scholarly journals Kaniuwatewara (when we get sick): understanding health-seeking behaviours among the Shawi of the Peruvian Amazon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alejandra Bussalleu ◽  
Pedro Pizango ◽  
Nia King ◽  
James Ford ◽  
I. H. A. C. C. Research Team ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Healthcare System ◽  
Service Use ◽  
Comparative Method ◽  
Indigenous Populations ◽  
Specific Information ◽  
Structured Interviews ◽  
Health Seeking ◽  
Healthcare Facilities ◽  
Traditional Remedies

Abstract Background Detailed qualitative information regarding Indigenous populations’ health-seeking behaviours within Peru’s plural healthcare system is lacking. Such context-specific information is prerequisite to developing evidence-based health policies and programs intended to improve health outcomes for Indigenous populations. To this end, this study aimed to characterize health-seeking behaviours, factors affecting health-seeking behaviours, and barriers to obtaining healthcare in two Indigenous Shawi communities in Peru. Methods Community-based approaches guided this work, and included 40 semi-structured interviews and a series of informal interviews. Data were analysed thematically, using a constant comparative method; result authenticity and validity were ensured via team debriefing, member checking, and community validation. Results Shawi health-seeking behaviours were plural, dynamic, and informed by several factors, including illness type, perceived aetiology, perceived severity, and treatment characteristics. Traditional remedies were preferred over professional biomedical healthcare; however, the two systems were viewed as complementary, and professional biomedical healthcare was sought for illnesses for which no traditional remedies existed. Barriers impeding healthcare use included distance to healthcare facilities, costs, language barriers, and cultural insensitivity amongst professional biomedical practitioners. Nevertheless, these barriers were considered within a complex decision-making process, and could be overridden by certain factors including perceived quality or effectiveness of care. Conclusions These findings emphasize the importance of acknowledging and considering Indigenous culture and beliefs, as well as the existing traditional medical system, within the professional healthcare system. Cultural competency training and formally integrating traditional healthcare into the official healthcare system are promising strategies to increase healthcare service use, and therefore health outcomes.

scholarly journals Healthcare beliefs and practices of kin caregivers in South Africa: implications for child survival

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Khuthala Mabetha ◽  
Nicole C. De Wet-Billings ◽  
Clifford O. Odimegwu
Keyword(s):  
South Africa ◽  
Content Analysis ◽  
Health Outcomes ◽  
Child Survival ◽  
Eastern Cape ◽  
Structured Interviews ◽  
Health Seeking ◽  
Beliefs And Practices ◽  
Thematic Content Analysis ◽  
Kwazulu Natal

Abstract Background Appropriate health-seeking practices may have a positive influence on child survival, particularly when practiced by kin caregivers of children who are below the age of 5 years. While literature has shown that children who are raised in kinship care often present with poor health outcomes and often have unmet healthcare needs, the health-seeking behaviours and practices of the children’s kin caregivers that ultimately influence these health outcomes remain largely unknown. In this paper, we explored the healthcare beliefs and practices of kin caregivers in South Africa on child survival. Methods Overall, 12 structured interviews were conducted with all the participants. Six [6] interviews were conducted in the Eastern Cape province and 6 were conducted in the KwaZulu-Natal province. The sample of participants was obtained by seeking permission from the child welfare authorities in the KwaZulu-Natal and Eastern Cape Department of Social Development (DSD) to assist in identifying a sample of the kin-caregivers who have provided primary care to children below the age of 5. The structured interviews were transcribed and analysed using thematic content analysis. After thematic content analysis was carried out, transcripts were given case numbers and then imported into NViVo version 11 for analysis and interpretation of the findings. Results The healthcare seeking behaviours and poor use of healthcare services of the caregivers were largely influenced by their notions and perceptions of health and illness. The notions and perceptions that the caregivers hold about the health statuses of the children placed under their care and illness were found to be largely culturally determined and largely influenced by preconceptions and certain healthcare beliefs. Increased reliance on traditional herbs, Notion of witchcraft and Faith healing emerged as key factors that influence health-seeking practices and beliefs of kin caregivers, thus influencing under-five mortality. Conclusion Kin caregivers should be equipped with the necessary guidance, resources and training that facilitate the successful fulfilment of the caregiving role, given the number of unmet needs and challenges that they face. This will in turn translate into positive child health outcomes.

