Public Healthcare Access: Burdens and Adaptation in Ibarapa Nomadic Community of Southwestern Nigeria

2020 ◽  
pp. 002190962097580
Author(s):  
Aderemi Ajala ◽  
Blessing Nonye Onyima
Keyword(s):  
Healthcare Access ◽  
Herbal Remedies ◽  
Public Healthcare ◽  
High Morbidity ◽  
Equitable Access ◽  
Southwestern Nigeria ◽  
Healthcare Facilities ◽  
Faith Based ◽  
Health Clinics ◽  
Snake Bites

Health burden, coping strategies and access to public healthcare facilities are examined using a medical ecological approach and ethnography among Ibarapa nomads. They live in bands in far distances from Yoruba populated towns in the Ibarapa area, where grazing culture makes healthcare facilities inaccessible. Vulnerable to high morbidity and health risks due to snake-bites, malaria, zoonosis and some other infections, but lacking healthcare facilities, they mostly use faith-based healing, herbal remedies and self-medications. Seventeen percent of the nomads access healthcare facilities from distant towns in Ibarapa. Equitable access to healthcare requires mobile healthcare for semi-sedentary nomads and permanent health clinics for sedentary nomads.

Is Medical Tourism Really Unethical? An Alternate Perspective for Developing Countries

2021 ◽  
pp. 245513332110623
Author(s):  
Divya Chaudhry
Keyword(s):  
Developing Countries ◽  
Medical Tourism ◽  
Healthcare Access ◽  
Public Healthcare ◽  
Global Public Health ◽  
Healthcare Facilities ◽  
Equity Issues ◽  
Opting Out ◽  
Ethical Concerns ◽  
Academic Literature

This article makes a case for leveraging medical tourism (MT) from the perspective of improving healthcare access in developing countries. The expansion of MT at an unprecedented rate has given rise to a number of ethical concerns in both home and destination countries. Ethical debates in this field have transcended the realm of global public health and have emerged across various disciplines including development, social justice, legal, trade and policy studies. Much of the academic literature in these domains has categorically held MT responsible for commodification of healthcare, creating a duality in healthcare systems of developing countries and making healthcare inaccessible and unaffordable for the disadvantaged sections of the population. While all these claims normatively seem justified, this article asserts that despite the several ethical concerns that have been raised, MT may not necessarily exacerbate healthcare equity issues in developing countries. In fact, MT may benefit destination countries by creating a highly specialised private sector which may provide services not only to foreign patients but also to wealthier domestic patients. Voluntary opting-out of domestic patients from public healthcare will result in decongestion of public healthcare facilities, which in turn could be accessed to a greater extent by the underprivileged population at affordable cost. In addition to contributing to the limited academic literature on this particular aspect of MT, this article presents an alternate view to promote MT in developing countries from the perspective of addressing challenges related to healthcare access.

scholarly journals Disparities in Healthcare Services and Spatial Assessments of Mobile Health Clinics in the Border Regions of Thailand

2021 ◽  
Vol 18 (20) ◽  
pp. 10782
Author(s):  
Hiranya Sritart ◽  
Kuson Tuntiwong ◽  
Hiroyuki Miyazaki ◽  
Somchat Taertulakarn
Keyword(s):  
Mobile Health ◽  
Program Implementation ◽  
Spatial Data ◽  
Local Level ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Border Region ◽  
Healthcare Facilities ◽  
Health Clinics ◽  
Additional Support

Reducing the disparities in healthcare access is one of the important goals in healthcare services and is significant for national health. However, measuring the complexity of access in truly underserved areas is the critical step in designing and implementing healthcare policy to improve those services and to provide additional support. Even though there are methods and tools for modeling healthcare accessibility, the context of data is challenging to interpret at the local level for targeted program implementation due to its complexity. Therefore, the purpose of this study is to develop a concise and context-specific methodology for assessing disparities for a remote province in Thailand to assist in the development and expansion of the efficient use of additional mobile health clinics. We applied the geographic information system (GIS) methodology with the travel time-based approach to visualize and analyze the concealed information of spatial data in the finer analysis resolution of the study area, which was located in the border region of the country, Ubon Ratchathani, to identify the regional differences in healthcare allocation. Our results highlight the significantly inadequate level of accessibility to healthcare services in the regions. We found that over 253,000 of the population lived more than half an hour away from a hospital. Moreover, the relationships of the vulnerable residents and underserved regions across the province are underlined in the study and substantially discussed in terms of expansion of mobile health delivery to embrace the barrier of travel duration to reach healthcare facilities. Accordingly, this research study addresses regional disparities and provides valuable references for governmental authorities and health planners in healthcare strategy design and intervention to minimize the inequalities in healthcare services.

