Practices employed by South African healthcare providers to obtain consent for treatment from children

2016 ◽  
Vol 25 (5) ◽  
pp. 640-652
Author(s):  
Michelle Bester ◽  
Yolanda Havenga ◽  
Zea Ligthelm
Keyword(s):  
Health Services ◽  
South African ◽  
Research Design ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Mental Capacity ◽  
Access To Health Services ◽  
Structured Interviews ◽  
Medical Practitioners ◽  
Access To Health

Background: The ability to consent promotes children’s access to health services. Healthcare providers should assess and arrive at a clinical judgement about the child’s maturity and mental capacity to obtain valid consent. Research objective: The objective of the study was to determine practices employed by South African healthcare providers to obtain consent for treatment from children. Research design: A qualitative, explorative, descriptive research design was used and the study was contextual. Participants and research context: In all, 24 healthcare providers (professional nurses and medical practitioners) were purposively sampled from a hospital and primary health clinics. Semi-structured interviews were used. Ethical consideration: Ethical approval was obtained from the Institutional Review Board and gatekeepers. Written informed consent was obtained from each participant. Findings: Healthcare providers’ current practices in obtaining consent from children revealed inconsistency in implementation as well as the yardstick used to determine children’s mental capacity. Building trust with children, sharing information and assessment were interlinked in obtaining consent. Discussion: The inconsistent practice has implications for children’s access to healthcare services. Conclusion: Inconsistent practices in the implementation of consent laws have the potential to violate children’s rights to bodily and psychological integrity, access to health services and having their opinions heard and be taken into consideration. Through uncovering the current perceptions and practices and a literature review, guidelines intended for use by the Department of Health could be developed.

scholarly journals Accessing community health services: challenges faced by poor people with disabilities in a rural community in South Africa

2012 ◽  
Vol 1 (1) ◽  
Author(s):  
Lisbet Grut ◽  
Gubela Mji ◽  
Stine H. Braathen ◽  
Benedicte Ingstad
Keyword(s):  
Health Services ◽  
Family Members ◽  
People With Disabilities ◽  
Community Health Services ◽  
Poor People ◽  
Social Forces ◽  
Access To Health Services ◽  
Structured Interviews ◽  
Her Family ◽  
Access To Health

Poor people with disabilities who live in poor rural societies experience unique problems in accessing health services. Their situation is influenced by multiple factors which unfold and interplay throughout the person’s life course. The difficulties do not only affect the person with a disability and his or her family, but also impact on the relevant care unit. The barriers are rooted in a life in poverty, upheld and maintained by poverty-reinforcing social forces of the past and the present, and reinforced by the lack of the person’s perspective of the health services. This article explores how difficulties may interact and influence access to and utilisation of health services, and how this may render health services out of reach even when they are available. The study reveals that non-compliance is not necessarily about neglect but could as well be a matter of lived poverty. The study was based on in-depth interviews with people with disabilities and family members, and semi-structured interviews with health personnel. The data analysis is contextual and interpretive. When offering health services to people with disabilities living in resource-poor settings, services should take into consideration the person’s history, the needs, and the resources and abilities of the family group. Rethinking access to health services should transcend a narrow medical institutionalization of health professional’s training, and include a patient’s perspective and a social vision in understanding and practice. Such rethinking requires health service models that integrate the skills of health professionals with the skills of disabled people and their family members. Such skills lie dormant at community level, and need to be recognized and utilized.

scholarly journals Examining Stakeholder’s Views On Refugee Healthcare Needs, Current Barriers in Accessing Healthcare Services and Future Healthcare Direction in New Zealand: A Qualitative Phenomenological Approach

2021 ◽  
Author(s):  
Bafreen Sherif ◽  
Ahmed Awaisu ◽  
Nadir Kheir
Keyword(s):  
New Zealand ◽  
Health Services ◽  
Qualitative Methodology ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Healthcare Personnel ◽  
Structured Interviews ◽  
Health Seeking ◽  
Healthcare Needs