“My Roommates Would Laugh at me”: Young Males Reveal Embarrassment over Lack of Food Skills

2020 ◽  
pp. 1-8
Author(s):  
Kristen Simonds ◽  
Lucy Yixuan Zhang ◽  
June I. Matthews
Keyword(s):  
Young Adults ◽  
Food Safety ◽  
Parental Influence ◽  
Comparative Method ◽  
Food Selection ◽  
Young Men ◽  
Structured Interviews ◽  
Young Males ◽  
Solid Foundation ◽  
And Storage

Purpose: This descriptive qualitative study explored young males’ perceptions of food skills in 3 domains: food selection and planning, food preparation, and food safety and storage. Methods: Semi-structured interviews were audio-recorded and transcribed verbatim. Data were analyzed using the constant comparative method. Results: Forty-four young men (aged 17–35) reported varying levels of food skills, from little/no confidence to very confident and skilled. Most participants learned food skills from their mothers. Greater involvement in food selection and planning at a young age appeared to be related to parental influence and encouragement, exposure to food skills at school, and interest in food-related activities, which, in turn, provided a solid foundation for being confident cooks as young adults. Most notable was the lack of knowledge about, or confidence in, food safety and storage. Young men with low self-perceived food skills were deeply embarrassed about this deficiency in front of peers who had higher levels of confidence and skills. Conclusions: Future interventions or curricula should emphasize food safety and storage. This research also illustrates the importance of the home environment in teaching food skills to youth and ensuring that food skills are taught well before young adults begin living independently.

Crowdsourcing Covid-19 signals in sub-Saharan Africa: Leveraging digital contributor networks for participatory surveillance of Covid-19 symptoms and deaths (Preprint)

2020 ◽  
Author(s):  
Ngozi A Erondu ◽  
Sagal A Ali ◽  
Mohamed Ali ◽  
Schadrac C Agbla
Keyword(s):  
Public Health ◽  
Sub Saharan Africa ◽  
Specific Information ◽  
Surveillance Systems ◽  
Health Seeking ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Local Networks ◽  
The World ◽  
Sub Saharan

BACKGROUND In sub-Saharan Africa, underreporting of cases and deaths has been attributed to various factors including, weak disease surveillance, low health-seeking behaviour of flu like symptoms, and stigma of Covid-19. There is evidence that SARS-CoV-2 spread mimics transmission patterns of other countries across the world. Since the Covid-19 pandemic has changed the way research can be conducted and in light of restrictions on travel and risks to in-person data collection, innovative approaches to collecting data must be considered. Nearly 50% of Africa’s population is a unique mobile subscriber and it is one of the fastest growing smart-phone marketplaces in the world; hence, mobile phone platforms should be considered to monitor Covid-19 trends in the community. OBJECTIVE We demonstrate the use of digital contributor platforms to survey individuals about cases of flu-like symptoms and instances of unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia, and Zimbabwe. METHODS Rapid cross-sectional survey of individuals with severe flu and pneumonia symptoms and unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia and Zimbabwe RESULTS Using a non-health specific information platform, we found COVID-19 signals in five African countries, specifically: •Across countries, nearly half of the respondents (n=739) knew someone who had severe flu or pneumonia symptoms in recent months. •One in three respondents from Somalia and one in five from Zimbabwe respondents said they knew more than five people recently displaying flu and/or pneumonia symptoms. •In Somalia there were signals that a large number of people might be dying outside of health facilities, specifically in their homes or in IDP or refugee camps. CONCLUSIONS Existing digital contributor platforms with local networks are a non-traditional data source that can provide information from the community to supplement traditional government surveillance systems and academic surveys. We demonstrate that using these distributor networks to for community surveys can provide periodic information on rumours but could also be used to capture local sentiment to inform public health decision-making; for example, these insights could be useful to inform strategies to increase confidence in Covid19 vaccine. As Covid-19 continues to spread somewhat silently across sub-Saharan Africa, regional and national public health entities should consider expanding event-based surveillance sources to include these systems.