scholarly journals Accessing public healthcare in Oslo, Norway: the experiences of Thai immigrant masseuses

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Naomi Tschirhart ◽  
Esperanza Diaz ◽  
Trygve Ottersen
Keyword(s):  
Cultural Values ◽  
Healthcare System ◽  
Health Workers ◽  
Healthcare Access ◽  
Access To Healthcare ◽  
Public Healthcare ◽  
Health Coverage ◽  
Thai Women ◽  
Healthcare Facilities ◽  
Healthcare Needs

Abstract Background Thai massage is a highly gendered and culturally specific occupation. Many female Thai masseuses migrate to Norway as marriage migrants and as such are entitled to the same public healthcare as Norwegian citizens. Additionally, anyone who is not fluent in Norwegian is entitled to have an interpreter provided by the public healthcare system. Norway and most other countries aspire to universal health coverage, but certain immigrant populations continue to experience difficulties accessing appropriate healthcare. This study examined healthcare access among Thai migrant masseuses in Oslo. Methods Guided by access to healthcare theory, we conducted a qualitative exploratory study in 2018 with Thai women working as masseuses in Oslo, Norway. Through semi-structured in-depth interviews with 14 Thai women, we explored access to healthcare, health system navigation and care experiences. We analyzed the data using thematic analysis and grouped the information into themes relevant to healthcare access. Results Participants did not perceive that their occupation limited their access to healthcare. Most of the barriers participants experienced when accessing care were related to persistent language challenges. Women who presented at healthcare facilities with their Norwegian spouse were rarely offered interpreters, despite their husband’s limited capacity to translate effectively. Cultural values inhibit women from demanding the interpretation services to which they are entitled. In seeking healthcare, women sought information about health services from their Thai network and relied on family members, friends and contacts to act as informal interpreters. Some addressed their healthcare needs through self-treatment using imported medication or sought healthcare abroad. Conclusions Despite having the same entitlements to public healthcare as Norwegian citizens, Thai migrants experience difficulties accessing healthcare due to pervasive language barriers. A significant gap exists between the official policy that professional interpreters should be provided and the reality experienced by study participants. To improve communication and equitable access to healthcare for Thai immigrant women in Norway, health personnel should offer professional interpreters and not rely on Norwegian spouses to translate. Use of community health workers and outreach through Thai networks, may also improve Thai immigrants’ knowledge and ability to navigate the Norwegian healthcare system.

scholarly journals “Just So You Know, It Has Been Hard”: Food Retailers’ Perspectives of Implementing a Food and Nutrition Policy in Public Healthcare Settings

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2053
Author(s):  
Kristy Karying. Law ◽  
Claire Elizabeth. Pulker ◽  
Janelle Diann. Healy ◽  
Christina Mary. Pollard
Keyword(s):  
Nutrition Policy ◽  
Public Healthcare ◽  
Healthcare Facilities ◽  
Voluntary Standards ◽  
Policy Success ◽  
Healthcare Settings ◽  
Food Retailers ◽  
Food And Nutrition ◽  
The Cost ◽  
Public Health Practitioners

