Facilitators and Barriers to Health Seeking among People Who Use Drugs in the Sunyani Municipality of Ghana: An Exploratory Study

Drug use is one of the global public health issues, and its accompanying disorders have consequences on people’s mental, physical, and environmental health. Nevertheless, the majority of people who use drugs have never been treated for drug dependence and other health conditions whilst others discontinue their treatment for drug use disorder. Using the health belief model, the study aimed at exploring facilitators and barriers to health-seeking among people who use drugs in the Sunyani Municipality of Ghana. A descriptive study design was used, employing a qualitative approach. In-depth interviews were conducted with a total of 22 participants, including two key informants (male and female). The first group of participants was recruited from the ghetto (an area in the municipality where people who use drugs are usually located). The other group of participants was recruited using hospital-based records. The interview data were transcribed, coded, and analysed for the generation of themes with the aid of Nvivo version 12 pro. The results showed that people who use drugs face health challenges such as drug dependence, malaria, lungs and breathing complications, cardiovascular complications, and skin complications. People who use drugs experienced poor perceived quality of life and low health status. Health-seeking behaviours of interviewees were influenced by the perceived benefit, perceived severity, cues to action, among others. Multiple sources of healthcare were used by the people who use drugs. Whereas ease of communication, perceived severity, benefit, among others were facilitators to their health-seeking behaviours, cost, dwindling social support, lack of knowledge of the condition, and fear of arrest by law enforcement agencies also served as barriers to seeking healthcare at the orthodox health facilities. This paper suggests a holistic approach to help improve the health and health-seeking behaviours of people who use drugs. The researchers wish to indicate that an earlier version of this manuscript has been presented at the University of Ghana as a thesis.

Download Full-text

Facilitators and Barriers to Health-Seeking Behaviours among Filipino Migrants: Inductive Analysis to Inform Health Promotion

BioMed Research International ◽

10.1155/2015/506269 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 18

Author(s):

D. Maneze ◽

M. DiGiacomo ◽

Y. Salamonson ◽

J. Descallar ◽

P. M. Davidson

Keyword(s):

Health Promotion ◽

English Language ◽

Cultural Beliefs ◽

Cultural Influences ◽

Service Access ◽

Health Seeking Behaviour ◽

Health Seeking ◽

Facilitators And Barriers ◽

Filipino Migrants ◽

Barriers To Health

Understanding factors that influence health-seeking behaviour of migrants is necessary to intervene for behaviour change. This paper explores Filipino migrants’ perceptions of facilitators and barriers to maintaining health in Australia. Open-ended survey item responses reflecting factors that assisted and hindered health following migration to Australia were inductively analysed. Three hundred and thirty-seven of the 552 survey respondents (61%) provided open-ended responses. Responses were grouped into two major categories: individual factors, including personal resources and cultural influences, and environmental factors encompassing both the physical conditions in the host country and health service access. Awareness of practices that enhance health was a major personal facilitator of health-seeking behaviour; however, competing priorities of daily living were perceived as barriers. Cultural beliefs and practices influenced health-seeking behaviour. Despite high self-rated English language skills in this population, new migrants and the elderly cited communication difficulties as barriers to accessing health services. Insight into facilitators and barriers to health-seeking behaviour in this less researched migrant population revealed tools for enhancing engagement in health promotion programs addressing healthy lifestyle.

Download Full-text

Drug Use and Prison

10.1093/med/9780199374847.003.0012 ◽

2018 ◽

Author(s):

Joanne Csete ◽

Rick Lines ◽

Ralf Jürgens

Keyword(s):

Drug Use ◽

Social Services ◽

Drug Dependence ◽

Due Process ◽

Scale Up ◽

Standard Of Care ◽

People Who Use Drugs ◽

International Consensus ◽

Criminal Sanctions ◽

Health Related

This chapter discusses protections of the health-related rights of prisoners that are encoded in widely ratified human rights instruments and in guidelines for which there is broad international consensus. People who use drugs while detained or incarcerated, however, rarely enjoy the standard of care to which they are entitled, which includes HIV prevention activities and other services that are available in the community. In some countries, people accused of minor drug infractions may be detained for long periods in centers that purport to provide treatment for drug dependence but are effectively labor camps that do not provide health care and where “patients” face physical abuse and denial of due process. There is an urgent need to establish and scale up health services for people who use drugs in custodial environments, with independent monitoring of the existence and quality of care and measures to ensure that health professionals working with people who use drugs in prison and pre-trial detention can work without interference. More important, however, drug dependence and minor drug infractions that often accompany it should be managed through health and social services rather than criminal sanctions. Reducing the use of prison and pretrial detention as a response to drug use and minor possession may be the most important measure for respecting, protecting and fulfilling the health-related rights of people who use drugs. Compulsory “treatment” centers should be closed in favor of humane care provided in the community.

