scholarly journals Making Gendered Healthcare Work Visible: Over-Looked Labour in Four Diverse European Settings

2019 ◽  
Vol 7 (2) ◽  
pp. 33-43 ◽  
Author(s):  
Hannah Bradby ◽  
Jenny Phillimore ◽  
Beatriz Padilla ◽  
Tilman Brand
Keyword(s):  
Service Providers ◽  
Point Of View ◽  
Health Needs ◽  
Health Priorities ◽  
Public Healthcare ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
The Public ◽  
Universal Healthcare ◽  
Healthcare Work

Healthcare has long been a gendered enterprise, with women taking responsibility for maintaining health and engaging with service providers. Universal healthcare provision notwithstanding, women nonetheless undertake a range of healthcare work, on their own account and on behalf of others, which remains largely invisible. As part of a multi-method comparative European study that looked at access to healthcare in diverse neighbourhoods from the point of view of people’s own health priorities, the concept of ‘healthcare bricolage’ describes the process of mobilizing resources and overcoming constraints to meet particular health needs. Bricolage mediates between different kinds of resources to meet particular challenges and describing these processes makes visible that work which has been unseen, over-looked and naturalised, as part of a gendered caring role. Drawing on 160 semi-structured interviews and a survey with 1,755 residents of highly diverse neighbourhoods in Germany, UK, Sweden and Portugal, this article illustrates the gendered nature of healthcare bricolage. The complex variations of women’s bricolage within and beyond the public healthcare system show how gendered caring roles intersect with migration status and social class in the context of particular healthcare systems.

scholarly journals Access to healthcare for children with Congenital Zika Syndrome in Brazil: perspectives of mothers and health professionals

2019 ◽  
Vol 34 (7) ◽  
pp. 499-507 ◽  
Author(s):  
Maria S V Albuquerque ◽  
Tereza M Lyra ◽  
Ana P L Melo ◽  
Sandra A Valongueiro ◽  
Thalia V B Araújo ◽  
...  
Keyword(s):  
Health System ◽  
Health Professionals ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Public Healthcare ◽  
Gender Inequalities ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
The Public ◽  
Congenital Zika Syndrome

Abstract The Congenital Zika Syndrome (CZS) epidemic took place in Brazil between 2015 and 2017 and led to the emergence of at least 3194 children born with CZS. We explored access to healthcare services and activities in the Unified Health Service (Sistema Único de Saúde: SUS) from the perspective of mothers of children with CZS and professionals in the Public Healthcare Network. We carried out a qualitative, exploratory study, using semi-structured interviews, in two Brazilian states—Pernambuco, which was the epicentre of the epidemic in Brazil, and Rio de Janeiro, where the epidemic was less intense. The mothers and health professionals reported that healthcare provision was insufficient and fragmented and there were problems with follow-up care. There was a lack of co-ordination and an absence of communication between the various specialized services and between different levels of the health system. We also noted a public–private mixture in access to healthcare services, resulting from a segmented system and related to inequality of access. High reported household expenditure is an expression of the phenomenon of underfunding of the public system. The challenges that mothers and health professionals reported exposes contradictions in the health system which, although universal, does not guarantee equitable and comprehensive care. Other gaps were revealed through the outbreak. The epidemic provided visibility regarding difficulties of access for other children with disabilities determined by other causes. It also made explicit the gender inequalities that had an impact on the lives of mothers and other female caregivers, as well as an absence of the provision of care for these groups. In the face of an epidemic, the Brazilian State reproduced old fashioned forms of action—activities related to the transmitting mosquito and to prevention with an emphasis on the individual and no action related to social determinants.

scholarly journals Identifying executive challenges of performance-based payment from medical and educational hospitals managers’ perspective and offering solutions in Isfahan (2018)

2019 ◽  
Author(s):  
Alireza Jabbari ◽  
Nasrin Shaarbafchi Zadeh ◽  
Behrooz Maddahian
Keyword(s):  
Financial Incentives ◽  
Service Providers ◽  
Public Hospitals ◽  
Structured Interviews ◽  
Educational Support ◽  
The Public ◽  
Health Service Providers ◽  
Research Population ◽  
Information And Communication ◽  
Correct Implementation

