Restrictions on Undocumented Immigrants’ Access to Health Services: The Public Health Implications of Welfare Reform

Abstract: Tuberculosis (TB) is a contagious disease that is still the world's attention, Until now, there is not a single country that is free of TB (Kemenkes 2011). Public Health Center (puskesmas) Janti is a puskesmas where the number of TB BTA+ sufferers increases every year while the number of treatment success rate at Puskesmas Janti decreases every year. In 2013 is 96%, in 2014 is 87,50% and in 2015 is 85,37%. Increasing the number of patients and decreasing the number of success rates of treatment indicates that the utilization of health services is less. This study aims to find out the relationship of Education, Health Service Access and Family Support with Health Service Utilization of BTA+ Pulmonary TB Patients at Public Health Center (puskesmas) Janti Malang. The design of this study is quantitative correlation with samples of all patients with TB Paru + BTA who are still doing treatment at Puskesmas Janti in September 2016 until April 2017. The analysis used correlation test and logistic regression test with cross sectional approach. The results of the research analysis found that there is a significant relationship between education, access to health services and family support together with the utilization of health services of patients Tb Paru BTA+. Based on the results of determination coefficient R2 (Nagelkerke) of 0.619, this means that education (X1), access to health services (X2), and family support (X3) has contributed 61.9% to the utilization of health services of patients with TB Paru BTA+ at Puskesmas Janti.Keywords: education, access, family support, health service utilizationAbstrak: Tuberkulosis (TB) adalah penyakit menular yang masih menjadi perhatian dunia, hingga saat ini, belum ada satu negara pun yang bebas TB (Kemenkes 2011). Puskesmas Janti adalah satu puskesmas yang berada di Kota Malang dengan jumlah pasien TB Paru BTA+ yang paling tinggi dan meningkat setiap tahun diantara puskesmas yang lain di Kota Malang, sedangkan jumlah angka keberhasilan pengobatan di Puskesmas Janti mengalami penurunan setiap tahun. Tahun 2013 sebesar 96%, pada tahun 2014 sebesar 87,50% dan pada tahun 2015 sebesar 85,37%. Peningkatan jumlah penderita dan penurunan jumlah angka keberhasilan pengobatan menunjukkan bahwa pemanfaatan pelayanan kesehatan kurang. Penelitian ini bertujuan untuk mengetahui Hubungan Pendidikan, Akses Pelayanan Kesehatan dan Dukungan Keluarga dengan Pemanfaatan Pelayanan Kesehatan Penderita TB Paru BTA+ di Puskesmas Janti Kota Malang. Rancangan penelitian ini adalah kuantitatif korelasional dengan sampel seluruh penderita TB Paru BTA+ yang masih melakukan pengobatan di Puskesmas Janti pada bulan September 2016 sampai dengan April 2017. Analisis menggunakan uji korelasi dan uji regresi logistik dengan pendekatan cross sectional. Hasil analisis penelitian di dapatkan ada hubungan yang dignifikan antara pendidikan, akses pelayanan kesehatan dan dukungan keluarga secara bersama-sama dengan pemanfaatan pelayanan kesehatan penderita Tb Paru BTA+. Berdasarkan hasil koefisien determinasi R2 (Nagelkerke) sebesar 0,619, hal ini berarti bahwa pendidikan (X1), akses pelayanan kesehatan (X2), dan dukungan keluarga (X3) memiliki kontribusi sebesar 61,9% terhadap pemanfaatan pelayanan kesehatan penderita TB Paru BTA+ di Puskesmas Janti.Kata Kunci: pendidikan, akses pelayanan kesehatan, dukungan keluarga, pemanfaatan pelayanan kesehatan penderita TB Paru BTA+

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Cultural singularities: indigenous elderly access to Public Health Service

Revista da Escola de Enfermagem da USP ◽

10.1590/s0080-623420150000400008 ◽

2015 ◽

Vol 49 (4) ◽

pp. 0589-0595 ◽

Cited By ~ 3

Author(s):

Ana Carla Borghi ◽

Angela Maria Alvarez ◽

Sonia Silva Marcon ◽

Lígia Carreira

Keyword(s):

Public Health ◽

Health Care ◽

Health Services ◽

Public Health Service ◽

Primary Caregivers ◽

The Elderly ◽

Access To Health Services ◽

Access To Health ◽

Assistance Service ◽

Routine Procedures

OBJECTIVEDescribing how Kaingang seniors and their primary caregivers experience access to public health services.METHODA qualitative study guided by ethnography, conducted with 28 elderly and 19 caregivers. Data were collected between November 2010 and February 2013 through interviews and participative observation analyzed by ethnography.RESULTSThe study revealed the benefits and difficulties of the elderly access to health services, the facility to obtain health care resources such as appointments, medications and routine procedures, and the difficulties such as special assistance service problems and delays in the dispatching process between reference services.CONCLUSIONThe importance of knowing and understanding the cultural specificities of the group in order to offer greater opportunities for the elderly access to health services was reinforced.