Download Full-text

“Running myself ragged”: stressors faced by peer workers in overdose response settings

Harm Reduction Journal ◽

10.1186/s12954-020-00449-1 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Zahra Mamdani ◽

Sophie McKenzie ◽

Bernadette Pauly ◽

Fred Cameron ◽

Jennifer Conway-Brown ◽

...

Keyword(s):

Drug Use ◽

Focus Groups ◽

Mixed Methods Research ◽

Financial Burden ◽

People Who Use Drugs ◽

Frequency Distributions ◽

Sequential Mixed Methods ◽

Health Quality ◽

Mental Health Effects ◽

Perception Of Health

Abstract Background Peer workers or “peers” (workers with past or present drug use experience) are at the forefront of overdose response initiatives, and their role is essential in creating safe spaces for people who use drugs (PWUD). Working in overdose response settings has benefits for peer workers but is also stressful, with lasting emotional and mental health effects. Yet, little is known about the stressors peer workers face and what interventions can be implemented to support them in their roles. Methods This project used a community-based sequential mixed-methods research design. Eight peer researcher-led focus groups (n = 31) were conducted between November 2018 and March 2019 to assess needs of peer workers. The transcripts were thematically coded and analysed using interpretative description. These results informed a survey, which was conducted (n = 50) in September 2019 to acquire quantitative data on peer workers’ perception of health, quality of life, working conditions and stressors. Frequency distributions were used to describe characteristics of participants. X2 distribution values with Yates correction were conducted to check for association between variables. Results Five themes emerged from the focus groups that point to stressors felt by peer workers: (1) financial insecurity; (2) lack of respect and recognition at work; (3) housing challenges; (4) inability to access and/or refer individuals to resources; and (5) constant exposure to death and trauma. Consistent with this, the factors that survey participants picked as one of their “top three stressors” included financial situation, work situation, and housing challenges. Conclusion Peer workers are faced with a diversity of stressors in their lives which often reflect societal stigmatization of drug use. Recognition of these systemic stressors is critical in designing interventions to ease the emotional, physical and financial burden faced by peer workers.

Download Full-text

Realities and challenges of breastfeeding policy in the context of HIV: a qualitative study on community perspectives on facilitators and barriers related to breastfeeding among HIV positive mothers in Baringo County, Kenya

International Breastfeeding Journal ◽

10.1186/s13006-021-00385-1 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Betty Mogesi Samburu ◽

Judith Kimiywe ◽

Sera Lewise Young ◽

Frederick Murunga Wekesah ◽

Milka Njeri Wanjohi ◽

...

Keyword(s):

Exclusive Breastfeeding ◽

Cultural Practices ◽

Health Workers ◽

Male Involvement ◽

Holistic Approach ◽

Antiretroviral Drugs ◽

Hiv Positive ◽

Community Perspectives ◽

Hiv Positive Mothers ◽

Facilitators And Barriers

Abstract Background Although recent policies have sought to increase the rates of exclusive breastfeeding (EBF) and continued breastfeeding for HIV exposed infants, few programs have considered the multiple social and cultural barriers to the practice. Therefore, to generate evidence for exclusive and continued breastfeeding policies in Kenya, we examined community perspectives on the facilitators and barriers in adherence to EBF for the HIV positive mothers. Methods Qualitative research was conducted in Koibatek, a sub-County in Baringo County Kenya, in August 2014 among 205 respondents. A total of 14 focus group discussions (n = 177), 14 In-depth Interviews and 16 key informant interviews were conducted. Transcribed data was analyzed thematically. NVivo version 10.0 computer qualitative software program was used to manage and facilitate the analysis. Results Facilitators to exclusive breastfeeding were perceived to include counselling at the health facility, desire to have a healthy baby, use of antiretroviral drugs and health benefits associated with breastmilk. Barriers to EBF included poor dissemination of policies, knowledge gap, misinterpretation of EBF, inadequate counselling, attitude of mother and health workers due to fear of vertical HIV transmission, stigma related to misconception and misinformation that EBF is only compulsory for HIV positive mothers, stigma related to HIV and disclosure, social pressure, lack of male involvement, cultural practices and traditions, employment, food insecurity. Conclusions There are multiple facilitators and barriers of optimal breastfeeding that needs a holistic approach to interventions aimed at achieving elimination of mother to child transmission. Extension of infant feeding support in the context of HIV to the community while building on existing interventions such as the Baby Friendly Community Initiative is key to providing confidential support services for the additional needs faced by HIV positive mothers.