Abstract Background The annual New Zealand refugee quota was increased to 1500 places from 2020 onwards as a response to the global refugee crisis. The specific healthcare needs of refugees are not clearly understood globally and communication between healthcare providers and refugees remains poor. Methods A phenomenological qualitative methodology was employed to conduct semi-structured interviews among purposively selected stakeholders who work in refugee organisations and relevant bodies in New Zealand. Results The participants indicated the need for a national framework of inclusion, mandating cultural competency training for frontline healthcare and non-healthcare personnel, creation of a national interpretation phone line, and establishing health navigators. Barriers to accessing health services identified included some social determinants of health such as housing and community environment; health-seeking behaviour and health literacy; and social support networks. Future healthcare delivery should focus on capacity building of existing services, including co-design processes, increased funding for refugee-specific health services, and whole government approach. Conclusion Policymakers and refugee organisations and their frontline personnel should seek to address the deficiencies identified in order to provide equitable, timely and cost-effective healthcare services for refugees in New Zealand.

scholarly journals Barriers and Facilitators to Accessing Health Services: A Qualitative Study Amongst People with Disabilities in Cameroon and India

2019 ◽  
Vol 16 (7) ◽  
pp. 1126 ◽  
Author(s):  
Maria Zuurmond ◽  
Islay Mactaggart ◽  
Nanda Kannuri ◽  
Gudlavalleti Murthy ◽  
Joseph Oye ◽  
...  
Keyword(s):  
Health Services ◽  
Access To Health Care ◽  
Social Inclusion ◽  
Service Providers ◽  
People With Disabilities ◽  
Personal Factors ◽  
Access To Health Services ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Access To Health

Background: Article 25 of the UNCRPD stipulates the right of people with disabilities to the highest attainable standard of health, and the timely uptake of appropriate health and rehabilitation services. This study seeks to explore the factors which influence access to health care among adults with disabilities in Cameroon and India. Methods: A total of 61 semi-structured interviews were conducted with a purposive sample of adults with vision, hearing or musculoskeletal impairments, using data from an earlier cross-sectional disability survey. In addition, 30 key informants were interviewed to provide contextual information about the local services and context. Results: Key themes included individual-level factors, understanding and beliefs about an impairment, and the nature of the impairment and interaction with environmental factors. At the community and household level, key themes were family dynamics and attitudes, economic factors, social inclusion and community participation. Intersectionality with gender and age were cross-cutting themes. Trust and acceptability of health service providers in India and poor understanding of referral processes in both countries were key service-level themes. Conclusions: The interaction of environmental and personal factors with the impairment and their levels of participation and inclusion in community structures, all contributed to the take up of services. This study illustrated the need for a multi-faceted response to improve access to health services for people with disabilities.

scholarly journals Financial Barriers to Access to Health Services for Adult People with Disability in Iran: The Challenges for Universal Health Coverage

2019 ◽  
Author(s):  
Shahin SOLTANI ◽  
Amirhossein TAKIAN ◽  
Ali AKBARI SARI ◽  
Reza MAJDZADEH ◽  
Mohammad KAMALI
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Universal Health Coverage ◽  
Healthcare Services ◽  
Health Coverage ◽  
Access To Health Services ◽  
Financial Barriers ◽  
Access To Health ◽  
People With Disability ◽  
Universal Health

Background: Reducing inequities in access to healthcare is one of the most important goals for all health systems. Financial barriers play a fundamental role here. People with disability (PWD) experience further financial barriers in access to their needed healthcare services. This study aimed to explore the causes of barriers in access to health services for PWD in Tehran, Iran. Methods: In this qualitative study, we used semi-structured in-depth interviews to collect data and selected participants through purposeful sampling with maximum variation. We conducted 56 individual interviews with people with disability, healthcare providers and policymakers from Sep 2015 until May 2016, at different locations in Tehran, Iran. Results: We identified four categories and eight subcategories of financial barriers affecting access to healthcare services among PWD. Four categories were related to health insurance (i.e. lack of insurance coverage for services like dentistry, occupational therapy and speech therapy), affordability (low income for PWD and their family), financial supports (e.g. low levels of pensions for people with disabilities) and transportation costs (high cost of transportation to reach healthcare facilities for PWD). Conclusion: Financial problems can lead to poor access to health care services. To achieve universal health coverage, government should reduce health insurance barriers and increase job opportunities and sufficient financial support for PWD. 

