Protecting pro-poor health services during financial crises: Lessons from experience

2009 ◽  
pp. 23-53 ◽  
Author(s):  
Pablo Gottret ◽  
Vaibhav Gupta ◽  
Susan Sparkes ◽  
Ajay Tandon ◽  
Valerie Moran ◽  
...  
Keyword(s):  
Health Services ◽  
Financial Crises ◽  
Poor Health

A 'snap shot' of the health of homeless people in inner Sydney: St Vincent's Hospital

2011 ◽  
Vol 35 (1) ◽  
pp. 52 ◽  
Author(s):  
Caroline N. Chin ◽  
Kate Sullivan ◽  
Stephen F. Wilson
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Health Services ◽  
Physical Health ◽  
Homeless People ◽  
Health Resources ◽  
Poor Health ◽  
Health Profile ◽  
The Poor ◽  
Health Comorbidities

Objectives. The poor health profile of people who are homeless results in a disproportionate use of health resources by these people. An in-hospital count of demographic and health data of homeless patients was conducted on two occasions at St Vincent’s Hospital in Sydney as an indicator of health resource utilisation for the Sydney region. Methods. Two in-hospital counts were conducted of homeless patients within the boundaries of St Vincent’s Hospital to coincide with the inaugural City of Sydney homeless street counts in winter 2008 and summer 2009. Data collected included level of homelessness, principal diagnosis, triage category, bed occupancy and linkages to services post hospital discharge. Results. Homeless patients at St Vincent’s utilised over four times the number of acute ward beds when compared with the state average. This corresponds to a high burden of mental health, substance use and physical health comorbidities in homeless people. There was high utilisation of mental health and drug and alcohol services by homeless people, and high levels of linkages with these services post-discharge. There were relatively low rates of linkage with general practitioner and ambulatory care services. Conclusion. Increasing knowledge of the health needs of the homeless community will assist in future planning and allocation of health services. What is known about the topic? The poor health status of people who are homeless has been previously noted in the USA, Canada and Scotland. What does this paper add? Homeless people living in Sydney also have a poor health profile and a disproportionate use of health resources when compared to people in the general population. What are the implications for practitioners? Health services for homeless people should be equipped to deal with mental health, substance use and physical health comorbidities.

scholarly journals Exploring the association between urbanisation and self-rated health of older adults in China: evidence from a national population sample survey

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e029176 ◽  
Author(s):  
Ye Liu ◽  
Baishi Huang ◽  
Ruoyu Wang ◽  
Zhixin Feng ◽  
Yuqi Liu ◽  
...  
Keyword(s):  
Economic Growth ◽  
Older Adults ◽  
Land Use ◽  
Health Services ◽  
Population Sample ◽  
Poor Health ◽  
Sample Survey ◽  
Land Use Conversion ◽  
Self Rated Health ◽  
Population Concentration

ObjectivesThis study investigated the association between urbanisation and self-rated health of older adults in China, particularly how different dimensions, rate and level of urbanisation are related to older people’s health. Additionally, it examined the moderating effect of education on the association between each of the four dimensions of urbanisation and older people’s health.DesignThe study uses a cross-sectional survey design.ParticipantsThis study analysed 236 030 individuals (aged 60–79 years) nested within 267 prefecture-level cities from 2005 China’s 1% population sample survey.Outcome measuresSelf-rated health was the outcome variable. Four groups of predictors assessed prefectures’ level and rate of urbanisation: land-use conversion, economic growth, population concentration and health services. Multilevel logistic regression was used to examine the association between self-rated health and the level and rate of urbanisation, after adjusting for individual-level covariates. Multiplicative interactions explored variations by education.ResultsThe odd of reporting fair or poor health was negatively associated with the level and rate of population concentration (OR 0.93,95%CI 0.87 to 0.99 and 0.74,95%CI 0.59 to 0.93, respectively) and positively associated with the level of health services (OR 1.12, 95% CI 1.06 to 1.19). Land-use conversion, economic growth and health service improvements (the forms of rate of urbanisation) were not significantly associated with self-rated health. Education had a moderating effect on the association between urbanisation and self-rated health.ConclusionsOlder people living in more densely populated areas and areas undergoing rapid population concentration were less likely to report fair or poor health. This result supports healthy migration and ‘salmon bias’ hypotheses. No urban health penalty was observed for the older adults in China; therefore, the following pathways linking urbanisation to health are unclear: lifestyle changes, environmental pollution and cultivated land reduction.

scholarly journals Influence of Children’s Health on Primary School Academic Performance In Uganda. A Case Study of Fort Portal Municipality, Kabarole District, Uganda.

2021 ◽  
Author(s):  
◽  
Brenda Kanyesige
Keyword(s):  
Academic Performance ◽  
Health Services ◽  
Primary School ◽  
Group Discussion ◽  
Poor Health ◽  
Sub Saharan Africa ◽  
Children's Health ◽  
Children’S Health ◽  
World Population ◽  
Access To Health Services

ABSTRACT Background: The world population comprises 2.2 billion children below 18 years, 1.9 billion of which live in developing countries, 1 billion being caught up below the poverty line, and 340 million in sub-Saharan Africa. 640 million do not have adequate shelter, 400 million do not have safe drinking water and 270 million have no access to health services. In Uganda, better health care is widely thought to improve primary school performance and post-school productivity. This study investigated the influence of children’s health on primary school academic performance in Fort Portal municipality, Kabarole district. Methodology: Questionnaires were used as the major research tool and it was supplemented through the use of interview guide and Focus Group Discussion guide. Data collection was then followed by analysis and interpretation of findings. Results: 49.5% of children fall sick at least once a year. 20.6% fall sick once every two months, 15.5% monthly, 8.2% twice a week and 6.2% once a week. The major effects of poor health on academic performance include; absenteeism, lack of concentration in class, missing tests and exams. Girls get preferential treatment when it comes to accessing medical care from the school nurse. The study showed that provision of medicine was viewed as the best option. Conclusion Malaria, cough and flu are the most common health problem faced by pupils and poor health affects children’s academic performance. Recommendations: Massive sensitization campaign about the spread of cough and flu, enhancing health education in schools, recruitment of nurses that would be residents in schools, economic empowerment of parents, encouraging more NGOs to extent their work in health services to Fort Portal Municipality and provision free health services to school-going children as well as regular medical check up preferably once every three weeks.

