scholarly journals Challenges to manage pandemic of coronavirus disease (COVID-19) in Iran with a special situation: a qualitative multi-method study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hamidreza Khankeh ◽  
Mehrdad Farrokhi ◽  
Juliet Roudini ◽  
Negar Pourvakhshoori ◽  
Shokoufeh Ahmadi ◽  
...  
Keyword(s):  
Health System ◽  
Social Protection ◽  
Social Inequalities ◽  
Mental Health Problems ◽  
Patient Flow ◽  
Lessons Learned ◽  
Vulnerable Groups ◽  
Contact Tracing ◽  
Cultural Issues ◽  
Structured Interviews

Abstract Background With the unprecedented expansion of COVID-19 in the world since December 2019, Iran’s health system, like other countries, faced various challenges in managing the disease, which led to numerous experiences and lessons learned. This study was conducted to identify these challenges regarding unique political, economic, and cultural issues, which could help other countries with similar situations. Methods The present study was performed using a qualitative multi-method approach with a content analysis method. The data were collected through in-depth and semi-structured interviews and focused group discussions with 60 key persons who were selected purposefully, including policymakers, health care workers, and affected people by the disease, and the review of all available national reports between February 21, 2020, and March 22, 2021. The data collection and analysis were done simultaneously. Results Identified critical challenges for the management of COVID-19 in the health system were limited evidence and scientific controversies, poor social prevention and social inequalities, burnout and sustained workload among healthcare workers, improper management of resources and equipment, the lack of a guideline for contact tracing, and patient flow management, and mental health problems in the community. Conclusions According to our results, measures should be taken to conduct a continuous comprehensive risk assessment and develop a national response plan with an emphasis on precise contact tracing, active screening, patient flow, paying attention to the psychological and social dimensions of the disease, and also transparency of social inequalities in the face of risk factors of the COVID-19. Also, the social protection programs should become a vital tool for policymakers and supporting the vulnerable groups using the capacity of the community and international cooperation to develop a vaccine, which is difficult to procure due to the sanctions.

scholarly journals Challenges to Manage Pandemic of Coronavirus Disease (COVID-19) in Iranian Special Situation: A Qualitative Multi-Method Study

2021 ◽  
Author(s):  
Hamidreza Khankeh ◽  
Mehrdad Farrokhi ◽  
Juliet Roudini ◽  
Negar Pourvakhshoori ◽  
Shokoufeh Ahmadi ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Workers ◽  
Social Inequalities ◽  
Patient Flow ◽  
Lessons Learned ◽  
Vulnerable Groups ◽  
Contact Tracing ◽  
Cultural Issues ◽  
Care Workers

Abstract BackgroundWith the unprecedented expansion of COVID-19 in the world since December 2019, the Iranian health system like other countries faced various challenges in managing the disease, which led to obtaining numerous experiences and lessons learned. The aim of this study is to identify these challenges, in regard with unique political, economic, and cultural issues which could help to other countries with similar situation.MethodsThe present study was performed using a qualitative multi-method approach with a content analysis method. The data were collected through in-depth and semi-structured interviews and Focused Group Discussions with 60 key persons, policy makers, health care workers and affected people by the disease, and the review of all available national reports between February 21, 2020, and December 22, 2020. The data collection and analysis process took place simultaneously.ResultsIn this study, critical challenges related to the management of COVID-19 in the health system were, including; The limited evidence and scientific controversies, Poor social prevention and social inequalities, Burnout and sustained workload among health care workers, Improper management of resources and equipment, Lack of guideline for case contact tracing and patient-flow, Community mental health problem. ConclusionsAccording to the study, measurements should be taken to conduct a continuous comprehensive risk assessment and develop a national response plan with an emphasis on exact case contact tracing, active screening, patient flow, paying attention to the psychological and social dimensions of the disease and also transparency of social inequalities in the face of risk factors of the COVID-19. And finally, supporting vulnerable groups using community capacity and cooperating international community to provide vaccine which is difficult to procure due to the sanction.