scholarly journals Encountering suicide in primary healthcare rehabilitation: the experiences of physiotherapists

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Åse Lundin ◽  
Anna Bergenheim
Keyword(s):  
At Risk ◽  
Healthcare System ◽  
Primary Healthcare ◽  
Qualitative Content Analysis ◽  
Western Hemisphere ◽  
Mental Wellbeing ◽  
Healthcare Personnel ◽  
Public Health Issue ◽  
Structured Interviews ◽  
Patients At Risk

Abstract Background Suicide is a serious public health issue and one of the most common causes of death globally. Suicide has long-lasting impact on personal, relational, community and societal levels. Research has shown that patients often seek help in the primary healthcare system preceding a suicide. Studies exploring the experiences of encountering patients at risk for suicide have been performed among various categories of healthcare personnel, such as nurses and psychiatry residents as well as emergency room staff. There is a lack of research regarding primary healthcare rehabilitation staff, despite the fact that physiotherapists are the third largest health profession in the Western hemisphere and often work with patients experiencing mental health symptoms. The aim of this study was to explore the experiences of encountering patients at risk for suicide among physiotherapists working in a primary healthcare rehabilitation setting. Methods Semi-structured interviews were conducted with 13 physiotherapists working in primary healthcare rehabilitation clinics in the Gothenburg area, Sweden. The interviews were recorded on audio and transcribed into written text. A qualitative content analysis was performed on the material collected. Results The analysis of the material revealed an overarching theme, Through barriers and taboos – the physiotherapist finds a way, with five main categories: possibilities for identification, obstacles in meeting suicide, workplace environment matters, where does the patient belong? and education and experience are keys. Conclusions The present study indicates that physiotherapists in the primary healthcare system encounter patients experiencing suicidality, and they expressed a strong desire to care for both the physical and mental wellbeing of the patients. Despite reporting many barriers, the physiotherapists often found a way to form a meaningful therapeutic alliance with the patient and to ask about possible suicidality in their clinical practice. The result suggests that physiotherapists could play a larger role in working with patients experiencing suicidality in a primary healthcare setting and that they could be viewed as possible gatekeepers in identification as well as referral of these patients into other parts of the healthcare system.

scholarly journals “You run out of hope:” An Exploration of Low-Income Parents’ Experiences with Food Insecurity using Photovoice

2021 ◽  
pp. 1-21
Author(s):  
Payge Lindow ◽  
Irene H. Yen ◽  
Mingyu Xiao ◽  
Cindy W. Leung
Keyword(s):  
Food Insecurity ◽  
San Francisco ◽  
Low Income ◽  
Eating Behaviors ◽  
Comparative Method ◽  
Well Being ◽  
Structured Interviews ◽  
Unhealthy Eating ◽  
Low Income Families ◽  
The Impact

ABSTRACT Objective: Using an adaption of the Photovoice method, this study explored how food insecurity affected parents’ ability to provide food for their family, their strategies for managing household food insecurity, and the impact of food insecurity on their well-being. Design: Parents submitted photos around their families’ experiences with food insecurity. Afterwards, they completed in-depth, semi-structured interviews about their photos. The interviews were transcribed and analyzed for thematic content using the constant comparative method. Setting: San Francisco Bay Area, California, USA. Subjects: 17 parents (14 mothers and 3 fathers) were recruited from a broader qualitative study on understanding the experiences of food insecurity in low-income families. Results: Four themes were identified from the parents’ photos and interviews. First, parents described multiple aspects of their food environment that promoted unhealthy eating behaviors. Second, parents shared strategies they employed to acquire food with limited resources. Third, parents expressed feelings of shame, guilt, and distress resulting from their experience of food insecurity. And finally, parents described treating their children to special foods to cultivate a sense of normalcy. Conclusions: Parents highlighted the external contributors and internal struggles of their experiences of food insecurity. Additional research to understand the experiences of the food-insecure families may help to improve nutrition interventions targeting this structurally vulnerable population.

