Perceptions about the accessibility of healthcare services among ethnic minority women: a qualitative study among Arab Bedouins in Israel

Abstract Background Access to healthcare services has major implications for vulnerable populations’ health. Socio-cultural and gender characteristics shape the utilization and access of healthcare services among ethnic minorities worldwide. One such vulnerable ethnic minority is the Arab Bedouin women in Israel. As women, they are marginalized in their community, where women do not have full equity and they experience multiple barriers to healthcare services The main objective of this study is to provide a nuanced, experiential, emic description of healthcare accessibility issues among Bedouin women in Israel. Identifying the barriers, they face in accessing healthcare may help healthcare policymakers make changes based on and tailored to Bedouin women’s needs. Methods A qualitative study included in-depth semi-structured interviews with 21 Arab Bedouin village residents, consisting of 14 women and 7 men. Eligible participants were Arab Bedouins over 18 years of age and who used healthcare services at least once in the last 5 years. The interviews were carried out in Arabic-Bedouin dialect and included demographic questions, open-ended questions that asked about participants’ perceptions regarding their experiences with healthcare services, including the factors that helped and hindered them in accessing these services and questions regarding suggestions for improving the accessibility of healthcare services based on the identified needs. Data collected were analyzed using thematic analysis. Study trustworthiness was ensured using audit, reflexivity, and peer debriefing. Results Arab Bedouin women experienced varied barriers while accessing healthcare services. This study uncovered how language, cultural and gender barriers intersect with other disadvantages ingrained in social norms, values and beliefs and affect the access of a minority women subgroup to healthcare services. The participants identified subgroups of Bedouin women (e.g. elderly Bedouin women) affected differently by these barriers. Conclusion Taking into consideration the identified needs and the Arab Bedouin women’s unique characteristics, along with adopting the intersectional approach should help improve access to healthcare services among such a vulnerable subgroup and other subgroups within minorities worldwide.

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The Combination of Gender and Ethnic Quotas in Electoral Politics

10.1093/oso/9780198829621.003.0004 ◽

2018 ◽

Author(s):

Melanie M. Hughes

Keyword(s):

Ethnic Minority ◽

Ethnic Minorities ◽

Minority Women ◽

The Political ◽

Gender Quotas ◽

Ethnic Minority Women ◽

Multicultural Feminism ◽

Ethnic Quotas ◽

And Gender ◽

National Legislatures

Around the world, countries are increasingly using quotas to enhance the diversity of political representatives. This chapter considers the histories and policy designs of ethnic and gender quotas that regulate national legislatures. Most countries with quotas target only one type of under-represented group—for example, women or ethnic minorities. Even in countries with both gender and ethnic quotas (called ‘tandem quotas’), the policies typically evolved separately and work differently. Women and ethnic minorities are treated as distinct groups, ignoring the political position of ethnic minority women. However, a handful of countries have ‘nested quotas’ that specifically regulate the political inclusion of ethnic minority women. The second half the chapter focuses explicitly on nested quotas. It lays out how nested quotas work, where and how they have been adopted, and the prospect for their spread to new countries in the future. The chapter concludes with reflections on the promises and pitfalls of nested quotas as a vehicle for multicultural feminism.

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Transition from Childcare Institutions to Adulthood for Youth: Through the Lens of Identity and Gender

Institutionalised Children Explorations and Beyond ◽

10.1177/2349300320980553 ◽

2020 ◽

pp. 234930032098055

Author(s):

Garima Sharma

Keyword(s):

Young Adults ◽

Qualitative Study ◽

Social Factor ◽

Smooth Transition ◽

Structured Interviews ◽

Male And Female ◽

Female Youth ◽

Youth Identity ◽

The Social ◽

And Gender

This article explores the transition of youth from childcare institutions as young adults through the lens of youth identity and gender. The research revolves around rethinking the delicate boundaries of adolescence and adulthood for the ‘institutionalised’ youth that is already on the edge of the society. This research tries to understand and decode the experiences of youth, who have lived in the childcare institutions. The childcare institutions reinforce the gender roles through its practices and structure, enabling gaps and challenges for both male and female youth outside the childcare institutions. There is an absence of a strong mechanism, enabling the smooth transition of youth from childcare institutions to adulthood. This results in unprepared young adults for an unplanned transition, fostering several challenges on them as they exit the childcare system. This is a qualitative study. The research includes both male and female youth who have lived in childcare institutions situated in Delhi. The data was collected using semi-structured interviews with the youth. This study finds that youth leaving the childcare institutions are at higher risks of having negative adult outcomes in life. While there is an absolute absence of any body or mechanism to help the youth transit smoothly, childcare institutions reinforce the inferiority and exclusion on a child during the stay period, creating a foundation for youth to perceive the social factor outside the institutions.

