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 Impact of the societal response to COVID-19 on access to healthcare for non-COVID-19 health issues in slum communities of Bangladesh, Kenya, Nigeria and Pakistan: results of pre-COVID and COVID-19 lockdown stakeholder engagements

2020 ◽  
Vol 5 (8) ◽  
pp. e003042 ◽  
Author(s):  
Syed A K Shifat Ahmed ◽  
Motunrayo Ajisola ◽  
Kehkashan Azeem ◽  
Pauline Bakibinga ◽  
Yen-Fu Chen ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Workers ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Government Support ◽  
Gender Based Violence ◽  
Healthcare Facilities ◽  
Healthcare Seeking ◽  
Gender Based

IntroductionWith COVID-19, there is urgency for policymakers to understand and respond to the health needs of slum communities. Lockdowns for pandemic control have health, social and economic consequences. We consider access to healthcare before and during COVID-19 with those working and living in slum communities.MethodsIn seven slums in Bangladesh, Kenya, Nigeria and Pakistan, we explored stakeholder perspectives and experiences of healthcare access for non-COVID-19 conditions in two periods: pre-COVID-19 and during COVID-19 lockdowns.ResultsBetween March 2018 and May 2020, we engaged with 860 community leaders, residents, health workers and local authority representatives. Perceived common illnesses in all sites included respiratory, gastric, waterborne and mosquitoborne illnesses and hypertension. Pre-COVID, stakeholders described various preventive, diagnostic and treatment services, including well-used antenatal and immunisation programmes and some screening for hypertension, tuberculosis, HIV and vectorborne disease. In all sites, pharmacists and patent medicine vendors were key providers of treatment and advice for minor illnesses. Mental health services and those addressing gender-based violence were perceived to be limited or unavailable. With COVID-19, a reduction in access to healthcare services was reported in all sites, including preventive services. Cost of healthcare increased while household income reduced. Residents had difficulty reaching healthcare facilities. Fear of being diagnosed with COVID-19 discouraged healthcare seeking. Alleviators included provision of healthcare by phone, pharmacists/drug vendors extending credit and residents receiving philanthropic or government support; these were inconsistent and inadequate.ConclusionSlum residents’ ability to seek healthcare for non-COVID-19 conditions has been reduced during lockdowns. To encourage healthcare seeking, clear communication is needed about what is available and whether infection control is in place. Policymakers need to ensure that costs do not escalate and unfairly disadvantage slum communities. Remote consulting to reduce face-to-face contact and provision of mental health and gender-based violence services should be considered.

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 Surgery in Brazilian Health Care: funding and physician distribution

2017 ◽  
Vol 44 (2) ◽  
pp. 202-207 ◽  
Author(s):  
NIVALDO ALONSO ◽  
BENJAMIN B. MASSENBURG ◽  
RAFAEL GALLI ◽  
LUCAS SOBRADO ◽  
DARIO BIROLINI
Keyword(s):  
Local Population ◽  
Surgical Care ◽  
National Database ◽  
Public Healthcare ◽  
Health Coverage ◽  
Inequality Index ◽  
Public And Private ◽  
Healthcare Facilities ◽  
The Public ◽  
The North

ABSTRACT Objective: to analyze demographic Brazilian medical data from the national public healthcare system (SUS), which provides free universal health coverage for the entire population, and discuss the problems revealed, with particular focus on surgical care. Methods: data was obtained from public healthcare databases including the Medical Demography, the Brazilian Federal Council of Medicine, the Brazilian Institute of Geography and Statistics, and the National Database of Healthcare Establishments. Density and distribution of the medical workforce and healthcare facilities were calculated, and the geographic regions were analyzed using the public private inequality index. Results: Brazil has an average of two physicians for every 1,000 inhabitants, who are unequally distributed throughout the country. There are 22,276 board certified general surgeons in Brazil (11.49 for every 100,000 people). The country currently has 257 medical schools, with 25,159 vacancies for medical students each year, with only around 13,500 vacancies for residency. The public private inequality index is 3.90 for the country, and ranges from 1.63 in the Rio de Janeiro up to 12.06 in Bahia. Conclusions: A significant part of the local population still faces many difficulties in accessing surgical care, particularly in the north and northeast of the country, where there are fewer hospitals and surgeons. Physicians and surgeons are particularly scarce in the public health system nationwide, and better incentives are needed to ensure an equal public and private workforce.