Suicidal ideation in an ethnically mixed, highland Guatemalan community

2021 ◽  
pp. 136346152097693
Author(s):  
Carla Pezzia ◽  
Luisa M. Hernandez
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Ethnic Identity ◽  
Suicidal Ideation ◽  
Mental Health Care ◽  
Protective Factor ◽  
Indigenous Populations ◽  
Structured Interviews ◽  
And Gender ◽  
Survey Responses

Reported suicide rates in Latin America remain low, but there is evidence to suggest they may be increasing, particularly among indigenous populations. To better understand who may be at risk for suicide, we examined the prevalence of suicidal ideation and explored factors contributing to suicidal thoughts in an ethnically mixed, highland Guatemalan community. The data presented in this article are from a mixed methods ethnographic field project conducted over 15 months from 2010 to 2011 in Panajachel, Guatemala. We surveyed a random sample of 350 community members. Survey questions included standardized modules from the Mini-International Neuropsychiatric Interview, as well as questions on experiences of violence and mental health care. We also conducted semi-structured interviews with 13 self-selected survey participants with current suicidal ideation. These interviews included questions regarding survey responses, experiences of mental illness, and access to mental health care. A total of 55 survey participants (N = 350; 15.7%) scored positive for suicidality. Ethnic identity, gender, psychiatric illness, and experiences of violence were all correlated to suicidal ideation. Qualitative interview data highlight distinctions between genders within prominent themes of religion, family, experiences of violence, and seeking resources. Three key findings emerged from our research that are relevant to the literature: 1) ethnic identity may be both a critical risk and a protective factor for suicide in some indigenous people; 2) intersections between violence and gender highlight different patterns in suicidal ideation; and 3) high rates of suicidal ideation and other psychiatric comorbidities underscore the need for greater access to mental health services.

scholarly journals What do you mean by engagement? – evaluating the use of community engagement in the design and implementation of chronic disease-based interventions for Indigenous populations – scoping review

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sahr Wali ◽  
Stefan Superina ◽  
Angela Mashford-Pringle ◽  
Heather Ross ◽  
Joseph A. Cafazzo
Keyword(s):  
Chronic Disease ◽  
Health Outcomes ◽  
Community Engagement ◽  
Participatory Research ◽  
Scoping Review ◽  
Indigenous Health ◽  
Well Being ◽  
Indigenous Populations ◽  
Local Context ◽  
Engagement Strategies

Abstract Background Indigenous populations have remained strong and resilient in maintaining their unique culture and values, despite centuries of colonial oppression. Unfortunately, a consequential result of facing years of adversity has led Indigenous populations to experience a disproportionate level of poorer health outcomes compared to non-Indigenous populations. Specifically, the rate of Indigenous chronic disease prevalence has significantly increased in the last decade. Many of the unique issues Indigenous populations experience are deeply rooted in their colonial history and the intergenerational traumas that has subsequently impacted their physical, mental, emotional and spiritual well-being. With this, to better improve Indigenous health outcomes, understanding the local context of their challenges is key. Studies have begun to use modes of community engagement to initiate Indigenous partnerships and design chronic disease-based interventions. However, with the lack of a methodological guideline regarding the appropriate level of community engagement to be used, there is concern that many interventions will continue to fall short in meeting community needs. Objective The objective of this study was to investigate the how various community engagement strategies have been used to design and/or implement interventions for Indigenous populations with chronic disease. Methods A scoping review guided by the methods outlined by Arksey and O’Malley was conducted. A comprehensive search was completed by two reviewers in five electronic databases using keywords related to community engagement, Indigenous health and chronic disease. Studies were reviewed using a descriptive-analytical narrative method and data was categorized into thematic groups reflective of the main findings. Results We identified 23 articles that met the criteria for this scoping review. The majority of the studies included the use a participatory research model and the procurement of study approval. However, despite the claimed use of participatory research methods, only 6 studies had involved community members to identify the area of priority and only five had utilized Indigenous interview styles to promote meaningful feedback. Adapting for the local cultural context and the inclusion of community outreach were identified as the key themes from this review. Conclusion Many studies have begun to adopt community engagement strategies to better meet the needs of Indigenous Peoples. With the lack of a clear guideline to approach Indigenous-based participatory research, we recommend that researchers focus on 1) building partnerships, 2) obtaining study approval and 3) adapting interventions to the local context.