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Digital Health Innovation Ecosystems

International Journal of Reliable and Quality E-Healthcare ◽

10.4018/ijrqeh.2019040101 ◽

2019 ◽

Vol 8 (2) ◽

pp. 1-14 ◽

Cited By ~ 2

Author(s):

Gloria Ejehiohen Iyawa ◽

Marlien Herselman ◽

Adele Botha

Keyword(s):

Developing Countries ◽

Qualitative Study ◽

Digital Health ◽

Healthcare Services ◽

Structured Interviews ◽

Innovation Ecosystem ◽

Health Innovation ◽

Innovation Ecosystems ◽

Governmental Organizations ◽

Key Participants

The purpose of this paper was to identify key participants, benefits, and challenges of a digital health innovation ecosystem in Namibia. The paper also aimed to identify strategies for implementing digital health innovation ecosystems in Namibia. This is a qualitative study that adopted semi-structured interviews in meeting the objectives of the study. The findings suggest that implementing digital health innovation ecosystems within the Namibian context will result in better processes of delivering healthcare services to patients. However, implementing such an ecosystem would require resources from both academic and governmental organizations. The need for skilled experts for managing the ecosystem would also be required. Hence, adopting the guidelines for implementing a digital health innovation ecosystem in developing countries, the study proposed guidelines which would make a digital health innovation ecosystem work for the Namibian context. The findings of this study can be used by healthcare managers within the Namibian context.

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Understanding Barriers to the Access to Healthcare and Rehabilitation Services: A Qualitative Study with Mothers or Female Caregivers of Children with a Disability in Indonesia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182111546 ◽

2021 ◽

Vol 18 (21) ◽

pp. 11546

Author(s):

Gregorius Abanit Asa ◽

Nelsensius Klau Fauk ◽

Lillian Mwanri ◽

Paul Russell Ward

Keyword(s):

Data Analysis ◽

Qualitative Study ◽

Healthcare Professionals ◽

Healthcare Services ◽

Access To Healthcare ◽

Rehabilitation Services ◽

Snowball Sampling ◽

God's Will ◽

Faith Based ◽

Rehabilitation Centers

Accessibility to healthcare and rehabilitation services for children with a disability (CWD) is essential to improving their health and wellbeing. However, access to the services, especially in many settings in developing countries with scarcity of resources, is still limited. As part of a qualitative study exploring impacts of caring for CWD on mothers or female caregivers and their coping strategies, this paper describes barriers for access to healthcare and rehabilitation services for CWD in Belu district, Indonesia. One-on-one, in-depth interviews were conducted with 22 mothers or female caregivers of CWD. Participants were recruited using a combination of purposive and snowball sampling techniques. These were supplemented with interviews with two staff of disability rehabilitation centers in Belu to understand any additional barriers. Data analysis was guided by a qualitative data analysis framework. Our analysis identified that lack of affordability of healthcare services (high costs and low financial capacity of mothers) was the key barrier for access to healthcare and rehabilitation services CWD. Religious or faith-based factors, such as being a non-Catholic (Belu is predominantly Catholic), converting from Catholic to other religions, and the belief in children’s disability condition as “God’s will”, were also influencing factors for lack of access to the services. Shortage of staff, distrust in the therapy skills of staff at rehabilitation centers, and unavailability of appropriately trained healthcare professionals were structural or system-related barriers. The findings indicate the need for government-owned and run disability rehabilitation centers (not faith-based), the provision of fully subsidised health insurance to provide free services, and the provision of qualified therapists and healthcare professionals (to build trust) in Belu and other similar settings in Indonesia.

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Understanding men’s psychological reactions and experience following a cardiac event: a qualitative study from the MindTheHeart project

BMJ Open ◽

10.1136/bmjopen-2019-029560 ◽

2019 ◽

Vol 9 (9) ◽

pp. e029560 ◽

Cited By ~ 1

Author(s):

Jalila Jbilou ◽

Jean Grenier ◽

Marie-Helene Chomienne ◽

France Talbot ◽

Heather Tulloch ◽

...

Keyword(s):