scholarly journals Drones Optimized Therapy System (DrOTS): Use of Drones for Tuberculosis Diagnosis in Nepal

2019 ◽  
pp. 14
Author(s):  
Uttam Pudasaini
Keyword(s):  
Public Health ◽  
Primary Healthcare ◽  
Urban Areas ◽  
Access To Health Care ◽  
Health Workers ◽  
Healthcare Access ◽  
Health Care Facilities ◽  
Health Centers ◽  
Diagnostic Tools ◽  
Healthcare Facilities

Over 50% of the total Nepalese population lives in hilly and mountainous areas with extremely poor transportation and access to health care facilities. With advanced health centers concentrated only in urban areas, and diagnostic laboratories not being present in most primary healthcare facilities, majority of people are forced to have to walk by foot, in an average 6-8 hours, to access proper healthcare facilities. Drone Optimized Therapy System, (DrOTS) aims to improve access to healthcare access in rural villages of Nepal. The pilot phase currently involved improving the accessibility of Tuberculosis diagnostic tests by linking communit y health workers (CHWs) with state-of-the-art diagnostic tools (GeneXpert) via drones in two municipalities of Pyuthan district, Nepal. The drones fly from central Hospitals to remote healthcare centers and bring back sputum samples for diagnosis. The purpose of this project is to assist the Ministry of Health and Population (MoHP) and National Tuberculosis Center (NTC) by generating the data necessary to assess the suitability of the drones-based services for nationwide expansion. The aerial distance between any two points being lesser than the actual road distance, drone technology has come out as a very popular tool in transporting medical samples/medicines between health centers. Drones can be used as crucial tools to connect primary healthcare facilities to hospitals by delivering patient information such as blood, urine, sputum, stool etc. samples required for diagnosis from primary facilities to hospitals, and medicines from hospitals to patients in nearby rural locations for treatment. The project team consists of multisector experts; Public Health- Birat Nepal Medical Trust (BNMT), Drones & Tech - WeRobotics, Nepal Flying Labs & DroNepal, Research: The Liverpool School of Tropical Medicine, Govt. stakeholders: MoHP Nepal, the National TB Center and the District Public Health Office (DPHO Pyuthan) is supported by Stony Brook University and the Simons Foundation.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 14

scholarly journals Nurses in Advanced Roles as a strategy for equitable access to health care in the WHO Western Pacific Region: A mixed methods study

2020 ◽  
Author(s):  
Sue Kim ◽  
Tae Wha Lee ◽  
Gwang Suk Kim ◽  
Eunhee Cho ◽  
Yeonsoo Jang ◽  
...  
Keyword(s):  
Access To Health Care ◽  
Healthcare Access ◽  
Delphi Survey ◽  
Western Pacific ◽  
Current Status ◽  
Pacific Region ◽  
Health Coverage ◽  
Western Pacific Region ◽  
Healthcare Needs ◽  
Advanced Roles

Purpose: This study investigated the current responsibilities of nurses in advanced roles (NARs), future healthcare needs, and the implications of these components for professional development of nurses. Design: This study employed a descriptive survey on the current status of NARs in the Western Pacific region (WPR), followed by a Delphi survey and exploratory interviews. Experts from WPR countries who were individuals with recognized national expertise on NARs from clinical, academic, and/or government-related backgrounds were invited to participate in this study from December 2017 to December 2018. Methods: Fifteen experts from ten countries provided descriptive data on the current status of NARs in the WPR via email. The data were used to grasp the spectrum of NAR and construct a working definition of NARs. This formed the basis for the Delphi survey, in which 27 experts from 14 countries completed the following three sections via email: Areas in need of NARs; Strengths, Weakness, Opportunities, and Threats analysis; and the role of NARs in promoting universal health coverage. Descriptive statistics were used for the survey and Delphi survey. For the exploratory interviews, semi-structured individual interviews were conducted with 19 key informants from 12 countries. Content analysis was performed for interview data. Delphi and interview findings were integrated in the final stage. Findings: Thirty-seven roles were identified and categorized according to the regulations for the specific roles. Emergency care, critical care, elderly health, child health, and rural/remote communities were identified as fields with particular need for NARs. Providing effective services, influencing government leadership, and advocating for health system sustainability were deemed necessary for NAR to improve equitable healthcare access. Conclusions: Demand for NARs is high in the WPR and we presented 15 items across five core strategic areas within the nursing community to enhance NAR development. Governmental-level recommendations include establishing legislative protection, remuneration, supportive channels, and conducting national needs assessments.