scholarly journals Health Insurance in Myanmar: The Views and Perception of Healthcare Consumers and Health System Informants on the Establishment of a Nationwide Health Insurance System

Risks ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 81
Author(s):  
Marjolein van Rooijen ◽  
Chaw-Yin Myint ◽  
Milena Pavlova ◽  
Wim Groot
Keyword(s):  
Health Insurance ◽  
Health System ◽  
Rural Areas ◽  
Social Protection ◽  
Vulnerable Groups ◽  
Health Insurance System ◽  
Structured Interviews ◽  
Insurance System ◽  
Supplementary Health Insurance ◽  
Insurance Model

(1) Background: Health insurance and social protection in Myanmar are negligible, which leaves many citizens at risk of financial hardship in case of a serious illness. The aim of this study is to explore the views of healthcare consumers and compare them to the views of key informants on the design and implementation of a nationwide health insurance system in Myanmar. (2) Method: Data were collected through nine focus group discussions with healthcare consumers and six semi-structured interviews with key health system informants. (3) Results: The consumers supported a mandatory basic health insurance and voluntary supplementary health insurance. Tax-based funding was suggested as an option that can help to enhance healthcare utilization among the poor and vulnerable groups. However, a fully tax-based funding was perceived to have limited chances of success given the low level of government resources available. Community-based insurance, where community members pool money in a healthcare fund, was seen as more appropriate for the rural areas. (4) Conclusion: This study suggests a healthcare financing mechanism based on a mixed insurance model for the creation of nationwide health insurance. Further inquiry into the feasibility of the vital aspects of the nationwide health insurance is needed.

scholarly journals The Impacts of Socioeconomic Crisis in Portugal on Social Protection and Social Work Practices

2021 ◽  
Vol 13 (23) ◽  
pp. 13198
Author(s):  
Inês Casquilho-Martins
Keyword(s):  
Social Work ◽  
Social Workers ◽  
Social Problems ◽  
Social Protection ◽  
Social Inequalities ◽  
Social Work Practice ◽  
Fundamental Rights ◽  
Social Intervention ◽  
Vulnerable Groups ◽  
Structured Interviews

The effects of the international crisis brought economic and financial risks, as well as consequences for human, social and sustainable development. This study aims to analyse the effects of social intervention with families since the 2008 crisis in Portugal. Through a qualitative approach, we conducted semi-structured interviews with social workers (23), to identify the main impacts of the crisis and the adopted social intervention practices. We highlight a new increase in social problems and the growth of vulnerable groups facing an unprepared social protection system. The Portuguese case reveals that the effects of austerity have shown a decline in the welfare and benefits system, leading to worsened social problems, such as increased poverty and unemployment, as well as social inequalities. Social Work was required to respond to these consequences, although organisational contexts and austerity measures constrained practitioners’ autonomy. By reflecting on this critical period, we seek to contribute to better social protection and assistance models in the face of the current and future crisis. In this sense, Social Work practice ensures a means to guarantee fundamental rights and social justice, preparing social workers and social intervention for new challenges in crisis contexts.

scholarly journals Three Shortcomings of the Social Investment Perspective

2013 ◽  
Vol 12 (4) ◽  
pp. 553-564 ◽  
Author(s):  
Bea Cantillon ◽  
Wim Van Lancker
Keyword(s):  
Capital Investment ◽  
Social Inclusion ◽  
Social Protection ◽  
Social Inequalities ◽  
State Intervention ◽  
Individual Responsibility ◽  
Social Progress ◽  
Vulnerable Groups ◽  
Social Investment ◽  
The Social