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Exploring Accessibility of Community Pharmacy Services

INNOVATIONS in pharmacy ◽

10.24926/iip.v6i3.392 ◽

2015 ◽

Vol 6 (3) ◽

Cited By ~ 25

Author(s):

Sarah E. Kelling

Keyword(s):

Health Care ◽

Health Services ◽

Community Pharmacy ◽

Health Care Professionals ◽

Community Pharmacists ◽

Access To Health Services ◽

The Public ◽

Access To Health ◽

Accessibility Of Health Services ◽

System Access

Objective: To use selected literature to describe strengths and opportunities for improvement related to accessibility of health services in the community pharmacy setting. Summary: Pharmacists have been described as one of the most accessible health care professionals, particularly as nearly 90% of Americans live within 5 miles of a community pharmacy. However, geography alone does not provide access to health services. Individuals must be able to gain entry into the health care system, access a health care location where needed services are provided, and find a health care provider with whom the patient can communicate and trust. Current and potential opportunities for community pharmacists to increase access via each step are described. Conclusion: Community pharmacists are highly accessible health care professionals who are trusted by patients. Opportunities exist to further increase access to dispensing and non-dispensing services in order to better meet the needs of the public. Type: Commentary

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Patterns of Health Services Utilization in Rural Canada

Chronic Diseases and Injuries in Canada ◽

10.24095/hpcdp.31.s1.01 ◽

2011 ◽

Vol 31 (supplement 1) ◽

pp. 1-36 ◽

Cited By ~ 7

Author(s):

RW Pong ◽

M DesMeules ◽

D Heng ◽

C Lagacé ◽

JR Guernsey ◽

...

Keyword(s):

Public Health ◽

Rural Communities ◽

Health Services ◽

Descriptive Analysis ◽

Health Agency ◽

Public Health Agency ◽

Health Determinants ◽

Access To Health Services ◽

Research Project ◽

The Public

Canadians value ease of access to their health services. Although many studies have focused on accessibility to health services in Canada, few have examined rural-urban differences in this aspect, particularly from a national perspective. Yet disparities in access to health services exist between rural and urban populations, as do the challenges of delivering health care to more remote areas or to those with small populations. “Canada’s Rural Communities: Understanding Rural Health and Its Determinants” is a three-year research project co-funded by the Canadian Population Health Initiative (CPHI) of the Canadian Institute for Health Information (CIHI) and the Public Health Agency of Canada (PHAC). It involves investigators from the Public Health Agency of Canada, the Centre for Rural and Northern Health Research (CRaNHR) at Laurentian University, and other researchers. The first publication of the research project was How Healthy Are Rural Canadians? An Assessment of Their Health Status and Health Determinants;Footnote 1a1a this, the second publication, is a descriptive analysis of the utilization patterns of a broad range of health services by rural residents compared to their urban counterparts.

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Access to Health Services for Undocumented Immigrants in Apulia

Journal of Immigrant and Minority Health ◽

10.1007/s10903-014-0009-8 ◽

2014 ◽

Vol 17 (2) ◽

pp. 618-623 ◽

Cited By ~ 4

Author(s):

G. Brindicci ◽

G. Trillo ◽

C. R. Santoro ◽

A. Volpe ◽

L. Monno ◽

...

Keyword(s):

Health Services ◽

Undocumented Immigrants ◽

Access To Health Services ◽

Access To Health

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The perception of Italian pregnant women and new mothers about their psychological wellbeing, lifestyle, delivery, and neonatal management experience during the COVID-19 pandemic lockdown: a web-based survey

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03904-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Viviana Stampini ◽

Alice Monzani ◽

Silvia Caristia ◽

Gianluigi Ferrante ◽

Martina Gerbino ◽

...