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.

Experiences of Transgender People in the Healthcare System: A Complex Analysis

2018 ◽  
Vol 8 (1) ◽  
pp. 56-61
Author(s):  
Kathryn Rotzinger
Keyword(s):  
Healthcare Provider ◽  
Healthcare System ◽  
Role Models ◽  
Complex Analysis ◽  
Healthcare Access ◽  
Holistic Model ◽  
Transgender People ◽  
Healthcare Needs ◽  
Agents Of Change ◽  
Resolution Strategies

A nursing perspective following McIntyre and McDonald’s framework was used to unpack the complex issue of challenges faced by transgender people in the Canadian healthcare system, considering historical, ethical, legal, social, cultural, political, and economic perspectives. Transgender people have unique healthcare needs which are often misunderstood or unaddressed by healthcare professionals, leading to poorer outcomes and inequities. Issues concerning transgender people are becoming a focus and a higher priority for society. This literature review reveals the complexity of this issue as the roots in historical, ethical, legal, social, cultural, political, and economic contexts are explored. A variety of barriers and facilitators exist to addressing and resolving this issue, including transgender people avoiding healthcare, intolerance, lack of knowledge and understanding, lack of healthcare provider training, media representation, and economic costs. The analysis of this issue can be used to inform resolution strategies to utilize facilitators and overcome barriers, including increasing awareness and knowledge, improving education and healthcare provider competency, and utilizing nurse leaders as advocates, role models, and agents of change. Improving care of transgender people is a nursing leadership priority. By implementing the suggested resolution strategies, the healthcare system can begin to move towards a more inclusive, understanding, and holistic model of care to improve healthcare access and outcomes for transgender people.

Prehospital Care of Tsunami Victims in Thailand: Description and Analysis

2006 ◽  
Vol 21 (3) ◽  
pp. 204-210 ◽  
Author(s):  
Dagan Schwartz ◽  
Avishay Goldberg ◽  
Issac Ashkenasi ◽  
Guy Nakash ◽  
Rami Pelts ◽  
...  
Keyword(s):  
Primary Care ◽  
Healthcare System ◽  
Prehospital Care ◽  
Western Coast ◽  
Medical Department ◽  
Disaster Plan ◽  
Healthcare Facilities ◽  
Tsunami Disaster ◽  
Medical Response ◽  
Healthcare Needs

AbstractIntroduction:On 26 December 2004 at 09:00 h, an earthquake of 9.0 magnitude (Richter scale) struck the area off of the western coast of northern Sumatra, Indonesia, triggering a Tsunami. As of 25 January 2005, 5,388 fatalities were confirmed, 3,120 people were reported missing, and 8,457 people were wounded in Thailand alone. Little information is available in the medical literature regarding the response and restructuring of the prehospital healthcare system in dealing with major natural disasters.Objective:The objective of the study was to analyze the prehospital medical response to the Tsunami in Thailand, and to identify possible ways of improving future preparedness and response.Methods:The Israeli Defense Forces (IDF) Home Front Command Medical Department sent a research delegation to study the response of the Thai medical system to the 2004 earthquake and Tsunami disaster. The delegation met with Thai healthcare and military personnel, who provided medical care for and evacuated the Tsunami victims. The research instruments included questionnaires (open and closed questions), interviews, and a review of debriefing session reports held in the days following the Tsunami.Results:Beginning the day after the event, primary health care in the affected provinces was expanded and extended. This included: (1) strengthening existing primary care facilities with personnel and equipment; (2) enhancing communication and transportation capabilities; (3) erecting healthcare facilities in newly constructed evacuation centers; (4) deploying mobile, medical teams to make house calls to flood refugees in affected areas; and (5) deploying ambulance crews to the affected areas to search for survivors and provide primary care triage and transportation.Conclusion:The restructuring of the prehospital healthcare system was crucial for optimal management of the healthcare needs of Tsunami victims and for the reduction of the patient loads on secondary medical facilities. The disaster plan of a national healthcare system should include special consideration for the restructuring and reinforcement prehospital system.