In this article we critically assess the social investment perspective that has become the dominant paradigm in European social policymaking. We identify and discuss some of its shortcomings that may hamper social progress for all. In doing so, we focus on three pillars central to the idea of social investment: social inclusion through work, individual responsibility and human capital investment. We find that the social investment perspective has some serious flaws when it comes to the social protection of vulnerable groups. This is strongly related to the continuing relevance of social class in explaining and remedying social inequalities. We conclude that investment cannot be the only rationale for welfare state intervention and that protecting people should remain equally high on the policy agenda.

scholarly journals Multidrug-resistant tuberculosis from the health providers’ perspective: strategies for compliance and equity in seeking the care in COVID-19 era (Brazil, 2020)

2021 ◽  
Author(s):  
Ludmilla Leidianne Limirio Souza ◽  
Felipe Lima dos Santos ◽  
Juliane de Almeida Crispim ◽  
Regina Célia Fiorati ◽  
Sónia Dias ◽  
...  
Keyword(s):  
Health System ◽  
Health Professionals ◽  
Social Protection ◽  
Multidrug Resistant ◽  
Global Scale ◽  
Health Providers ◽  
Structured Interviews ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb

Abstract BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) itself is a serious phenomenon on a global scale that can worsen with the COVID-19 pandemic. The study aimed to understand the perception of health professionals about multidrug-resistant tuberculosis, their strategies to ensure adherence to treatment and the challenges in the context of the COVID-19 pandemic, in a priority municipality for disease control in the state of São Paulo, Brazil. METHODS: We conducted a qualitative study and recruited fourteen health professionals, four doctors, three nurses, three nursing technicians, three nursing assistants and a social worker, working in the Ribeirão Preto health system. Remote semi-structured interviews were conducted with these professionals. For data analysis, Thematic Content Analysis was applied according to the theoretical framework defined for the study. RESULTS: The findings showed the relationship between poverty, inequality and MDR-TB. Concerning the COVID-19 pandemic, reports from professionals show an interference in the monitoring of patients. As for social protection and the benefits that covered the patients, they were cut. Professionals also reported concerns about obtaining COVID-19 and adopting strategies to ensure adherence, as well as reinforcements of the DOTS strategy. CONCLUSION: The study advances in knowledge by highlighting the challenges faced by the health system for the adherence of MDR-TB patients in a context aggravated by Pandemic. The strategies defined by these health professionals have somehow guaranteed the achievement of equity and avoided the catastrophic encounter between TB-MDR and COVID-19.

scholarly journals Providers’ Perspectives on Provision of Family Planning to HIV-Positive Individuals in HIV Care in Nyanza Province, Kenya

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Sara J. Newmann ◽  
Kavita Mishra ◽  
Maricianah Onono ◽  
Elizabeth A. Bukusi ◽  
Craig R. Cohen ◽  
...  
Keyword(s):  
Family Planning ◽  
Patient Flow ◽  
Healthcare Providers ◽  
Hiv Care ◽  
Hiv Positive ◽  
Cultural Issues ◽  
Structured Interviews ◽  
Nyanza Province ◽  
Attitudes And Practices ◽  
Hiv Positive Women

Objective. To inform an intervention integrating family planning into HIV care, family planning (FP) knowledge, attitudes and practices, and perspectives on integrating FP into HIV care were assessed among healthcare providers in Nyanza Province, Kenya.Methods. Thirty-one mixed-method, structured interviews were conducted among a purposive sample of healthcare workers (HCWs) from 13 government HIV care facilities in Nyanza Province. Structured questions and case scenarios assessed contraceptive knowledge, training, and FP provision experience. Open-ended questions explored perspectives on integration. Data were analyzed descriptively and qualitatively.Results. Of the 31 HCWs interviewed, 45% reported previous FP training. Few providers thought long-acting methods were safe for HIV-positive women (19% viewed depot medroxyprogesterone acetate as safe and 36% viewed implants and intrauterine contraceptives as safe); fewer felt comfortable recommending them to HIV-positive women. Overall, providers supported HIV and family planning integration, yet several potential barriers were identified including misunderstandings about contraceptive safety, gendered power differentials relating to fertility decisions, staff shortages, lack of FP training, and contraceptive shortages.Conclusions. These findings suggest the importance of considering issues such as patient flow, provider burden, commodity supply, gender and cultural issues affecting FP use, and provider training in FP/HIV when designing integrated FP/HIV services in high HIV prevalence areas.

