scholarly journals Addressing Barriers to Health Care Access of Congenital Heart Disease Patients in Guyana

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110129
Author(s):  
Sarah Ames ◽  
Emma Pillsworth ◽  
Arnelle Sparman-Shelto ◽  
Debra Lynne Isaac

In order to mitigate the late presentation and resulting poor outcomes of children with advanced cardiac disease, the Ministry of Public Health (MOPH) in Guyana has expressed interest in identifying ways to improve access to health care for these children. The goal of this study was to identify barriers faced by CHD patients and their families in accessing pediatric cardiology services in Guyana, and to identify limitations to the diagnosis and referral of CHD patients by health care professionals. Two surveys were used to gain insight into the experiences of practicing health care professionals and the parent(s) or guardian(s) of children with CHD. Patients were identified based on convenience sampling at cardiology clinics and outreach clinics in both urban and rural Guyana. Physicians were identified using convenience sampling at health posts in rural Guyana. Fifty-two (n = 52) families were identified and interviewed throughout the regions visited. The majority of families identified distance, the need to travel, and their inability, financially and practically, to attend clinic as the main barrier to accessing specialized care. Twelve (n = 12) health care providers were interviewed. They identified limited knowledge surrounding the diagnosis and management of CHD, and perceived impracticality of referring patients to specialized services, despite being aware of the referral process. This study identifies the need for improved outreach and support for health care providers and families, especially those living in rural communities. It identifies some of the challenges faced in managing patients with CHD in Guyana, while establishing specific areas for quality improvement.

2020 ◽  
Vol 16 (3) ◽  
pp. 253-267
Author(s):  
Dirk Lafaut ◽  
Gily Coene

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.


2018 ◽  
Vol 15 (1) ◽  
pp. 31-33 ◽  
Author(s):  
Tanya Holt ◽  
Gregory Hansen ◽  
Veronica McKinney ◽  
Ivar Mendez

Indigenous children living in rural and remote Canada have limited access to paediatric specialty services. As such, they experience a high rate of medical transport out of their home communities. The Truth and Reconciliation Commission’s calls to action has prioritized access to health care that is culturally safe and community directed. Remote presence robotic technology—a novel form of telemedicine—seeks to overcome the barriers of distance and time to improve health care access. The robot allows for direct patient visualization, examination, and communication with local health care providers and family members. This intervention may reduce unnecessary paediatric transfers, and enhance culturally safe care in the child’s home community through timely access to paediatric subspecialty care.


2011 ◽  
Vol 31 (4) ◽  
Author(s):  
Marjorie DeVault ◽  
Rebecca Garden ◽  
Michael A. Schwartz

<p>Keywords</p><p>Deaf/hard-of-hearing, Health-care communication, Narrative, Effective communication access, Cultural competency, Social model of deafness</p><p>Abstract</p><p>Deaf people experience disparities in health care that are often the result of (or exacerbated by) difficulties of communication. Health care providers often lack cultural understandings of Deaf communication and culture and thus do not provide effective communication access. U.S. disability law is meant to guarantee communication access, but deaf people's stories of access indicate that they may still encounter barriers to effective access. We report on an action research project designed to enhance communication among deaf people, health care professionals, and sign-language interpreters. We draw upon a social model of disability, which locates barriers to inclusion in society and the environment rather than the embodied difference or impairment, and extend that to the condition of deafness. We argue that narrative and dialogue that develops cultural understandings of Deaf communication and culture can offer a means of facilitating mutual understanding among the parties involved. Our hope is that interventions based on this approach will contribute to greater health-care access for deaf people.</p>


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Lebano ◽  
S Hamed ◽  
H Bradby ◽  
A Gil-Salmerón ◽  
J Garcés-Ferrer ◽  
...  