Professionals’ knowledge of the family health program on the actions taken by the sector of control, evaluation, regulation and audit

2011 ◽  
Vol 5 (3) ◽  
pp. 741
Author(s):  
Adna De Araújo Silva ◽  
Lucilane Maria Sales da Silva ◽  
Maria Verônica Sales da Silva ◽  
Marcelo Costa Fernandes
Keyword(s):  
Health Services ◽  
Family Health ◽  
Access To Health Services ◽  
Structured Interviews ◽  
Family Health Program ◽  
Health Strategy ◽  
Access To Health ◽  
The Family ◽  
Family Health Strategy ◽  
Control Evaluation

ABSTRACTObjective: to check the knowledge of professionals in the Family Health Strategy on activities undertaken by the sector of control, evaluation, regulation and audit. Methodology: this is about a descriptive study from qualitative approach. It was applied a semi-structured interviews with three doctors and 16 nurses who are part of the team from Family Health Strategy in the municipality of Morada Nova/CE, in October 2007. This study was approved by the ethics committee of the Federal University of Ceara with the protocol number COMEP No. 208/07. Results: according to the statements, the study subjects understand the actions performed in the industry as a set of control actions, evaluating and monitoring the work of health professionals, but also to regulate users' access to health services. Most professionals are unaware of the current team that makes up the CARA of the municipality, however agree that the team should be composed of a multidisciplinary team, preferably with specialization in the area. Conclusion: let us consider how the actions performed by CARA may contribute to the improvement of the SUS, aiming at improving the care provided by health services to its users. Descriptors: clinical audit, family health, single health system. RESUMOObjetivo: verificar o conhecimento dos profissionais da Estratégia Saúde da Família sobre as atividades realizadas pelo setor de controle, avaliação, regulação e auditoria. Metodologia: estudo descritivo com abordagem qualitativa. Foi aplicado uma entrevista semi-estruturada com três médicos e 16 enfermeiros que fazem parte da equipe da Estratégia Saúde da Família no município de Morada Nova/CE, em outubro de 2007. Estudo aprovado pelo Comitê de Ética da Universidade Federal do Ceará com o número de protocolo Comepe nº 208/07. Resultados: de acordo com as falas, os sujeitos do estudo entendem as ações realizadas no setor como sendo um conjunto de ações de controle, avaliação e fiscalização do trabalho dos profissionais de saúde, como também de regulação do acesso dos usuários aos serviços de saúde. A maioria dos profissionais não tem conhecimento da atual equipe que compõe a CARA do município, entretanto concordam que a equipe deveria ser composta de uma equipe multidisciplinar, preferencialmente com especialização na área. Conclusão: considere-se o quanto as ações desempenhadas pela CARA podem contribuir para o aperfeiçoamento do SUS, visando à melhoria da assistência prestada pelos serviços de saúde aos seus usuários. Descritores:  auditoria clínica; saúde da família; sistema único de saúde.RESUMENObjetivo: verificar los conocimientos de los profesionales de la Estrategia de Salud de la Familia sobre las actividades realizadas por el sector de control, evaluación, regulación y fiscalización. Metodología: estudio descriptivo con enfoque cualitativo. Se aplicó una entrevista semi-estructurada con 03 médicos y 16 enfermeras que forman parte del Estrategia Salud de la Familia en el municipio de Morada Nova - CE, en octubre de 2007. Este estudio fue aprobado por el comité de ética de la Universidade Federal de Ceará con el número de protocolo Comepe N º 208/07. Resultados: de acuerdo con las declaraciones, los sujetos del estudio entienden las acciones realizadas en la industria como un conjunto de medidas de control, evaluación y seguimiento de la labor de los profesionales de la salud, sino también para regular el acceso de los usuarios a los servicios de salud. La mayoría de profesionales no son conscientes de que el equipo actual que hace que el rostro del municipio, sin embargo de acuerdo en que el equipo debe estar compuesto por un equipo multidisciplinario, preferentemente con especialización en el área. Conclusión: vamos a considerar cómo las acciones realizadas por CARA puede contribuir a la mejora del SUS, con el objetivo de mejorar la atención recibida por los servicios de salud a sus usuarios. Descriptores: auditoría clínica; salud de la família; sistema único de salud.

