scholarly journals Prison conditions and standards of health care for women and their children incarcerated in Zimbabwean prisons

2020 ◽  
Vol 16 (3) ◽  
pp. 319-336
Author(s):  
Rosemary Mhlanga-Gunda ◽  
Stephanie Kewley ◽  
Nehemiah Chivandikwa ◽  
Marie-Claire Van Hout
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Correctional Officers ◽  
Minority Group ◽  
Continuum Of Care ◽  
Health Conditions ◽  
Large Female ◽  
Content Type ◽  
Access To Health ◽  
Women In Prison

Purpose The Sub-Saharan African (SSA) region remains at the epicentre of the HIV epidemic and disproportionately affecting women, girls and prisoners. Women in prison are a minority group and their special health needs relating to gender sensitivity, reproductive health, their children and HIV/AIDs are frequently neglected. Our study responded to this need, and aimed to investigate the issue. Design/methodology/approach A qualitative study using focus group discussions and key informant interviews explored the perspectives of women in prison, correctional officers, correctional health professionals and non-governmental organisations around prison conditions and standards of health care while incarcerated in a large female prison in Zimbabwe. Narratives were transcribed and analysed using thematic analysis. Findings The three key themes that emerged are as follows: “Sanitation and hygiene in the prison”, “Nutrition for women and children” and “Prison-based health services and health care”. Divergence or agreement across perspectives around adequate standards of sanitation, hygiene, quality and adequacy of food, special diets for those with health conditions, access to health care in prison and the continuum of care across incarceration and community are presented. Practical implications Understanding prison environmental cultures which shape correctional staff’s understanding and responsiveness to women in prison, environmental health conditions and access to health care are vital to improve conditions and continuum of care in Zimbabwe. Originality/value Policy and technical guidance continues to emphasise the need for research in SSA prisons to garner insight into the experiences of women and their children, with a particular emphasis on the prison environment for them, their health outcomes and health-care continuum. This unique study responded to this need.

Supporting older military veterans in the rural US

2018 ◽  
Vol 19 (4) ◽  
pp. 286-297
Author(s):  
Bret Hicken ◽  
Kimber Parry
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Access To Health Care ◽  
Veterans Health ◽  
Health Administration ◽  
Care Needs ◽  
Content Type ◽  
Access To Health ◽  
The Us

Purpose The purpose of this paper is to provide an overview of rural older veterans in the US and discuss how the US Department of Veterans Affairs (VA) is increasing access to health care for older veterans in rural areas. Design/methodology/approach This is a descriptive paper summarizing population and program data about rural veterans. Findings VA provides a variety of health care services and benefits for older veterans to support health, independence, and quality of life. With the creation of the Veterans Health Administration Office of Rural Health (ORH) in 2006, the needs of rural veterans, who are on average older than urban veterans, are receiving greater attention and support. ORH and VA have implemented several programs to specifically improve access to health care for rural veterans and to improve quality of care for older veterans in rural areas. Originality/value This paper is one of the first to describe how VA is addressing the health care needs of older, rural veterans.

scholarly journals “I was trying to speak to their human side” coping responses of Belgium’s undocumented migrants to barriers in health-care access

2020 ◽  
Vol 16 (3) ◽  
pp. 253-267
Author(s):  
Dirk Lafaut ◽  
Gily Coene
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Access ◽  
Access To Health Care ◽  
Undocumented Migrants ◽  
Care Providers ◽  
Content Type ◽  
Coping Responses ◽  
Care Access ◽  
Access To Health

Purpose Undocumented migrants experience major legal constraints in their health-care access. Little is known on how undocumented migrants cope with these limitations in health-care access as individuals. The purpose of this study is to explore the coping responses of undocumented migrants when they experience limited health-care access in face-to-face encounters with health-care providers. Design/methodology/approach The authors conducted multi-site ethnographic observations and 25 semi-structured in-depth interviews with undocumented migrants in Belgium. They combined the “candidacy model” of health-care access with models from coping literature on racism as a framework. The candidacy model allowed them to understand access to health care as a dynamic and interactive negotiation process between health-care workers and undocumented migrants. Findings Responses to impaired health-care access can be divided into four main strategies: (1) individuals can react with a self-protective response withdrawing from seeking further care; (2) they can get around the obstacle; (3) they can influence the health-care worker involved by deploying discursive or performative skills; or (4) they can seek to confront the source of the obstacle. Research limitations/implications These findings point to the importance of care relations and social networks, as well as discursive and performative skills of undocumented migrants when negotiating barriers in access to health care. Originality/value This study refines the candidacy model by highlighting how individuals respond on a micro-level to shifts towards exclusionary health policies and, by doing so dynamically, change provision of health-care services.