Mandated policies to improve food environments in public settings are an important strategy for governments. Most Australian governments have mandated policies or voluntary standards for healthy food procurement in healthcare facilities, however, implementation and compliance are poor. A better understanding of the support required to successfully implement such policies is needed. This research explored food retailers’ experiences in implementing a mandated food and nutrition policy (the Policy) in healthcare settings to identify barriers, enablers, and impacts of compliance. Three 90-min workshops facilitated by two public health practitioners were undertaken with 12 food retailers responsible for operating 44 outlets across four hospitals in Perth, Western Australia. Workshop discussions were transcribed non-verbatim and inductive thematic content was analyzed. Three main themes were identified: (1) food retailers had come to accept their role in implementing the Policy; (2) the Policy made it difficult for food retailers to operate successfully, and; (3) food retailers needed help and support to implement the Policy. Findings indicate the cost of implementation is borne by food retailers. Communications campaigns, centralized databases of classified products, reporting frameworks, recognition of achievements, and dedicated technical expertise would support achieving policy compliance. Feasibility assessments prior to policy implementation are recommended for policy success.

scholarly journals ‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South Africa

2021 ◽  
Vol 6 (4) ◽  
pp. e004360
Author(s):  
Dumisani MacDonald Hompashe ◽  
Ulf-G Gerdtham ◽  
Carmen S Christian ◽  
Anja Smith ◽  
Ronelle Burger
Keyword(s):  
Health Systems ◽  
Primary Healthcare ◽  
Healthcare Workers ◽  
Quality Care ◽  
Public Healthcare ◽  
Health Coverage ◽  
Access To Health Services ◽  
Healthcare Provision ◽  
Healthcare Facilities ◽  
Patients Experience

Introduction Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions of care, and patients’ experience thereof relative to satisfaction with visits. This paper investigates the role of non-clinical dimensions of care in patient satisfaction. Methods Our study describes the interactions of informed and non-informed patients with primary healthcare workers at 39 public healthcare facilities in two metropolitan centres in two South African provinces. Our analysis included 1357 interactions using standardised patients (for informed patients) and patients’ exit interviews (for non-informed patients). The data were combined for three types of visits: contraception, hypertension and tuberculosis. We describe how satisfaction with care was related to patients’ experiences of non-clinical dimensions. Results We show that when real patients (RPs) reported being satisfied (vs dissatisfied) with a visit, it was associated with a 30% increase in the probability that a patient is greeted at the facilities. Likewise, when the RPs reported being satisfied (vs dissatisfied) with the visit, it was correlated with a 15% increase in the prospect that patients are pleased with healthcare workers’ explanations of health conditions. Conclusion Informed patients are better equipped to assess health-systems responsiveness in healthcare provision. Insights into responsiveness could guide broader efforts aimed at targeted education and empowerment of primary healthcare users to strengthen health systems and shape expectations for appropriate care and conduct.

scholarly journals Integrated strategies of participatory surveillance to promote flu vaccine coverage in HCWs

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Rizzo ◽  
S Zaffina ◽  
M R Vinci ◽  
A Santoro ◽  
F Gilardi ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Vaccine Coverage ◽  
Demographic Data ◽  
Good Practice ◽  
Phone Call ◽  
High Morbidity ◽  
Healthcare Facilities ◽  
Negative Case ◽  
Flu Vaccine ◽  
Participatory Surveillance

Abstract Problem Influenza represents a threat for healthcare facilities where sudden outbreaks of illness can lead to high morbidity and mortality in vulnerable patients and increase absenteeism in HCWs. Despite WHO recommends annual influenza vaccination of HCWs, flu vaccine coverage (FVC) remain very low in most EU countries. Description of the Problem Despite an important increase in FVC recorded in last years in our hospital, FVC remains under 75%. We pilot a prospective cohort study in HCWs in order to test new methods for influenza vaccination promotion. We create a web-based system integrating information on vaccination status (unvaccinated HCWs, 1/2/3 years vaccinated ones) and demographic data. The Hospital Ethical Committee approved the study. During the 2019/20 influenza season we nested a test-negative case-control study in the cohort to evaluate Influenza vaccine effectiveness against influenza-like-illness (ILI) laboratory confirmed as influenza in HCWs. Results A total of 443 on 2675 HCWs were recruited in the cohort and weekly received specific SMS messages and phone call for a personal invitation to get flu shot. The median age of the cohort was 43,3 (range 21-72) with 128 male (28,9%). In the cohort a FVC of 26/205 (12,7%) was registered in HCWs never vaccinated in the previous 3 seasons. Nasopharyngeal swabs were distributed to 205 subjects for influenza confirmation and they received weekly messages in order to check their health status remanding to self-swab in the case of ILI symptoms. Lessons Using a new and integrated strategy for influenza vaccination promotion in HCWs can increase the FVC. The use of personal direct messages to HCWs and the possibility of confirming or excluding influenza in case of ILI symptoms in those vaccinated and unvaccinated, seems to be very effective in increasing vaccine coverage. Moreover, the cohort could be also used for further research studies as for example the effect of repeated influenza vaccination. Key messages The presented practice appears to be effective and could be applied to larger HCWs population. This strategy could be considered as a good practice of workplace vaccination promotion.

