scholarly journals A qualitative study on African immigrant and refugee families’ experiences of accessing primary health care services in Manitoba, Canada: it’s not easy!

Author(s):  
Roberta Lynn Woodgate ◽  
David Shiyokha Busolo ◽  
Maryanne Crockett ◽  
Ruth Anne Dean ◽  
Miriam R. Amaladas ◽  
...  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Carine Sandrine Ngo Bikoko Piemeu ◽  
Christine Loignon ◽  
Émilie Dionne ◽  
Andrée-Anne Paré-Plante ◽  
Jeannie Haggerty ◽  
...  

Abstract Background Primary healthcare is the main entry to the health care system for most of the population. In 2008, it was estimated that about 26% of the population in Quebec (Canada) did not have a regular family physician. In early 2017, about 10 years after the introduction of a centralized waiting list for patients without a family physician, Québec had 25% of its population without a family physician and nearly 33% of these or 540,000, many of whom were socially vulnerable (SV), remained registered on the list. SV patients often have more health problems. They also face access inequities or may lack the skills needed to navigate a constantly evolving and complex healthcare system. Navigation interventions show promise for improving access to primary health care for SV patients. This study aimed to describe and understand the expectations and needs of SV patients. Methods A descriptive qualitative study rooted in a participatory study on navigation interventions implemented in Montérégie (Quebec) addressed to SV patients. Semi-structured individual face-to-face and telephone interviews were conducted with patients recruited in three primary health care clinics, some of whom received the navigation intervention. A thematic analysis was performed using NVivo 11 software. Results Sixteen patients living in socially deprived contexts agreed to participate in this qualitative study. Three main expectations and needs of patients for navigation interventions were identified: communication expectations (support to understand providers and to be understood by them, discuss about medical visit, and bridge the communication cap between patients and PHC providers); relational expectations regarding emotional or psychosocial support; and pragmatic expectations (information on available resources, information about the clinic, and physical support to navigate the health care system). Conclusions Our study contributes to the literature by identifying expectations and needs specified to SV patients accessing primary health care services, that relate to navigation interventions. This information can be used by decision makers for navigation interventions design and inform health care organizational policies.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Oliveira Miranda ◽  
P Santos Luis ◽  
M Sarmento

Abstract Background Primary health care services are the cornerstone of all health systems. Having clear data on allocated human resources is essential for planning. This work intended to map and compare the primary health care human resources of the five administrative regions (ARS) of the Portuguese public health system, so that better human resources management can be implemented. Methods The chosen design was a descriptive cross sectional study. Each of the five ARS were divided into primary health care clusters, which included several primary health care units. All of these units periodically sign a “commitment letter”, where they stand their service commitments to the covered population. This includes allocated health professionals (doctors, nurses), and the information is publicly accessible at www.bicsp.min-saude.pt. Data was collected for 2017, the year for which more commitment letters were available. Several ratios were calculated: patients/health professional; patients/doctor (family medicine specialists and residents); patients/nurse and patients/family medicine specialist. Mean, standard deviation, minimum and maximum values were calculated. Results National patients/health professional ratio was 702 with the mean of the 5 ARS calculated at 674+-7.15% (min 619, max 734) whilst the national patients/doctor ratio was 1247 with the mean of the 5 ARS calculated at 1217+-7.17% (min 1074, max 1290). National patients/nurse ratio was 1607 with the mean of the 5 ARS calculated at 1529+-13.08% (min 1199, max 1701). Finally, national patients/family medicine specialist ratio was 1711 with the mean of the 5 ARS calculated at 1650+-6,36% (min 1551, max 1795). Conclusions Human resources were differently spread across Portugal, with variations between the five ARS in all ratios. The largest differences occur between nursing staff, and may translate into inequities of access, with impact on health results. A more homogeneous human resources allocation should be implemented. Key messages Human resources in the Portuguese primary health care services are not homogeneously allocated. A better and more homogeneous allocation of human resources should be implemented to reduce access health inequities.


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