scholarly journals An Assessment of Cost of Access to Health Services of Severely Disabled People in Chitwan

2018 ◽  
pp. 102-112
Author(s):  
Chudamani Poudel ◽  
Ramesh Baral
Keyword(s):  
Health Care ◽  
Health Outcome ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Health Services ◽  
Health Care Services ◽  
Poor Health ◽  
Health Maintenance ◽  
Care Services ◽  
Cord Injury

There are many barriers that keep people with disabilities from fully engaging in health care services. This study assessed the direct medical, direct non-medical and indirect cost as well as potential barriers and obstacles that people with spinal cord injury and intellectual disabilities faced in accessing health care services. This study conducted in Chitwan district of Nepal used both quantitative and qualitative information. For quantitative study, structured interview were conducted to assess the cost involved in health care services with 60 persons divided into Physical (spinal cord injury) and intellectual disability. In-depth interviews and Focus Group Discussions (FGDs) were conducted for qualitative study to find out their experiences regarding barriers, coping strategies and their needs and expectation when accessing health care services.Physical (spinal cord injury) disability accounted 46.67% while 53.33% were intellectual disabled. 48.3% were in poor health and 51.67% in fair health condition. The total mean values of direct medical cost for both types of disability were Rs. 6682.53 in the past six month. The qualitative reports suggest that people with severe disability faces numbers of barriers in accessing health services. This is seen as the key reason for their poor health outcome. High cost incurred in medical services and physical health maintenance, worse socio-economic status, and layers of barriers in accessing health care services were the reason of poorer health outcome and exclusion from the society.Economic Journal of Development Issues Vol. 23&24 No. 1-2, (2017) Combined Issue, Page : 102-112

Doctors for the Poor in Urban Nepal

2003 ◽  
Vol 33 (2) ◽  
pp. 83-85 ◽  
Author(s):  
Martin A K Allaby
Keyword(s):  
Developing Countries ◽  
Health Services ◽  
Primary Healthcare ◽  
Health Professionals ◽  
Health Workers ◽  
Poor Health ◽  
Personal Satisfaction ◽  
Voluntary Work ◽  
The Poor ◽  
Referral Systems

Altruism on the part of doctors and other health workers may help make health services affordable for the poor, but the altruistic contribution of doctors who are nationals of developing countries has largely been ignored. This paper describes the results of two related surveys carried out between February and April 2001 to determine the characteristics of indigenous charitable clinics in Patan, Nepal, and the attitudes of the Nepali health professionals who work in them. In 2001, 33 Nepali health professionals were working without payment in 13 charitable clinics in Patan. Altogether they provided care to the same number of city residents as the general out-patient clinics of the city's 330-bed hospital. The scale of this activity had not previously been recognized. Half the clinics received an external subsidy; they were larger and had been running for longer than those without a subsidy. The most frequently mentioned reasons for deciding to work in a charitable clinic were a desire to serve the poor and improve society; to gain personal satisfaction; and a desire to help one's own community. To make best use of any indigenous professionals who do voluntary work for the poor, health planners should identify the number and type of charitable clinics in their area; provide them with small subsidies for essential drugs and equipment; publicize them to make sure they are well attended; and develop referral systems between charitable clinics and other local providers of primary healthcare.

Improving the ascertainment of refugee-background people in health datasets and health services

2018 ◽  
Vol 42 (2) ◽  
pp. 130 ◽  
Author(s):  
Jane Yelland ◽  
Elisha Riggs ◽  
Josef Szwarc ◽  
Dannielle Vanpraag ◽  
Wendy Dawson ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Outcomes ◽  
Delivery Of Health Care ◽  
Clinical Encounter ◽  
Service Planning ◽  
Poor Health ◽  
Care Providers ◽  
Childhood Health ◽  
Early Childhood Health

Ascertainment of vulnerable populations in health datasets is critical to monitoring disparities in health outcomes, enables service planning and guides the delivery of health care. There is emerging evidence that people of refugee backgrounds in Australia experience poor health outcomes and barriers to accessing services, yet a clear picture of these disparities is limited by what is routinely collected in health datasets. There are challenges to improving the accuracy of ascertainment of refugee background, with sensitivities for both consumers and providers about the way questions are asked. Initial testing of four data items in maternity and early childhood health services (maternal country of birth, year of arrival in Australia, requirement for an interpreter and women’s preferred language) suggests that these are straightforward items to collect and acceptable to service administrators, care providers and to women. In addition to the four data items, a set of questions has been developed as a guide for clinicians to use in consultations. These new approaches to ascertainment of refugee background are essential for addressing the risk of poor health outcomes for those who are forced to leave their countries of origin because of persecution and violence. What is known about the topic? Relatively little attention has been given to identifying refugee-background populations in health datasets and health services. What does the paper add? Four routinely collected data items will provide an indication of refugee background to better understand health disparities and guide service planning and the delivery of health care. What are the implications for practice? The data items, together with a set of questions for practitioners to use in the clinical encounter, are essentials to the provision of culturally competent health care.

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