Keyword(s):

Public Health ◽

Health Services ◽

Physical Exercise ◽

Pregnant Women ◽

Healthy Eating ◽

Mental Wellbeing ◽

Access To Health Services ◽

New Mothers ◽

Web Based ◽

Access To Health

Abstract Background In response to the COVID-19 pandemic, drastic measures for social distancing have been introduced also in Italy, likely with a substantial impact in delicate conditions like pregnancy and puerperium. The study aimed to investigate the changes in lifestyle, access to health services, and mental wellbeing during the first Italian lockdown in a sample of Italian pregnant women and new mothers. Methods We carried out a web-based survey to evaluate how pregnant women and new mothers were coping with the lockdown. We collected data about healthy habits (physical exercise and dietary habits), access to health services (care access, delivery and obstetric care, neonatal care, and breastfeeding), and mental wellbeing (psychological well-being and emotive support). Descriptive analysis was performed for both groups of participants, whereas a Poisson analysis was used to measure the association between some structural variables (age, education, socio-economic data, partner support, contact, free time, previous children, and pregnancy trimester) and anxiety or depression, difficulties in healthy eating and reduction in physical activity after lockdown started. Chi2 and Adjusted Prevalence Ratios were estimated only for pregnant women. Results We included 739 respondents (response rate 85.8 %), 600 were pregnant (81.2 %), and 139 (18.8 %) had delivered during lockdown (new mothers). We found a high score for anxiety and depression in 62.8 % of pregnant women and 61.9 % of new mothers. During the lockdown, 61.8 % of pregnant women reduced their physical exercise, and 44.3 % reported eating in a healthier way. 94.0 % of new mothers reported to have breastfed their babies during the hospital stay. Regarding the perceived impact of restrictive measures on breastfeeding, no impact was reported by 56.1 % of new mothers, whereas a negative one by 36.7 %. Conclusions The high prevalence of anxiety and depressive symptoms in pregnant women and new mothers should be a public health issue. Clinicians might also recommend and encourage “home” physical exercise. On the other hand, about half of the sample improved their approach towards healthy eating and a very high breastfeeding rate was reported soon after birth: these data are an interesting starting point to develop new strategies for public health.

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A health impact assessment (HIA) on a new motorway bypass in Strasbourg, France

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.591 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

D Christie ◽

G Dardier ◽

F Jabot ◽

A Roué-LeGall ◽

N Cantoreggi ◽

...

Keyword(s):

Air Pollution ◽

Health Services ◽

Rural Area ◽

Road Safety ◽

Living Environment ◽

City Centre ◽

Health Determinants ◽

Access To Health Services ◽

The Public ◽

Access To Health

Abstract Issue In 2018-2019, HIA was carried out on a projected 24-km north-south motorway bypass in a rural area west of Strasbourg, intended to alleviate pressure on a pre-existing motorway that cuts through the city centre. Although transport is a major source of impacts on health, HIA is rarely performed on new road construction projects, globally. Description The HIA included the screening, scoping, assessment and recommendations phases. Assessed health determinants were outdoor air quality, noise, mobility/access to health services, road safety, urban planning and the living environment. Methods included a literature review, the AirQ+ air pollution model, cartography and an NVivo analysis of answers to a public enquiry. Results Noise was set to increase for 1-4% of the population in the study area, but impacts related to air pollution appeared to be negligible and road safety did not change substantially. Mobility and access to health services were to improve, with strong local differences (inequalities): some areas benefitted from access to the new motorway without being affected by noise or traffic, while for others it was the opposite. Stakeholders who participated in the public enquiry were concerned about the loss of agriculturally and environmentally valuable land, viewed as a collective cultural asset. Those living in the vicinity of the bypass expressed anger at the reduction of the quantity and quality of green areas, which was experienced as an injustice given their choice to live in a rural area. Our recommendations related mainly to the pre-existing urban motorway, where reducing traffic volumes and speeds, as well as diverting trucks onto the new bypass, had the most promising effects on health. Lessons Due to its rural localization, the new road had limited health effects through air pollution, which is the focus of many transport-related HIAs. Through the analysis of the public enquiry, the HIA showed that the project generated anger and distress. Key messages The substantial investment represented by the new bypass did not solve pre-existing problems related to environmental health but generated new ones linked to social and mental health issues. Many HIAs miss out on valuable qualitative information because interviews or focus groups cannot be carried out with local stakeholders. Secondary analysis of public consultations can fill this gap.

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