Health equity funds as the pathway to universal coverage in Cambodia: care seeking and financial risk protection

2020 ◽  
Author(s):  
Theepakorn Jithitikulchai ◽  
Isabelle Feldhaus ◽  
Sebastian Bauhoff ◽  
Somil Nagpal
Keyword(s):  
Health Services ◽  
Health System ◽  
Health Equity ◽  
Universal Coverage ◽  
Healthcare Services ◽  
Care Seeking ◽  
Health Coverage ◽  
Access To Health Services ◽  
Financial Risk Protection ◽  
Access To Health

Abstract Cambodia has developed the health equity fund (HEF) system to improve access to health services for the poor, and this strengthens the health system towards the universal health coverage goal. Given rising healthcare costs, Cambodia has introduced several innovations and accomplished considerable progress in improving access to health services and catastrophic health expenditures for the targeted population groups. Though this is improving in recent years, HEF households remain at the higher risk of catastrophic spending as measured by the higher share of HEF households with catastrophic health expenses being at 6.9% compared to the non-HEF households of 5.5% in 2017. Poverty targeting poses another challenge for the health system. Nevertheless, HEF appeared to be more significantly associated with decreased out-of-pocket expenditure per illness among those who sought care from public providers. Increasing population and cost coverages of the HEF and effectively attracting beneficiaries to the public sector will further enhance the financial protection and pave the pathway towards universal coverage. Our recommendations focus on leveraging the HEF experience for expanding coverage and increasing equitable access, as well as strengthening the quality of healthcare services.

scholarly journals Health and Demographic Characteristics of Patients Attending a Newly-Opened Medical Facility in a Remote Amazonian Community: A Descriptive Study

2018 ◽  
Vol 6 (4) ◽  
pp. 106 ◽  
Author(s):  
Lucy Guile ◽  
Devon Graham ◽  
Anne Jachmann
Keyword(s):  
Health Services ◽  
Care Facility ◽  
Cross Sectional Study ◽  
Demographic Characteristics ◽  
Access To Health Services ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Poor Access ◽  
Access To Health ◽  
High Prevalence

Peru is a country with wide regional disparities in health. Remote Amazonian communities have high rates of poverty and poor access to health services. There is a lack of data on morbidity and use of health services in the region. We describe a descriptive, cross-sectional study of the demographic characteristics and presenting complaints of attendees to a newly-opened primary care facility in a remote community. This was supplemented by structured interviews of adult attendees to build a picture of sociocultural determinants of health locally, including engagement with traditional forms of medicine. Our study provides novel insights into an under-studied and under-resourced area. We found a young population with a high prevalence of infectious illnesses, particularly dermatological infections - a previously under-recognised source of morbidity in these communities. Poor literacy rates and widespread use of traditional forms of medicine have important implications for the provision of healthcare in this region.

scholarly journals Integrative literature review: access to primary healthcare services

2018 ◽  
Vol 71 (3) ◽  
pp. 1178-1188 ◽  
Author(s):  
Maura Cristiane e Silva Figueira ◽  
Wellington Pereira da Silva ◽  
Eliete Maria Silva
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Primary Healthcare ◽  
Healthcare Services ◽  
Health Plans ◽  
Access To Health Services ◽  
Primary Health ◽  
Study Selection ◽  
Access To Health ◽  
Access To Primary Care