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.

Equity analysis of health system accessibility from perspective of people with disability

2019 ◽  
Vol 24 (4) ◽  
pp. 298-309
Author(s):  
Hussain Zandam ◽  
Muhamad Hanafiah Juni
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Delivery ◽  
Access To Health Care ◽  
Care Delivery ◽  
Physical Disabilities ◽  
People With Disabilities ◽  
Cross Sectional Survey ◽  
Content Type ◽  
Access To Health

Purpose Self-evaluated access and accessibility has been found to be associated with healthcare seeking and quality of life. Studies have shown that, however, a vast majority of individuals with disability living in poor countries have limited access to healthcare influenced by several barriers. The purpose of this paper is to compare the perception of general accessibility of health care services and its association with access barriers and other contextual factors between people with physical disabilities and counterparts without disability. Design/methodology/approach This study is a cross sectional survey involving 213 individuals with physical disabilities and 213 counterparts without disability sampled using a multi-stage method. Data were collected using a structured questionnaire with sections on socioeconomic and living conditions, education, health, employment and access to health care. Data analysis involved using χ2 for proportions and T-test and multiple regressions (stepwise) method to determine significant factors that influence perception on accessibility. Findings The study finds that people with disabilities fared worse in various socioeconomic factors such as education, employment, income and assets possession. People with disabilities also experience more dimensional barriers and reported poor health system accessibility. The difference in accessibility continued after adjusting for other variables, implying that there are more inherent factors that explain the perception of access for people with disabilities. Practical implications Governments should ensure equitable access to health care delivery for people with disabilities through equitable health policies and services that are responsive to the needs of people with disabilities and promote the creation of enabling environment to enhance participation in health care delivery. Originality/value The authors confirm that the paper has neither been submitted to peer review, nor is in the process of peer reviewing or accepted for publishing in another journal. The author(s) confirms that the research in this work is original, and that all the data given in the paper are real and authentic. If necessary, the paper can be recalled, and errors corrected. The undersigned authors transfer the copyright for this work to the International Journal of Health Governance. The authors are free of any personal or business association that could represent a conflict of interest regarding the paper submitted, and the authors have respected the research ethics principles.

scholarly journals Inequities in immigrants’ access to health care services: disentangling potential barriers

2016 ◽  
Vol 37 (7) ◽  
pp. 1191-1208 ◽  
Author(s):  
Carlo Devillanova ◽  
Tommaso Frattini
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Emergency Services ◽  
Policy Implications ◽  
Content Type ◽  
Care Services ◽  
Second Generation Immigrants ◽  
Access To Health ◽  
Unequal Access

Purpose The purpose of this paper is to empirically assess whether immigrants suffer from unequal access to health care services, that add to prevailing socioeconomic barriers to care. Design/methodology/approach Using a uniquely rich Italian health survey, the authors estimate the correlation between immigrant status and the probability of accessing health services, conditional on a rich set of individual and territorial characteristics. Findings Results show that foreigners are more likely to contact emergency services and less likely to visit specialist doctors and use preventive care. Similar results hold for second-generation immigrants. Originality/value The authors discuss the sources of observed inequities and suggest tentative policy implications to promote equal access.

Access to health-care policies for refugees and asylum-seekers

2020 ◽  
Vol 16 (1) ◽  
pp. 22-45
Author(s):  
Salma El-Gamal ◽  
Johanna Hanefeld
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Asylum Seekers ◽  
Access To Health Care ◽  
Host Countries ◽  
Content Type ◽  
Poor General Health ◽  
Access To Health ◽  
The Uk ◽  
Refugees And Asylum Seekers