Introduction: Performance-based payment is a payment model that attempts to reward the measured dimensions of performance and encourages health service providers to achieve predetermined goals by financial incentives. This study aimed to identify executive challenges of performance-based payment from medical and educational hospitals managers’ perspective and offering solutions in Isfahan 2018. Methods: This study was a qualitative study. Semi structured interviews were used to collect data. The research population was 11 people (the managers of educational and medical hospitals in Isfahan) who were selected purposefully. All interviews were recorded and then written on a paper. The duration of the interviews varied between 45 to 60 minutes. The data were analyzed using MAXQDA120 software and based on thematic analysis. Results: In this study, , regarding executive challenges, seven themes and fifteen sub-themes were obtained, including the weakness of the performance-based payment project, weakness in education and educational support, low employee participation, weakness of information and communication technology, weakness of laws and regulations, unfavorable economic conditions of the public sector, and special conditions governing public hospitals.   Conclusion: performance-based payment, if implemented correctly, can lead to the improvement of quantitative and qualitative indicators related to employees’ performance. Correct implementation requires identifying challenges and obstacles and then corrective actions. This study was able to identify and present some of the operational challenges of the performance-based payment from the viewpoint of hospital managers.

scholarly journals Exploration of Silence's Motives Towards the Work Decisions: The Case of Jordanian Public and Private Schools

2019 ◽  
Vol 9 (1) ◽  
pp. 266
Author(s):  
Osama Khaled Alkhlaifat
Keyword(s):  
Decision Making ◽  
Private Schools ◽  
Human Resources Management ◽  
Point Of View ◽  
Decision Making Process ◽  
Structured Interviews ◽  
Public And Private ◽  
The Public ◽  
Work Related ◽  
Last Stage

The aim of this study has been to investigate and provide a deeper understanding of the motives of silence towards the participation in the work-related decisions, in both the public and private schools in the Jordanian capital (Amman). ‘100’ teachers were interviewed using the semi-structured interviews through the available communication means. The pre-set questions were directed to the sample of the study to identify both the situations related to the decisions and motives leading to silence and non-participation from the respondents' point of view. The motives were classified according to the factors to which they belong, as well as the situations were classified according to each stage of the decision-making process, where some specialists in the field of human resources management had been asked to help in accomplishing the classification. The results showed that the largest percentage of respondents faced at least one situation in which they chose to remain silent. Most of the situations mentioned were related to the first and last stage of decision-making process (identifying the problem and following up the decision). The results also showed that most of the motives were related to the organizational practices by the officials, where the total iteration is twice as the personal motives.

The Reproductive Health Priorities, Concerns, and Needs of Women in Midlife: A Feminist Poststructuralist Qualitative Analysis

2020 ◽  
pp. 104973232097049
Author(s):  
Amy Alspaugh ◽  
Eun-Ok Im ◽  
Melody D. Reibel ◽  
Julie Barroso
Keyword(s):  
Reproductive Health ◽  
Lived Experience ◽  
Healthy Aging ◽  
Health Needs ◽  
Health Priorities ◽  
Structured Interviews ◽  
Individualized Care ◽  
Perimenopausal Symptoms ◽  
Feminist Poststructuralist ◽  
Permanent Method

Reproductive health research rarely involves the inclusion of women over 40, creating a large knowledge gap regarding women in midlife. Women continue to have reproductive health needs, concerns, and priorities up to the point of menopause that should be examined to improve reproductive health outcomes and provide individualized care. In-depth, individual, semi-structured interviews were conducted with 20 women between the ages of 40 and 55 who had not reached menopause and did not have a permanent method of sterilization. Using the feminist poststructuralist tenets, three major themes were identified: (a) knowledge acquisition during the perimenopause, (b) subjectivity regarding family planning, and (c) the agency of aging. Participants spoke to a need for reproductive health that listens to their lived experience, addresses menopause clinically and positively, and encourages autonomously driven health priorities. Further research on effective nonhormonal contraception, education on perimenopausal symptoms, and healthy aging is necessary.

Extreme weather-related health needs of people who are homeless

2013 ◽  
Vol 19 (3) ◽  
pp. 250 ◽  
Author(s):  
Lynette Cusack ◽  
Antonia van Loon ◽  
Debbie Kralik ◽  
Paul Arbon ◽  
Sandy Gilbert
Keyword(s):  
Gap Analysis ◽  
Service Providers ◽  
South Australia ◽  
Homeless People ◽  
Extreme Weather ◽  
Health Needs ◽  
Extreme Weather Events ◽  
Temperate Climate ◽  
Structured Interviews ◽  
Extreme Cold

To identify the extreme weather-related health needs of homeless people and the response by homeless service providers in Adelaide, South Australia, a five-phased qualitative interpretive study was undertaken. (1) Literature review, followed by semi-structured interviews with 25 homeless people to ascertain health needs during extreme weather events. (2) Identification of homeless services. (3) Semi-structured interviews with 16 homeless service providers regarding their response to the health needs of homeless people at times of extreme weather. (4) Gap analysis. (5) Suggestions for policy and planning. People experiencing homelessness describe adverse health impacts more from extreme cold, than extreme hot weather. They considered their health suffered more, because of wet bedding, clothes and shoes. They felt more depressed and less able to keep themselves well during cold, wet winters. However, homeless service providers were more focussed on planning for extra service responses during times of extreme heat rather than extreme cold. Even though a city may be considered to have a temperate climate with a history of very hot summers, primary homeless populations have health needs during winter months. The experiences and needs of homeless people should be considered in extreme weather policy and when planning responses.