Abstract The Mig-HealthCare consortium conducted a qualitative study of the health care needs of vulnerable migrants/refugees in Europe. The research was conducted between Fall 2017 and Spring 2018. In total, 20 focus group discussions or, where necessary individual interviews (19), were organised with health care professionals and service providers; policymakers; and representatives from Non-Governmental Organisations - NGOs. Thematic qualitative analysis was employed. The main results of the analysis show that: Health care provision for migrants is uneven throughout the EU and variations exist even within the same country. Health care providers and NGOs agree that health care for migrants is inadequate and biased in favour of particular conditions and cases (minors, pregnant women and acute conditions). Challenges faced by different countries vary; while in some countries the main issue is legal access, in other basic needs such as sanitation and basic infrastructure were emphasised. Austerity measures following the 2008 financial crisis have negatively affected the health care system in general, which in turn has negatively affected the provision of health care for migrants/refugees. Discrimination linked to socio-economic and ethnic conditions is reported as a barrier to equal health care access. Knowledge, language and communication on both the demand and the supply side of health care provision emerge as crucial to ensure equal access for migrants/refugees. Gender may act as a barrier with women tending to be more marginalised in the host country, in terms of language proficiency and health literacy, lowering health care access. One of the main challenges for providing equal health care access for migrants has to do with the ability to balance a universal right to health with the particular means of achieving it. The evidence collected here shows how this tension between end and means is at work in different moments of the provision of health care for migrants/refugees.


2016 ◽  
Vol 31 (5) ◽  
pp. 485-491 ◽  
Author(s):  
Gabrielle A. Jacquet ◽  
Thomas Kirsch ◽  
Aqsa Durrani ◽  
Lauren Sauer ◽  
Shannon Doocy

AbstractIntroductionThe 2010 floods submerged more than one-fifth of Pakistan’s land area and affected more than 20 million people. Over 1.6 million homes were damaged or destroyed and 2,946 direct injuries and 1,985 deaths were reported. Infrastructure damage was widespread, including critical disruptions to the power and transportation networks.HypothesisDamage and loss of critical infrastructure will affect the population’s ability to seek and access adequate health care for years to come. This study sought to evaluate factors associated with access to health care in the aftermath of the 2010 Pakistan floods.MethodsA population-proportional, randomized cluster-sampling survey method with 80 clusters of 20 (1,600) households of the flood-affected population was used. Heads of households were surveyed approximately six months after flood onset. Multivariate analysis was used to determine significance.ResultsA total of 77.8% of households reported needing health services within the first month after the floods. Household characteristics, including rural residence location, large household size, and lower pre- and post-flood income, were significantly associated (P<.05) with inadequate access to health care after the disaster. Households with inadequate access to health care were more likely to have a death or injury in the household. Significantly higher odds of inadequate access to health care were observed in rural populations (adjusted OR 4.26; 95% CI, 1.89-9.61).ConclusionAdequate health care access after the 2010 Pakistani floods was associated with urban residence location, suggesting that locating health care providers in rural areas may be difficult. Access to health services also was associated with post-flood income level, suggesting health resources are not readily available to households suffering great income losses.JacquetGA, KirschT, DurraniA, SauerL, DoocyS. Health care access and utilization after the 2010 Pakistan floods. Prehosp Disaster Med. 2016;31(5):485–491.


2007 ◽  
Vol 23 (3) ◽  
pp. 143-153 ◽  
Author(s):  
Mary Lou Kelley

The population in Canada and other developing countries is aging, increasing the need for palliative care services. In rural communities, care of dying people is normally provided by health care professionals as part of a generalist practice, not by palliative care specialists. Despite a lack of specialists and resources, some rural communities have developed local palliative care programs. The goal of this research was to conceptualize rural communities’ process of developing palliative care programs using a theoretical perspective of community capacity development. Data were from nine focus groups of interdisciplinary rural health care providers who provided palliative care in seven provinces/territories of Canada. The outcome is a theoretical model that conceptualizes the process of developing palliative care programs in four sequential phases: antecedent community conditions, a catalyst, creating the team, and growing the program. The activities of each phase are outlined. This research offers practical and theoretical knowledge to guide practitioners and planners seeking to develop palliative care programs in other rural communities.


Author(s):  
Pauline A. Mashima

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.