scholarly journals Views of the Future of Partners of People with Multiple Sclerosis Who Attended a Lifestyle Modification Workshop: A Qualitative Analysis of Perspectives and Experiences

2020 ◽  
Vol 18 (1) ◽  
pp. 85
Author(s):  
Sandra L. Neate ◽  
Keryn L. Taylor ◽  
Nupur Nag ◽  
George A. Jelinek ◽  
Steve Simpson-Yap ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Health Outcomes ◽  
Lifestyle Modification ◽  
Structured Interviews ◽  
Interpretive Phenomenology ◽  
Related Risk ◽  
The Future ◽  
Partner Perceptions ◽  
And Control ◽  
The Impact

People with multiple sclerosis (PwMS) often experience uncertainty and fear about their futures. Partners of PwMS may share their concerns and experience fears about their own futures, limitations on their lives, ability to work, and becoming a carer. For PwMS, modification of lifestyle-related risk factors has been associated with improved health outcomes. For PwMS who attended residential lifestyle modification workshops (RLMW), sustained improved health outcomes have been demonstrated. Whether improved outcomes for PwMS who engage with lifestyle modification translate to improved partner perceptions of the future, is yet to be explored. We explored the perspectives of partners of PwMS who had attended a RLMW and the impact that the person with MS’s illness and their engagement with lifestyle modification had on their partners’ views of the future. Analysis of 21 semi-structured interviews used a methodology informed by Heidegger’s Interpretive Phenomenology. Three themes emerged: ‘uncertainty’, ‘planning for the future’ and ‘control, empowerment and confidence’. Subthemes included MS and lifestyle modification being a catalyst for positive change; developing a sense of control and empowerment; and hope, optimism and positivity. Lifestyle modification may provide benefits, not only to PwMS, but also to their partners, and should be considered part of mainstream management of MS.

scholarly journals Network governance forms in healthcare: empirical evidence from two Italian cancer networks

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Romiti ◽  
Mario Del Vecchio ◽  
Gino Sartor
Keyword(s):  
Healthcare System ◽  
Governance Structure ◽  
Network Governance ◽  
Public Healthcare ◽  
Structured Interviews ◽  
General Validity ◽  
Regional Administration ◽  
Trade Offs ◽  
Italian Regions ◽  
Cancer Networks

Abstract Background This study focuses on the application of Provan and Kenis’ modes of network governance to the specific field of public healthcare networks, extending the framework to an analysis of systems in which networks are involved. Thus, the aim of this study is to analyze and compare the governance of two cancer networks in two Italian regions that underwent system reconfiguration processes due to reforms in the healthcare system. Methods A qualitative study of two clinical networks in the Italian healthcare system was conducted. The sample for interviews included representatives of the regional administration (n = 4), network coordinators (n = 6), and general and clinical directors of health organizations involved in the two networks (n = 25). Data were collected using semi-structured interviews. Results Our study shows that healthcare system reforms have a limited impact on network governance structures. In fact, strong inertial tendencies characterize networks, especially network administrative organization models (NAO). Networks tend to find their own balance with respect to the trade-offs analyzed using a mix of formal and informal ties. Our study confirms the general validity of Provan and Kenis’ framework and shows how other specific factors and contingencies may affect the possibility that cancer networks find positive equilibria between competing needs of inclusivity and efficiency, internal and external legitimacy, and stability and flexibility. It also shows how networks react to external changes. Conclusions Our study shows the importance of considering three factors and contingencies that may affect network effectiveness: a) the importance of looking at network governance modes not in isolation, but in relationship to the governance of regional systems; b) the influence of a specific network’s governance structure on the network’s ability to respond to tensions and to achieve its goals; and c) the need to take into account the role of professionals in network governance.

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