scholarly journals Staying afloat: community perspectives on health system resilience in the management of pregnancy and childbirth care during floods in Cambodia

2020 ◽  
Vol 5 (4) ◽  
pp. e002272 ◽  
Author(s):  
Dell D Saulnier ◽  
Hom Hean ◽  
Dawin Thol ◽  
Por Ir ◽  
Claudia Hanson ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Health System ◽  
Health Systems ◽  
Public Health System ◽  
Health Needs ◽  
Structured Interviews ◽  
The Public ◽  
Pregnancy And Childbirth ◽  
Childbirth Care

IntroductionResilient health systems have the capacity to continue providing health services to meet the community’s diverse health needs following floods. This capacity is related to how the community manages its own health needs and the community and health system’s joined capacities for resilience. Yet little is known about how community participation influences health systems resilience. The purpose of this study was to understand how community management of pregnancy and childbirth care during floods is contributing to the system’s capacity to absorb, adapt or transform as viewed through a framework on health systems resilience.MethodsEight focus group discussions and 17 semi-structured interviews were conducted with community members and leaders who experienced pregnancy or childbirth during recent flooding in rural Cambodia. The data were analysed by thematic analysis and discussed in relation to the resilience framework.ResultsThe theme ‘Responsible for the status quo’ reflected the community’s responsibility to find ways to manage pregnancy and childbirth care, when neither the expectations of the health system nor the available benefits changed during floods. The theme was informed by notions on: i) developmental changes, the unpredictable nature of floods and limited support for managing care, ii) how information promoted by the public health system led to a limited decision-making space for pregnancy and childbirth care, iii) a desire for security during floods that outweighed mistrust in the public health system and iv) the limits to the coping strategies that the community prepared in case of flooding.ConclusionsThe community mainly employed absorptive strategies to manage their care during floods, relieving the burden on the health system, yet restricted support and decision-making may risk their capacity. Further involvement in decision-making for care could help improve the health system’s resilience by creating room for the community to adapt and transform when experiencing floods.

scholarly journals La ‘torre de marfil’ como apuesta segura: Políticas científicas y evaluación académica en México

2018 ◽  
Vol 26 ◽  
pp. 95 ◽  
Author(s):  
Federico Vasen
Keyword(s):  
Public Discourse ◽  
Merit Pay ◽  
Document Analysis ◽  
Point Of View ◽  
The Political ◽  
University Rankings ◽  
Structured Interviews ◽  
The Public ◽  
Academic Evaluation ◽  
Evaluation Practices

The article analyzes the signals received by social researchers in Mexico regarding the type of production expected from them in merit pay programs. The institutional public discourse embodied in official documents is contrasted with the description of the evaluation carried out by the evaluators themselves. The research is based in document analysis and semi-structured interviews to evaluators. The main conclusion of the study is that there is an asymmetry between the public discourse of the institutions and the behaviors that are rewarded in the evaluation practices themselves. While the political discourse  promotes a model of researcher committed to knowledge transfer and mobilization activities , academic evaluation practices encourage a classic academic profile. These contradictions could be explained by the ability of scientists to influence the content of policies in pursuit of their own interests. On the other hand, from the point of view of policymakers, the weight that international publications have for university rankings could exempt scientists from giving another justification for the importance of their work.

scholarly journals ASSESSING THE LEVEL OF PATIENT SATISFACTION ON PUBLIC HEALTHCARE FACILITIES IN SOUTH AFRICAN

2020 ◽  
Vol 8 (4) ◽  
pp. 172-181
Author(s):  
Ephrem Habtemichael Redda ◽  
Jhalukpreya Surujlal
Keyword(s):  
South Africa ◽  
Patient Satisfaction ◽  
South African ◽  
Healthcare Service ◽  
Healthcare Services ◽  
Public Healthcare ◽  
Healthcare Provision ◽  
Healthcare Facilities ◽  
The Public ◽  
Ethnic Grouping

Purpose of study: The purpose of this study was to assess patient satisfaction levels within South African public healthcare facilities. The influence of gender and ethnic grouping (race) perceptions of satisfaction of healthcare services was investigated. Methodology: The study followed a cross-sectional research design and a quantitative research method. The data was collected as part of the General Household Survey in 2018 by Statistics South Africa (the national statistics service of South Africa). Descriptive statistics and cross-tabulation were performed to address the research objectives of the study. Main findings: The results show that the majority of the patients who participated in the survey are satisfied with the public healthcare service they received. The leading provinces that achieved very satisfied patients are Limpopo, the Eastern Cape, Mpumalanga, KwaZulu-Natal, and Gauteng. Applications of the study: The study is important in many ways as it highlights the discrepancies of healthcare provision to the public health decision-makers. For example, the results show that generally, the male patients were slightly more satisfied with the healthcare services than their female counterparts. In terms of ethnic grouping, it appears that white patients are generally more satisfied with the public healthcare services they receive than other race groups. Novelty/originality of study: A study of this nature has not been conducted in South Africa apart from the anecdotal reports of the department of health and Statistics South Africa. The study delved to analyze the public healthcare service in all provinces of the republic and also provided insight into gender and racial perception of healthcare services in the country.