scholarly journals Experiences of Older People and Social Inclusion in Relation to Smart “Age-Friendly” Cities: A Case Study of Chongqing, China

2021 ◽  
Vol 9 ◽  
Author(s):  
Manlin Li ◽  
Ryan Woolrych
Keyword(s):  
Older People ◽  
Smart City ◽  
Social Inclusion ◽  
Social Inequalities ◽  
Smart Cities ◽  
Well Being ◽  
Vulnerable Groups ◽  
Structured Interviews ◽  
City Policy

Whilst cities can be sites of creativity, innovation, and change, they can also reproduce the conditions for the exclusion of vulnerable groups. Older people report experiencing specific barriers to accessing the city and are often excluded from the resources for ageing well. The smart city agenda has attempted to bring about technological change whilst also delivering improved quality of life for urban citizens. Smart technologies are a key element of the smart city and are viewed as having the potential to support the independence, autonomy, and well-being of older people. Yet, there has been little research exploring the role of the smart city in supporting the social inclusion of older people, nor any attempt to link this with key policy drivers on ageing e.g., age-friendly cities and communities. In response, the aim of this paper is to explore the experiences of older people living in a smart city in China and discuss how the smart city and age-friendly can be brought together to support positive social outcomes for older people. The paper presents qualitative findings from a multi-methods approach, including semi-structured interviews, walking interviews and focus groups. A total of 64 older people participated in the research across three diverse neighbourhoods in the case study smart city of Chongqing, China. The findings identified opportunities in the development and deployment of smart cities, including the potential for improved health and well-being and social connectedness. Yet in delivering on these benefits, a number of challenges were identified which may widen social inequalities, including inequities in access, issues of safety and security, and exclusion from the co-production of smart city policy and practise. The paper discusses the implications of the findings for future smart city policy and practise, specifically in delivering interventions that support older adults' social inclusion and the delivery of age-friendly cities and communities.

scholarly journals Setting Health Care Services Tariffs in Iran: Half a Century Quest for a Window of Opportunity

2020 ◽  
Author(s):  
Leila Doshmangir ◽  
Arash Rashidian ◽  
Farhad Kouhi ◽  
Vladimir S Gordeev
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Services ◽  
Analysis Data ◽  
Lessons Learned ◽  
Structured Interviews ◽  
Public And Private ◽  
Middle Income ◽  
Care Services ◽  
The Right

Abstract Background: The process of medical tariffs setting in Iran remains to be a contentious issue and is heavily criticized by many stakeholders. This paper explores the experience of setting health care services tariffs in the Iranian health care system over the last five decades. Methods: We analyzed data collected through literature review and reviews of the official documents developed at the various levels of the Iranian health system using inductive and deductive content analysis. Twenty-two face-to-face semi-structured interviews supplemented the analysis. Data were analysed and interpreted using 'policy triangle' and 'garbage can' models.Results: Our comprehensive review of changes in the medical tariff setting provides valuable lessons for major stakeholders. Most changes were implemented in a sporadic, inadequate, and a non-evidence-based manner. Disparities in tariffs between public and private sectors continue to exist. Lack of clarity in tariffs setting mechanisms and its process makes negotiations between various stakeholders difficult and can potentially become a source of a corrupt income. Such clarity can be achieved by using fair and technically sound tariffs. Technical aspects of tariff setting should be separated from the political negotiations over the overall payment to the medical professionals. Transparency regarding a conflict of interest and establishing punitive measures against those violating the rules could help improving trust in the doctor-patient relationship. Conclusion: Use of evidence-informed models and methods in medical tariff setting could help to strike the right balance in the process of health care services provision to address health system objectives. A sensitive application of policy models can offer significant insights into the nature of medical tariff setting and highlight existing constraints and opportunities. This study generates lessons learned in tariffs setting, particularly for low- and middle-income countries.