scholarly journals Access to Public Healthcare Services in Urban Areas in Nigeria: The Influence of Demographic and Socioeconomic Characteristics of the Urban Population

2021 ◽  
pp. 1-13
Author(s):  
Abubakar Abdullahi ◽  
Nalika Gunawardena
Keyword(s):  
Urban Areas ◽  
Urban Population ◽  
Economic Status ◽  
Composite Index ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Public Healthcare ◽  
Chi Square ◽  
Significance Level ◽  
Healthcare Facilities

Background: Ensuring access to healthcare facilities is a high priority need in developing countries. This research aimed to determine the influence of socio-demographic and economic characteristics of the urban population in Nigeria to access to public healthcare facilities. Methods: We conducted a community-based study in 400 households across the three urban areas of Gombe state, Nigeria. Access to healthcare facilities was quantified in a composite index which considers availability, accessibility and affordability. The head of families was interviewed for information related to access and for the socio-demographic and economic status of the residences. The influence of socio-demographic and economic characteristics was determined using a chi-square test with a significance level of <0.05. Results: Most of the population interviewed within the selected urban areas had good access (84%) to public healthcare facilities. Socio-demographic and economic characteristics of household representatives such as age (p = 0.02), religious status (p = 0.00), level of education (p =0 .00), employment (p = 0.00) and possession of healthcare insurance (p = 0.00) were found to significantly influence access to healthcare facilities in urban areas. Conclusion:  Access to public healthcare facilities within the urban areas was good and the study revealed some modifiable socio-demographic and economic factors that influence access. We recommend the intervention to address the factors to further improve access to public healthcare facilities and to achieve universal healthcare coverage.

scholarly journals Tracking aspects of healthcare activity during the first nine months of COVID-19 in Ireland: a secondary analysis of publicly available data

2021 ◽  
Vol 4 ◽  
pp. 98
Author(s):  
Domhnall McGlacken-Byrne ◽  
Sarah Parker ◽  
Sara Burke
Keyword(s):  
Healthcare System ◽  
Healthcare Access ◽  
Healthcare Delivery ◽  
Secondary Analysis ◽  
Public Healthcare ◽  
Language Therapy ◽  
Care Community ◽  
Universal Healthcare ◽  
Allied Healthcare ◽  
The Impact

Background: Sláintecare aims to introduce universal healthcare in Ireland. The COVID-19 pandemic poses both challenges and opportunities to this process. This study explored the impact of COVID-19 on aspects of Irish healthcare during the first nine months of the pandemic and considers the implications for Sláintecare implementation. Methods: Secondary analysis was undertaken on publicly available data on three key domains of the Irish healthcare system: primary care, community-based allied healthcare, and hospitals. Descriptive statistics were computed using Microsoft Excel 2016. Results: Up to March 2021, 3.76 million COVID-19 tests were performed by Ireland’s public healthcare system, 2.48 million (66.0%) of which were referred from the community. General practitioners delivered 2.31 million telephone triages of COVID-19 symptoms, peaking in December 2020 when 416,607 consultations occurred. Patient numbers across eight allied healthcare specialties fell by 35.1% versus previous years, with the greatest reductions seen in speech and language therapy (49.0%) and audiology (46.1%). Hospital waiting lists increased from 729,937 to 869,676 (or by 19.1%) from January 2019 to January 2021. In January 2021, 629,919 patients awaited a first outpatient clinic appointment, with 170,983 (27.1%) waiting longer than 18 months. The largest outpatient lists were observed in orthopaedic surgery (n=77,257); ear, nose and throat surgery (n=68,073); and ophthalmology (n=47,075). The proportion of patients waiting more than 12 months for a day-case gastrointestinal endoscopy rose from 6.0% in January 2020 to 19.0% in January 2021. Conclusions: Healthcare activity has been significantly disrupted by COVID-19, leading to increased wait times and greater barriers to healthcare access during the pandemic. Yet, Ireland’s health system responses also revealed strong willingness and ability to adapt and to implement novel solutions for healthcare delivery, rapidly and at scale. This has demonstrated what is achievable under Sláintecare and provides a unique opportunity to ‘build back better’ towards sustainable recovery.

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