Public and Private Healthcare in Slovenia in Relation to Choice and Accessibility of Services

2013 ◽  
Vol 3 (3) ◽  
pp. 1-14 ◽  
Author(s):  
Matic Kavčič ◽  
Majda Pahor
Keyword(s):  
Public Sector ◽  
Evolutionary Process ◽  
Secondary Data ◽  
Healthcare Services ◽  
Background Information ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Public And Private ◽  
The Public ◽  
Private Healthcare

This article starts with background information on the Slovenian healthcare system and the description of the evolutionary process and privatisation reforms that bring a mix of public and private healthcare services. The authors' aim is to conceptualise existing modes of public and private healthcare provision and discuss possible implications for user choice and accessibility of services. A descriptive and exploratory case study approach was employed. Literature and document analysis was complemented by secondary data and semi-structured interviews. The results demonstrate four modes of healthcare services in relation to public-private delivery. The ‘public non-profit' type refers to publicly financed and delivered services. The ‘private within public' type addresses services provided within and by the public sector for patients who pay out-of-pocket. The ‘private for public' type deals with services provided by private entities with concessions. The ‘private for-profit' type refers to completely private provision (without concession) of self-pay services. The strengths and weaknesses of each mode with respect to choice, space-time accessibility, financial accessibility and quality of services are critically discussed. The results of the study show that private healthcare services significantly complement and compete with public sector. In addition, there is a risk that uncontrolled mixing of public and private modes of practice may bring about unethical behaviour and corruption.

scholarly journals Translating Medicaid policy into practice: policy implementation strategies from three US states’ experiences enhancing substance use disorder treatment

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Erika L. Crable ◽  
Allyn Benintendi ◽  
David K. Jones ◽  
Alexander Y. Walley ◽  
Jacqueline Milton Hicks ◽  
...  
Keyword(s):  
Substance Use ◽  
Policy Implementation ◽  
Substance Use Disorder ◽  
Service Providers ◽  
Implementation Strategies ◽  
Local Context ◽  
Public Healthcare ◽  
Structured Interviews ◽  
Addiction Medicine ◽  
Us States

Abstract Background Despite the important upstream impact policy has on population health outcomes, few studies in implementation science in health have examined implementation processes and strategies used to translate state and federal policies into accessible services in the community. This study examines the policy implementation strategies and experiences of Medicaid programs in three US states that responded to a federal prompt to improve access to evidence-based practice (EBP) substance use disorder (SUD) treatment. Methods Three US state Medicaid programs implementing American Society of Addiction Medicine (ASAM) Criteria-driven SUD services under Section 1115 waiver authority were used as cases. We conducted 44 semi-structured interviews with Medicaid staff, providers and health systems partners in California, Virginia, and West Virginia. Interviews were triangulated with document review of state readiness and implementation plans. The Exploration, Preparation, Implementation, Sustainment Framework (EPIS) guided qualitative theme analysis. The Expert Recommendations for Implementing Change and Specify It criteria were used to create a taxonomy of policy implementation strategies used by policymakers to promote providers’ uptake of statewide EBP SUD care continuums. Results Four themes describe states’ experiences and outcomes implementing a complex EBP SUD treatment policy directive: (1) Medicaid agencies adapted their inner/outer contexts to align with EBPs and adapted EBPs to fit their local context; (2) enhanced financial reimbursement arrangements were inadequate bridging factors to achieve statewide adoption of new SUD services; (3) despite trainings, service providers and managed care organizations demonstrated poor fidelity to the ASAM Criteria; and (4) successful policy adoption at the state level did not guarantee service providers’ uptake of EBPs. States used 29 implementation strategies to implement EBP SUD care continuums. Implementation strategies were used in the Exploration (n=6), Preparation (n=10), Implementation (n=19), and Sustainment (n=6) phases, and primarily focused on developing stakeholder interrelationships, evaluative and iterative approaches, and financing. Conclusions This study enhances our understanding of statewide policy implementation outcomes in low-resource, public healthcare settings. Themes highlight the need for additional pre-implementation and sustainment focused implementation strategies. The taxonomy of detailed policy implementation strategies employed by policymakers across states should be tested in future policy implementation research.

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