Qualitative Study ◽

Focus Groups ◽

Psychosocial Adjustment ◽

Cardiac Event ◽

Clinical Training ◽

Healthcare Services ◽

Post Traumatic Stress ◽

Clinical Practices ◽

Structured Interviews ◽

Cardiac Rehabilitation Programme

ObjectivesEmotional issues such as depression, anxiety and post-traumatic stress disorder are common following a cardiac event. Despite their high prevalence, they often go undiagnosed and research suggests that men in particular are at higher risk. Therefore, a better understanding of men’s experiences with a cardiac event and ensuing health services is key for adapting approaches that meet their needs. The aim of this study was to describe the self-reported emotional challenges that men face following a cardiac event and to understand their patterns of psychosocial adjustment.DesignQualitative study (focus groups and one-on-one interviews) using an interpretive phenomenal analysis.SettingClinical settings (cardiac departments in hospitals, cardiac rehabilitation programme and family medicine clinics) and in the community in three Canadian provinces.ParticipantsA total of 93 men participated in the study through 22 focus groups and 5 semi-structured interviews, none has been excluded based on comorbidities.ResultsFour major themes emerged: (1) managing uncertainty and adversity; (2) distancing, normalising and accepting; (3) conformity to traditional masculine norms and (4) social, literacy and communication challenges.ConclusionsHealthcare professionals caring for men following a cardiac event must be aware of the psychological and social adjustments that accompany the physical challenges. However, there is a lack of explicit guidelines, tools and clinical training in men-sensitive approaches. Further research is required to better inform clinical practices and healthcare services.

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Healthcare inequities and barriers to access for homeless individuals: a qualitative study in Barcelona (Spain)

International Journal for Equity in Health ◽

10.1186/s12939-021-01409-2 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Andrés Cernadas ◽

Ángela Fernández

Keyword(s):

Qualitative Study ◽

Health Services ◽

Healthcare Workers ◽

Service Providers ◽

Universal Access ◽

Healthcare Services ◽

Medical Professional ◽

Homeless Population ◽

Public Health Services ◽

Structured Interviews

Abstract Background In Spain, homeless individuals have lower perceived quality of health than the rest of the population and their life expectancy is 30 years lower than the national average. While the Spanish health system provides universal access and coverage, homeless individuals do not access or use public care enough to maintain their health. The objective of this study is to determine if homeless individuals can access public health services in conditions of equality with the rest of the population, as established in healthcare legislation, and to better understand the causes of observed inequalities or inequities of access. Methods A detailed qualitative study was carried out in the city of Barcelona (Spain) from October 2019 to February 2020. A total of nine open and in-depth interviews were done with homeless individuals along with seven semi-structured interviews with key informants and two focus groups. One group was composed of eight individuals who were living on the street at the time and the other consisted of eight individuals working in healthcare and social assistance. Results The participants indicated that homeless individuals tend to only access healthcare services when they are seriously ill or have suffered some kind of injury. Once there, they tend to encounter significant barriers that might be 1) administrative; 2) personal, based on belief that that will be poorly attended, discriminated against, or unable to afford treatment; or 3) medical-professional, when health professionals, who understand the lifestyle of this population and their low follow-through with treatments, tend towards minimalist interventions that lack the dedication they would apply to other groups of patients. Conclusions The conclusions derived from this study convey the infrequent use of health services by homeless individuals for reasons attributable to the population itself, to healthcare workers and to the entire healthcare system. Accordingly, to reduce inequities of access to these services, recommendations to healthcare service providers include adapting facilities to provide more adequate care for this population; increasing sensitivity/awareness among healthcare workers; developing in situ care systems in places where the homeless population is most concentrated; and establishing healthcare collaboration agreements with entities that work with this population.

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Qualitative study on mental health and well-being of Syrian refugees and their coping mechanisms towards integration in the UK

BMJ Open ◽

10.1136/bmjopen-2020-046065 ◽

2021 ◽

Vol 11 (8) ◽

pp. e046065

Author(s):

Priyamvada Paudyal ◽

Mais Tattan ◽

Maxwell J F Cooper

Keyword(s):

Mental Health ◽

Qualitative Study ◽

Cultural Difference ◽

Mental Health Problems ◽

Community Support ◽

Well Being ◽

Healthcare Services ◽

Coping Mechanisms ◽

Syrian Refugees ◽

Structured Interviews

ObjectiveThis study aimed to explore the mental well-being of Syrian refugees and identify their coping mechanisms and pathways towards integration into new communities.DesignQualitative study using in-depth semi-structured interviews.Setting and participantsAdult Syrian refugees (>18 years old) currently residing in South East of England.Results12 participants (3 women and 9 men) took part in the study, all were born in Syria and the majority (n=9) were over 45 years of age. Our findings show that Syrian refugees face constant challenges as they try to integrate into a new society. Loss of and separation from loved ones as well as the nostalgia for the homeland were often cited as a source of psychological distress that created an overwhelming sense of sadness. Participants reported that they struggled for connectedness due to cultural difference and the problematic nature of rapidly formed migrant communities in their new setting. They believed in ‘being their own doctor’ and turning to faith, ritual and nature for healing and comfort. Taboo and stigma around mental health and language barriers were cited as barriers to accessing mental healthcare services.ConclusionPast experiences and present challenges frame Syrian refugees’ sense of well-being, impact use of healthcare and risk future mental health problems. It is hoped that this study will act as a catalyst for further research on this vulnerable group to promote integration, community support and culturally sensitive mental health services.

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