◽  
Author(s):  
Clare Lynette Harvey ◽  
Jonathan Sibley ◽  
Janine Palmer ◽  
Andrew Phillips ◽  
Eileen Willis ◽  
...  

Purpose The purpose of this paper is to outline a conceptual plan for innovative, integrated care designed for people living with long-term conditions (LTCs). Design/methodology/approach The conceptual plan delivers a partnership between the health system, the person with LTCs (chronic), their family, and the community. The partnership aims to support people at home with access to effective treatment, consistent with the New Zealand Government Health Strategy. This concept of people-owned care is provided by nurses with advanced practice skills, who coordinate care across services, locations and multiple LTCs. Findings With the global increase in numbers of people with multiple chronic conditions, health services are challenged to deliver good outcomes and experience. This model aims to demonstrate the effective use of healthcare resources by supporting people living with a chronic condition, to increase their self-efficacy and resilience in accordance with personal, cultural and social circumstance. The aim is to have a model of care that is replicable and transferable across a range of health services. Social implications People living with chronic conditions can be empowered to manage their health and well-being, whilst having access to nurse-led care appropriate to individual needs. Originality/value Although there are examples of case management and nurse-led coordination, this model is novel in that it combines a liaison nursing role that works in partnership with patients, whilst ensuring that care across a number of primary and secondary care services is truly integrated and not simply interfaced.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Eshetu Haileselassie Engeda ◽  
Berihun Assefa Dachew ◽  
Hiwot Kassa Woreta ◽  
Mengistu Mekonnen Kelkay ◽  
Tesfaye Demeke Ashenafie

Studies in the northern part of Ethiopia showed high prevalence of undiagnosed cluster of tuberculosis cases within the community which demanded an investigation of the health care seeking behaviour of tuberculosis suspects. A community-based cross-sectional study was conducted in Lay Armachiho district, Northwest Ethiopia. Individuals who had cough for at least two weeks and aged greater than or equal to 15 years were included in the study. Data were collected by interview using pretested and structured questionnaire. Logistic regression was computed and adjusted odds ratio with 95% confidence interval was calculated. Out of the total population surveyed (29, 735), 663 (2.2%) individuals were found to be pulmonary tuberculosis suspects. Majority of the suspects reported that they had visited a modern health care facility. Those aged 15 to 34 and aged 35–54 had secondary educational level and above; those who were civil servants, those who were farmers, those who had previous history of tuberculosis treatment, and those who perceived that they were sick were more likely to visit a modern health care facility. The proportion of respondents who had taken traditional measures was found to be higher than some other districts. Improving the socioeconomic status of the community is recommended.


2014 ◽  
Vol 30 (9) ◽  
pp. 1903-1911 ◽  
Author(s):  
J Rodrigo ◽  
Hanny Calache ◽  
Martin Whelan

The aim of this study was to investigate the socio-demographic characteristics of the eligible population of users of public oral health care services in the Australian state of Victoria, aged 17 years or younger. The study was conducted as a secondary analysis of data collected from July 2008 to June 2009 for 45,728 young clients of public oral health care. The sample mean age was 8.9 (SD: 3.5) years. The majority (82.7%) was between 6 and 17 years of age, and 50.3% were males. The majority (76.6%) was Australian-born and spoke English at home (89.1%). The overall mean DMFT was 1.0 (SD: 2.1) teeth, with a mean dmft of 3.16 (SD: 5.79) teeth. Data indicate that, among six year olds in the Significant Caries Index (SiC) category, the mean dmft was 6.82 teeth. Findings corroborate social inequalities in oral health outcome and provide suggestions for oral health services to develop strategies and priorities to reduce inequalities in health and well-being, and better coordinate and target services to local needs.


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