Download Full-text

Drug dealing and drug use prevention – a qualitative interview study of authorities’ perspectives on two open drug scenes in Stockholm

Substance Abuse Treatment Prevention and Policy ◽

10.1186/s13011-021-00375-w ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Kristin Feltmann ◽

Johanna Gripenberg ◽

Anna K. Strandberg ◽

Tobias H. Elgán ◽

Pia Kvillemo

Keyword(s):

Drug Use ◽

Police Officers ◽

Urban Areas ◽

Qualitative Content Analysis ◽

Organizational Factors ◽

Successful Implementation ◽

International Studies ◽

Drug Dealing ◽

Qualitative Interview Study ◽

Facilitators And Barriers

Abstract Background The use of illicit substances causes various health and social problems globally. Moreover, open drug use and dealing in urban areas, i.e., open drug scenes, can cause public order problems, lead to the recruitment of marginalized and young people for drug use or sale, and induce feelings of insecurity in the general public. Although some international studies have described various ways to manage open drug scenes, such as law enforcement and social interventions, there is limited knowledge about the facilitators and barriers promoting or impeding the implementation of such interventions. The aim of the current study was to explore how different authorities describe the nature of two open drug scenes in Stockholm and to derive authorities’ perspective on facilitators and barriers to implementing interventions to reduce open drug dealing, drug use, and related problems at these locations. Methods Semi-structured interviews with police officers, security staff, social workers, and municipality officials (n = 21) in the municipality of Stockholm were conducted and analyzed by qualitative content analysis. Results The analysis of the interviews generated the following categories: Problems, Interventions, Organizational factors, and External factors, revealing information about the strategic and daily counteracting work occurring at the open drug scenes as well as authorities’ perceptions of facilitators and barriers to implementing interventions to reduce open drug dealing, drug use, and related problems. Facilitators included motivated and skilled professionals and organized collaboration between key actors. Prominent barriers were a lack of resources to maintain personnel continuity at the scenes, policies that impede information sharing and put security staff in danger, and people who use or sell drugs without having residence permits. Conclusions To increase the possibility of successful implementation of interventions to counteract open drug dealing, politicians and authorities should pay attention to collaboration between key actors, sufficient resource allocation, possible modification of policy governing professional duties, and remedies to the vulnerability of individuals without residence permits.

Download Full-text

The U.S. Food and Drug Administration’s Complex Innovative Trial Design Pilot Meeting Program: Progress to date

Clinical Trials ◽

10.1177/17407745211050580 ◽

2021 ◽

pp. 174077452110505

Author(s):

Dionne Price ◽

John Scott

Keyword(s):

Public Health ◽

Drug Administration ◽

Trial Design ◽

Drug Evaluation ◽

Food And Drug Administration ◽

Medical Product ◽

Global Public Health ◽

Multiple Sources ◽

Meeting Program ◽

The U.S

Background The Center for Drug Evaluation and Research and the Center for Biologics Evaluation and Research of the U.S. Food and Drug Administration have been leaders in advancing science to protect and promote public health by ensuring that safe and effective drugs and biological products are available to those who need them. Recently, new therapeutic discoveries, increased understanding of disease mechanisms, the need for innovation to optimally use resources, and global public health crises have led to an evolving drug development landscape. As a result, the U.S. Food and Drug Administration and medical product developers are faced with unique challenges and opportunities. The U.S. Food and Drug Administration is proactively meeting the challenges of this evolving landscape through various efforts, including the Complex Innovative Trial Design Pilot Meeting Program. Our focus, here, will be on the pilot meeting program. Methods The U.S. Food and Drug Administration has defined a process to facilitate the implementation of the Complex Innovative Trial Design Pilot Meeting Program. The process is transparent and outlines the steps and timeline for submission, review, and meetings. Results Five submitted meeting requests have been selected for participation in the Complex Innovative Trial Design Pilot Meeting Program. Conclusion The pilot meeting program has been successful in further educating stakeholders on the potential uses of complex innovative designs in trials intended to provide substantial evidence of effectiveness. The selected submissions, thus far, have all utilized a Bayesian framework. The reasons for the use of Bayesian approaches may be due to the flexibility provided, the ability to incorporate multiple sources of evidence, and a desire to better understand the U.S. Food and Drug Administration perspective on such approaches. We are confident the pilot meeting program will have continued success and impact the collective goal of bringing safe and effective medical products to patients.