Purpose The influx of refugees and asylum-seekers over the past decade into the European Union creates challenges to the health systems of receiving countries in the preparedness and requisite adjustments to policy addressing the new needs of the migrant population. This study aims to examine and compare policies for access to health care and the related health outcomes for refugees and asylum-seekers settling both in the UK and Germany as host countries. Design/methodology/approach The paper conducted a scoping review of academic databases and grey literature for studies within the period 2010-2017, seeking to identify evidence from current policies and service provision for refugees and asylum-seekers in Germany and the UK, distilling the best practice and clarifying gaps in knowledge, to determine implications for policy. Findings Analysis reveals that legal entitlements for refugees and asylum-seekers allow access to primary and secondary health care free of charge in the UK versus a more restrictive policy of access limited to acute and emergency care during the first 15 months of resettlements in Germany. In both countries, many factors hinder the access of this group to normal health care from legal status, procedural hurdles and lingual and cultural barriers. Refugees and asylum-seeker populations were reported with poor general health condition, lower rates of utilization of health services and noticeable reliance on non-governmental organizations. Originality/value This paper helps to fulfill the need for an extensive research required to help decision makers in host countries to adjust health systems towards reducing health disparities and inequalities among refugees and asylum-seekers.

scholarly journals Behavioral Changes in Accessing Outpatient Care During the Covid-19 Pandemic

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Alfiah Hasanah ◽  
Donny Hardiawan ◽  
Jefani Marrosa ◽  
Adlan Ramadhan ◽  
Heriyaldi Heriyaldi ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Condition ◽  
Behavioral Changes ◽  
Health Conditions ◽  
Small Scale ◽  
Supply Side ◽  
The West ◽  
Access To Health ◽  
Economic Slowdown

Unwillingness to seek healthcare has been observed in citizens from many countries during the Covid-19 pandemic. Previous studies show that the changes in behavior are due to various reasons such as economic slowdown, loss of health insurance due to termination of employment, and fear of contracting the virus. This behavior may result in worsened health conditions, making a individual more susceptible to the virus. The supply side of health care is one of the things that should be considered in the discussion about access to health care in developing countries. This paper investigates access to the healthcare problem of Indonesians, discusses both the supply side and demand side by looking at the change of behavior due to the patients’ fear of getting treatment during pandemic covid-19. We will serve this purpose through a small-scale survey and offer some insights from a statistical analysis perspective as well. Based on a survey from 588 respondents from the west Indonesia region, this study observes that the respondents’ health condition shows no significant change before and during the Covid-19 pandemic era. On the other hand, the respondents’ frequency of accessing outpatient healthcare proves to be significantly decreasing during the Covid-19 pandemic era, with 23,4% of the respondents stating that they avoid utilizing outpatient healthcare as an effort to avoid the Coronavirus. The frequency of using Kartu Indonesia Sehat to access outpatient healthcare also shows a significant decrease during this pandemic era. 

scholarly journals Health outcomes in a national sample of American Indian and Alaska Native adults: Differences between multiple-race and single-race subgroups

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242934
Author(s):  
Ursula Running Bear ◽  
Nancy L. Asdigian ◽  
Janette Beals ◽  
Spero M. Manson ◽  
Carol E. Kaufman
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
American Indian ◽  
Access To Health Care ◽  
Multinomial Logistic Regression ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
Access To Health ◽  
Increased Risk

Objectives To determine differences among multi-race (MR) American Indian and Alaska Natives (AIAN), single race (SR) AIANs, and SR-Whites on multiple health outcomes. We tested the following hypotheses: MR-AIANs will have worse health outcomes than SR-AIANs; SR-AIANs will have worse health outcomes than SR-Whites; MR-AIANs will have worse health outcomes than SR-Whites. Methods Behavioral Risk Factor Surveillance System data were used to examine general health, risk behaviors, access to health care, and diagnosed chronic health conditions. Those identifying as SR-White, SR-AIAN, and MR-AIAN were included in multinomial logistic regression models. Results Compared to SR-AIANs, MR-AIANs had more activity limitations, a greater likelihood of experiencing cost as a barrier to health care and were more likely to be at increased risk and diagnosed with more chronic health conditions. Both SR and MR-AIANs have worse health than SR-Whites; MR-AIANs appear to be at increased risk for poor health. Conclusions The current study examined access to health care and nine chronic health conditions, neither of which have been considered in prior work. MR AIANs are at increased risk compared to SR groups. These observations beg for further inquire into the mechanisms underlying these differences including stress related to identify, access to care, and discrimination. Findings support the continued need to address health disparities among AIANs regardless of SR or MR identification.

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