scholarly journals Roma health mediators in Serbia – good example of multisectoral cooperation in health promotion

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
B Kilibarda ◽  
M Vasic ◽  
V Knjeginjic
Keyword(s):  
Health Promotion ◽  
Health System ◽  
Service Providers ◽  
Health Indicators ◽  
Target Population ◽  
Lessons Learned ◽  
Vulnerable Groups ◽  
Roma Population ◽  
The Republic ◽  
Roma Health

Abstract Issue Within the framework of the JA CHRODIS plus participants of the WP5 worked on identification of factors that contribute to collaboration within healthcare and between the broader health system and other sectors, as well as their enablers and barriers. In Serbia, practice that was identified and elaborated was aimed at improvement of health of Roma population. Description of the problem Based on available data, health indicators among Roma population in Serbia were two to three times worse than national averages. In order to tackle this issue, government of the Republic of Serbia, started with implementation of the project of education and inclusion of Roma health mediators in the health system. This project has been implemented in Serbia since 2009. Roma Health mediators (Roma ethical minority females) were trained for fast and efficient provision of support to Roma families. Results As a result of the project there was increased number of visits to health institutions and preventive check-ups of target population. Established cooperation between Roma health mediators and other health professionals in centers for primary health care, social care, and local self-government helped them in fulfilling their tasks, but also built capacity of other service providers to work in Roma communities. Through trainings they increase knowledge on various health, social and child care topics. Lessons Capacity building and inclusion of memebrs of vulnerable population into health promotion of the own to this population in terms of better acceptance of specific population population is useful to access groups as they can better understand and adapt to the needs of groups they want to reach. They should have opportunity to share their experience and lessons learned with experts involved in planning interventions for other vulberable groups. Key messages Building capacity of Roma mediators empowers them for integration into society beyond the scope of the Project. Lessons learned should be used for planning further actions for vulnerable groups.

scholarly journals The main directions of the state social policy of child protection in Uzbekistan

2021 ◽  
Vol 13 (4) ◽  
pp. 87-112
Author(s):  
Nodira M. Latipova ◽  
◽  
Charos A. Abdugafurova ◽  
Keyword(s):  
Child Protection ◽  
Social Protection ◽  
The State ◽  
Lessons Learned ◽  
Protection System ◽  
Vulnerable Groups ◽  
Difficult Situation ◽  
The Social ◽  
The Republic ◽  
The Impact

The article discusses the improvement of social protection of families and children in the Republic of Uzbekistan. Based on the analysis, the National System of Child Protection in the Republic of Uzbekistan was obtained, which is made up of certain components. Methods. The content of the article is based on various research methods, primarily on the assessment of the social protection system through interviews with stakeholders. The assessment critically assessed the strategies applied, identified lessons learned and best practices, accelerating the achievement of sustainable results for children in Uzbekistan, especially from the most vulnerable groups. The assessment was aimed at assessing the relevance, effectiveness, efficiency, sustainability, consistency and, if possible, the impact of the strategies adopted to achieve the results of the start program. It was concluded that the effectiveness of the social protection system for children and families is based on the presence of the listed structural components in it. , and in the subsequent parts of this book we will try to analyze the main of these components in relation to the system of social protection of children in Uzbekistan. Results. The article is based on the support for the development of recommendations for the strategic planning of the next program cycle. The level of humanity of the state policy towards its citizens in a difficult situation, a socially vulnerable situation is measured by the system of social support provided, which is aimed at creating opportunities for them to participate in life, equal with other citizens, for socio-political, economic, cultural and intellectual development.

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