Download Full-text

COVID-19 as an “Infodemic” in Public Health: Critical Role of the Social Media

Frontiers in Public Health ◽

10.3389/fpubh.2021.610623 ◽

2021 ◽

Vol 9 ◽

Author(s):

Debanjan Banerjee ◽

K. S. Meena

Keyword(s):

Public Health ◽

Social Media ◽

Critical Role ◽

Global Public Health ◽

Sources Of Information ◽

Multiple Sources ◽

Health Crisis ◽

Digital Platforms ◽

The Impact

The Coronavirus disease 2019 (COVID-19) pandemic has emerged as a significant and global public health crisis. Besides the rising number of cases and fatalities, the outbreak has also affected economies, employment and policies alike. As billions are being isolated at their homes to contain the infection, the uncertainty gives rise to mass hysteria and panic. Amidst this, there has been a hidden epidemic of “information” that makes COVID-19 stand out as a “digital infodemic” from the earlier outbreaks. Repeated and detailed content about the virus, geographical statistics, and multiple sources of information can all lead to chronic stress and confusion at times of crisis. Added to this is the plethora of misinformation, rumor and conspiracy theories circulating every day. With increased digitalization, media penetration has increased with a more significant number of people aiding in the “information pollution.” In this article, we glance at the unique evolution of COVID-19 as an “infodemic” in the hands of social media and the impact it had on its spread and public reaction. We then look at the ways forward in which the role of social media (as well as other digital platforms) can be integrated into social and public health, for a better symbiosis, “digital balance” and pandemic preparedness for the ongoing crisis and the future.

Download Full-text

Harm Reduction Policy for the Opioid Epidemic

The Opioid Epidemic ◽

10.1093/wentk/9780190916039.003.0017 ◽

2019 ◽

Author(s):

Yngvild Olsen ◽

Joshua M. Sharfstein

Keyword(s):

Social Justice ◽

Drug Use ◽

Harm Reduction ◽

People Who Use Drugs ◽

Opioid Epidemic ◽

Negative Consequences

What is harm reduction? Harm reduction is “a set of practical strategies aimed at reducing negative consequences associated with drug use.” It is also “a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.”...

Download Full-text

Enactments of a “holistic approach” in two Danish welfare institutions accommodating young adults with offending behavior and drug use experiences

Drugs and Alcohol Today ◽

10.1108/dat-12-2018-0071 ◽

2019 ◽

Vol 19 (3) ◽

pp. 208-219

Author(s):

Maria Dich Herold ◽

Cecilia Rand ◽

Vibeke Asmussen Frank

Keyword(s):

Young Adults ◽

Drug Use ◽

Holistic Approach ◽

Structured Interviews ◽

Institutional Practices ◽

Content Type ◽

Complex Problems ◽

Welfare Institutions ◽

Offending Behavior ◽

Offending Behaviour

Purpose The purpose of this paper is to discuss how a “holistic approach” is enacted in two interventions accommodating the same target group, young adults with offending behaviour and drug use experiences, but offered in very different contexts, the Prison Service and the community. The aim is to show how enactments of a “holistic approach”, although similar on paper, differ in welfare institutional practices due especially to organisational and structural conditions. Design/methodology/approach The paper is based on qualitative semi-structured interviews and written material from and about the two interventions. Findings Different enactments of a “holistic approach”, due to organisational and structural conditions of the interventions, construct different possibilities for institutional identities. These insights could be useful to take into consideration when discussing prevention initiatives (in a broad sense) for young people with complex problems, including co-occurring offending behaviour and drug use experience. Originality/value Research with a focus on citizens with complex problems who do not comply with OR conform to standard welfare institutions are limited. The authors contribute to this literature by focussing on young adults with offending behaviour and drug experiences.

Download Full-text