ABSTRACT Objective: Analyze the scientific production that describes the type of access to primary healthcare services and identify specific populations that have differentiated access to health services. Method: An integrative review. For study selection, the following databases were used: PubMed, Scopus, Bireme, and Cinahl. The sample included 22 national and international articles. Results: The results describe the access of specific populations to health services, the access to primary care through health plans and proposed improvements to the access to primary care. Conclusion: The access to services is a challenge in many countries and some strategies and policies are implemented to solve and improve primary health care.

scholarly journals Understanding Fall-Risk Factors for Inuvialuit Elders in Inuvik, Northwest Territories, Canada

ARCTIC ◽  
2019 ◽  
Vol 72 (1) ◽  
pp. 13-27
Author(s):  
Julia S. Frigault ◽  
Audrey R. Giles
Keyword(s):  
Health Services ◽  
Fall Prevention ◽  
Fall Risk ◽  
Cultural Practices ◽  
Coping Skills ◽  
Personal Health ◽  
Health Practices ◽  
Access To Health Services ◽  
Structured Interviews ◽  
Access To Health

Older Indigenous adults in Canada experience disproportionately poorer health outcomes than older non-Indigenous adults. Current fall-prevention literature suggests that older Indigenous adults have higher rates of falls and fall-related injuries; however, no information exists on older Inuit adults’ experience with falls. Using the social determinants of Inuit health (SDoIH) as a conceptual framework, this research sought to understand which of the SDoIH are believed by stakeholders (i.e., local fall prevention programmers [LFPPs] and Inuvialuit Elders) to affect most the likelihood of older Inuvialuit adults’ falls. The findings from the 12 semi-structured interviews and participant observations show that factors related to personal health status and conditions, personal health practices and coping skills, physical environments, social support networks, and access to health services increase older Inuvialuit adults’ likelihood of experiencing a fall. Some determinants, however, decrease their likelihood of experiencing falls (health practices, coping skills, and access to health services), and others, such as culture, were perceived as having little influence on falls. Specific cultural practices were identified as factors that influence the likelihood of older Inuvialuit adults experiencing a fall; however, the overall Inuvialuit culture was not. In light of these findings, we offer recommendations for LFPPs in Inuvik to implement fall-prevention programs that adequately address the SDoIH influencing older Inuvialuit adults’ fall risk and rates.

scholarly journals Access to Health Services and Assistance Offered to the Afro-Descendant Communities in Northern Brazil: A Qualitative Study

2021 ◽  
Vol 18 (2) ◽  
pp. 368
Author(s):  
Marcela de Oliveira Feitosa ◽  
Maria Elidiana Araújo Gomes ◽  
Iolanda Graepp Fontoura ◽  
Catilena Silva Pereira ◽  
Ana Maria da Costa Teixeira Carneiro ◽  
...  
Keyword(s):  
Health Services ◽  
Field Research ◽  
Descriptive Study ◽  
Northern Region ◽  
Access To Health Services ◽  
Structured Interviews ◽  
Access To Health ◽  
Northern Brazil ◽  
Health Demands ◽  
Descendant Communities

The remnants of quilombos, individuals of African descent, have faced several barriers throughout its history, either due to prejudice imposed by society, or the non-fulfillment of their rights guaranteed in the 1988 Constitution, such as access to health services. Thus, this study aims to evaluate the health care offered to quilombo communities in the northern region of Tocantins. This is an exploratory, descriptive study with a qualitative approach, including field research and focus group, carried out with 58 quilombo remnants people from communities in the northern region of Tocantins. Data collection was carried out between from October 2017 to July 2018, through semi-structured interviews. We found that these communities have limited access to health services, in addition to a negative perception of the assistance offered to the health of their population and the commitment of managers. Therefore, access to health and assistance received by the studied communities required to be prioritized since the care provided is not unique and has not met the health demands and needs of the remaining quilombos in northern Tocantins, Brazil.

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