2021 ◽  
pp. 089443932110257
Author(s):  
Md Irfanuzzaman Khan ◽  
Jennifer (M.I.) Loh

With the advent of telecommunication technologies and social media, many health care professionals are using social media to communicate with their patients and to promote health. However, the literature reveals a lacuna in our understanding of health care professionals’ perception of their behavioral intentions to use innovations. Using the Unified Technology Acceptance Framework (unified theory of acceptance and use of technology), in-depth interviews were conducted with 16 Australian health care experts to uncover their intent and actual use of social media in their medical practices. Results revealed that social media tools offered five significant benefits such as (i) enhanced communication between health care professionals and their patients, (ii) community support, (iii) enabled e-learning, (iv) enhanced professional network, and (v) expedited health promotion. However, result also revealed barriers to social media usage including (i) inefficiency, (ii) privacy concerns, (iii) poor quality of information, (iv) lack of trust, and (v) blurred professional boundary. Peer influence and supporting conditions were also found to be determinants of social media adoption behaviors among health care professionals. This study has important implications for health care providers, patients, and policy makers on the responsible use of social media, health promotion, and health communication. This research is also among the very few studies that explore Australian health care professionals’ intent and actual use of innovations within a health care setting.


Author(s):  
Shimaa A. Elghazally ◽  
Atef F. Alkarn ◽  
Hussein Elkhayat ◽  
Ahmed K. Ibrahim ◽  
Mariam Roshdy Elkhayat

Background: burnout syndrome is a serious and growing problem among medical staff. Its adverse outcomes not only affect health-care providers’ health, but also extend to their patients, resulting in bad-quality care. The COVID-19 pandemic puts frontline health-care providers at greater risk of psychological stress and burnout syndrome. Objectives: this study aimed to identify the levels of burnout among health-care professionals currently working at Assiut University hospitals during the COVID-19 pandemic. Methods: the current study adopted an online cross-sectional design using the SurveyMonkey® website for data collection. A total of 201 physicians were included and the Maslach Burnout Inventory (MBI) scale was used to assess the three burnout syndrome dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. Results: about one-third, two-thirds, and one-quarter of the respondents had high emotional exhaustion, high depersonalization, and low personal accomplishment, respectively. Younger, resident, and single physicians reported higher burnout scores. The personal accomplishment score was significantly higher among males. Those working more than eight hours/day and dealing with COVID-19 patients had significantly higher scores. Conclusion: during the COVID-19 pandemic, a high prevalence of burnout was recorded among physicians. Age, job title, working duration, and working hours/day were significant predictors for burnout syndrome subscale results. Preventive and interventive programs should be applied in health-care organizations during pandemics.


2020 ◽  
Vol 16 (3) ◽  
pp. 279-292
Author(s):  
Sarah Marshall

Purpose Ideas of health-related deservingness in theory and practise have largely been attached to humanitarian notions of compassion and care for vulnerable persons, in contrast to rights-based approaches involving a moral-legal obligation to care based on universal citizenship principles. This paper aims to provide an alternative to these frames, seeking to explore ideas of a human rights-based deservingness framework to understand health care access and entitlement amongst precarious status persons in Canada. Design/methodology/approach Drawing from theoretical conceptualizations of deservingness, this paper aims to bring deservingness frameworks into the language of human rights discourses as these ideas relate to inequalities based on noncitizenship. Findings Deservingness frameworks have been used in public discourses to both perpetuate and diminish health-related inequalities around access and entitlement. Although, movements based on human rights have the potential to be co-opted and used to re-frame precarious status migrants as “undeserving”, movements driven by frames of human rights-based deservingness can subvert these dominant, negative discourses. Originality/value To date, deservingness theory has primarily been used to speak to issues relating to deservingness to welfare services. In relation to deservingness and precarious status migrants, much of the literature focuses on humanitarian notions of the “deserving” migrant. Health-related deservingness based on human rights has been under-theorized in the literature and the authors can learn from activist movements, precarious status migrants and health care providers that have taken on this approach to mobilize for rights based on being “human”.


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