scholarly journals Survey of ethnobotanical cocktails commonly used in the treatment of malaria in southwestern Nigeria

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Rachel Omagha ◽  
Emmanuel Taiwo Idowu ◽  
Chibuisi Gideon Alimba ◽  
Adetoro Olubunmi Otubanjo ◽  
Adeniyi Kazeem Adeneye
Keyword(s):  
Herbal Medicines ◽  
Oral Route ◽  
Malaria Treatment ◽  
Herbal Remedies ◽  
Southwestern Nigeria ◽  
Traditional Treatment ◽  
South West ◽  
Pharmacological Screening ◽  
Selection Of ◽  
Structured Questionnaire

Abstract Background Combination of different antimalarials has become the popular method of care for malaria morbidity in conventional and traditional treatment approaches due to the need to increase the efficacy and reduce the selection of drug resistance. A worrisome concern is the critical gaps with regards to the information available on antimalarial herbal cocktails. This study presents cocktail herbal remedies in ethnomedicinal approaches to malaria treatment in Oyo and Ogun states, South West Nigeria. Ethnobotanical information on indigenous antimalarials used in combination remedies was collected from herbal practitioners using a semi-structured questionnaire. Results Findings showed majority of respondents treat malaria with combination herbal remedies. They sighted their beliefs and customs, the efficacy, affordability and availability of these herbs as reasons for their adoption of herbal medicines as their preferred mode of treating malaria. Enquiry revealed 26 sets of cocktail antimalarials from a variety of plant species. The plants and ingredients are extracted and used as decoction, infusion or steam baths. Oral route was the most popular mode of administration. Respondents reported they drink one to two medium-sized cups of the recipe on an average of two times daily within a duration of about 10 days. Conclusions Herbal antimalarial remedies continue to be the popular treatments option in our localities. This study provides knowledge of the diverse ways respondents combine medicinal herbs and other local ingredients for malaria treatment. Pharmacological screening is urgently needed to validate their safety and efficacy in order to protect the health of our locals heavily relying on them to combat high burdens of malaria.

Patients’ assessment of medical services quality – a determinant of changes in medical entity management on the example of Poland

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Katarzyna Dorota Hampel
Keyword(s):  
Empirical Research ◽  
Medical Services ◽  
Public Healthcare ◽  
Content Type ◽  
Healthcare Facilities ◽  
Starting Point ◽  
Medical Effectiveness ◽  
Medical Entity ◽  
Questionnaire Surveys ◽  
State Of Affairs

PurposeThe article’s primary goal is to identify areas requiring improvement in the activities of healthcare entities, suggest directions for future changes, and indicate the strengths and weaknesses of the clinic’s operation based on patients’ opinions. Subjectively expressed opinions of patients are treated as acceptance of the current state of affairs or the need to introduce changes in a given area.Design/methodology/approachThe empirical research was based on information obtained from questionnaire surveys on patients’ opinions about services provided by medical entities. The hypothesis was verified by research conducted in 23 (out of 50 possible) the most dynamically developing non-public healthcare institutions in one of the regions of Poland. The conducted research was based on a proprietary survey using questions on qualitative and quantitative scales.FindingsThe results of empirical research allowed us to identify areas requiring improvement and to propose future directions of changes in the surveyed units. The suggested changes should significantly improve efficiency in the organisation and management of a health facility, focused on medical effectiveness and patients’ health effectiveness.Originality/valueFrom a broader perspective, research results may become a starting point for further considerations on changes in the organisation and management of healthcare facilities. Using the study’s conclusions in practice may positively affect the improvement of the functioning of healthcare facilities, their better reputation and contribute to increasing competitiveness in the medical services market.

scholarly journals A comparison of the levels of satisfaction with the medical services provided by primary healthcare centers in selected communes in Lubelskie Voivodeship

2016 ◽  
Vol 126 (1) ◽  
pp. 8-12
Author(s):  
Daria Przybylska ◽  
Piotr Przybylski ◽  
Bartłomiej Drop ◽  
Krzysztof Czarnocki ◽  
Wojciech Przybylski ◽  
...  
Keyword(s):  
Family Medicine ◽  
Primary Healthcare ◽  
The Elderly ◽  
Healthcare Services ◽  
Medical Services ◽  
Public Healthcare ◽  
Healthcare Facilities ◽  
Primary Type ◽  
Primary Healthcare Centers

Abstract Introduction. Family medicine remains the primary type of medical services in Poland and it is supposed to treat both individual patients and the society as a whole. Due to the growing commercialization of the health service, most primary healthcare centers have transformed into non-public healthcare facilities. The public ones (called SPZOZ in Polish) account only for a small fraction of the whole number of primary healthcare facilities. The quality of medical services provided by such facilities, as patients see it, remains one of the key elements determining the development of family medicine centers. Aim. The aim of this paper was to assess patient satisfaction levels regarding the healthcare services they received in two primary healthcare institutions, both of the NZOZ and SPZOZ type, in a small town located close to Lublin. Material and methods. An anonymous survey was filled out by 30 patients of both a public and non-public healthcare center located in Niemce (Niemce Commune, Lublin District). The quality of services was assessed using an original questionnaire in the form of a poll. Results. The results obtained indicate a clear relationship between one’s trust to the physician, diagnosis accuracy and visiting the particular center again, in order to continue the treatment. For older subjects, it was nurses’ kindness and politeness that was the most important. The elderly appreciated the kindness and politeness of the nurses in particular. No significant differences were found between the institutions in respect of the overall perception of satisfaction with services. In terms of infrastructure assessment, the majority of positive feedback was provided for NZOZ. Conclusions. The findings above suggest that it is essential to conduct surveys on a regular basis, in order to check patients’ assessment of the service quality in various institutons.

Significant risk factors associated with facilities management (FM) outsourcing

2015 ◽  
Vol 22 (6) ◽  
pp. 771-796 ◽  
Author(s):  
Dubem I. Ikediashi ◽  
Stephen O. Ogunlana
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
The Body ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Facilities Management ◽  
Content Type ◽  
Healthcare Facilities ◽  
Factors Associated ◽  
Body Of Knowledge

Purpose – The purpose of this paper is to extend the body of knowledge on healthcare facilities management (FM) by investigating the risks associated with outsourcing of FM services in hospitals. Design/methodology/approach – The paper relied on two strands of methodology common with pragmatic research. Questionnaire survey (QS) used data from 208 respondents representing ten hospitals while three out of the ten hospitals involved in the QS were selected based on their willingness to enter the case study (CS) interview. Data collected were analysed using descriptive and inferential statistics for QS and using narrative techniques by discussing themes, sub-themes for the CS. Findings – Findings established 24 out of the 35 risk factors as critical, four factors as somehow critical, and five factors as not critical. Besides, nine risk factors were found to be significantly loaded on the five risk categories. The rank analysis also revealed that the top five critical risk factors are: inexperience and lack of requisite skills; possibility of fraud by vendor; financial failure of chosen vendor; vendor opportunism; and fall in morale of employees. Originality/value – The study provides an unambiguous contribution to exiting body of knowledge on outsourcing risks as it relates to healthcare FM. It reinforces the theory that risks exist in any form of relationship but developed a distinct body of factors associated with outsourcing of FM services particularly from the context of Nigeria’s public healthcare sector.

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