scholarly journals Disabled and immigrant, a double minority challenge. A qualitative study about the experiences of immigrant families raising a child with a disability and navigating the Norwegian healthcare system.

2019 ◽  
Author(s):  
Shahrzad Arfa ◽  
Per Koren Solvang ◽  
Berit Berg ◽  
Reidun Jahnsen

Abstract Background: Immigrants and their Norwegian-born children make up approximately 18% of the total population in Norway. The legitimacy of the healthcare system is a product of its ability to provide timely and appropriate services to the entire population. While several studies have been conducted on migrants’ utilization of healthcare services, immigrant families are systematically underrepresented in international studies of children with disabilities. This study, by focusing on experiences of immigrant families of children with disabilities who are navigating the Norwegian healthcare system, will generate knowledge of how accessible and tailored the services are from their point of view. Methods: This study took a qualitative approach, using semistructured interviews to explore the experiences of immigrant parents of children with disabilities from non-Western countries. The interviews were transcribed, coded, and analyzed via an inductive thematic analytic approach. Results: The findings show how the “immigrant experience” influenced the way the parents looked at, experienced, and even praised the services. The parents appreciated the follow-up services provided by the pediatric rehabilitation centers, which they experienced as predictable and well-organized. While navigating the services, they experienced several challenges, including the need for information, support, and timely help. They felt exhausted because of the years of struggle in the healthcare system to gain access to the help and services they needed. The feeling of being treated differently from the majority was another challenge they experienced while navigating the services. The findings also show how the parents’ experiences of communication with healthcare providers were influenced not only by their own language and communication skills but also by the healthcare providers’ intercultural communication skills and dominant organizational culture. Conclusions: The parents’ experiences show that there is still a gap between the public ideal of equal healthcare services and the reality of the everyday lives of immigrant families of children with disabilities. By exploring immigrant families’ experiences, this study highlights the importance of mobilization at both the individual and system levels to fill the current gap and provide tailored and accessible services to the entire population. Keywords: Immigrant families, Children with disabilities, Healthcare system.

2020 ◽  
Author(s):  
Shahrzad Arfa ◽  
Per Koren Solvang ◽  
Berit Berg ◽  
Reidun Jahnsen

Abstract • Background: Immigrants and their Norwegian-born children make up approximately 18% of the total population in Norway. While several studies have been conducted on immigrants’ utilization of healthcare services, immigrant families are systematically underrepresented in international studies of children with disabilities. By focusing on experiences of immigrant parents of children with disabilities navigating health and rehabilitation services in Norway, this study generated knowledge of how accessible and tailored the services were from their point of view. Methods: This study took a qualitative approach, using semi-structured interviews to explore the experiences of immigrant parents of children with disabilities from non-Western countries. The interviews were transcribed, coded, and analyzed via an inductive thematic analytic approach. Results: The findings show how the “immigrant experience” influenced the way the parents looked at, experienced, and even praised the services. The parents appreciated the follow-up services provided by the pediatric rehabilitation centers, which they experienced as predictable and well-organized. While navigating the services, they experienced several challenges, including the need for information, support, and timely help. They felt exhausted because of years of struggle in the healthcare system to access the help and services they needed. They expressed how this struggle had affected their own health. The feeling of being treated differently from the majority was another challenge they experienced while navigating the services. The findings also show how parents’ experiences of communication with healthcare providers were influenced not only by their own language and communication skills but also by the healthcare providers’ intercultural communication skills and dominant organizational culture. Conclusions: The parents’ experiences show that there is still a gap between the public ideal of equal healthcare services and the reality of the everyday lives of immigrant families of children with disabilities. By exploring immigrant parents’ experiences, this study highlights the importance of mobilization at both the individual and systemic levels to fill the current gap and provide tailored and accessible services to the entire population.


2020 ◽  
Author(s):  
Shahrzad Arfa ◽  
Per Koren Solvang ◽  
Berit Berg ◽  
Reidun Jahnsen

Abstract Background: Immigrants and their Norwegian-born children make up approximately 18% of the total population in Norway. While several studies have been conducted on migrants’ utilization of healthcare services, immigrant families are systematically underrepresented in international studies of children with disabilities. This study, by focusing on experiences of immigrant parents of children with disabilities who are navigating the Norwegian healthcare system in general and the pediatric rehabilitation services in particular, will generate knowledge of how accessible and tailored the services are from their point of view. Methods: This study took a qualitative approach, using semi-structured interviews to explore the experiences of immigrant parents of children with disabilities from non-Western countries. The interviews were transcribed, coded, and analyzed via an inductive thematic analytic approach. Results: The findings show how the “immigrant experience” influenced the way the parents looked at, experienced, and even praised the services. The parents appreciated the follow-up services provided by the pediatric rehabilitation centers, which they experienced as predictable and well-organized. While navigating the services, they experienced several challenges, including the need for information, support, and timely help. They felt exhausted because of the years of struggle in the healthcare system to gain access to the help and services they needed. They expressed how this struggle had affected their own health. The feeling of being treated differently from the majority was another challenge they experienced while navigating the services. The findings also show how the parents’ experiences of communication with healthcare providers were influenced not only by their own language and communication skills but also by the healthcare providers’ intercultural communication skills and dominant organizational culture. Conclusions: The parents’ experiences show that there is still a gap between the public ideal of equal healthcare services and the reality of the everyday lives of immigrant families of children with disabilities. By exploring immigrant parents’ experiences, this study highlights the importance of mobilization at both the individual and system levels to fill the current gap and provide tailored and accessible services to the entire population. Keywords: Immigrant parents, Children with disabilities, Healthcare system.


2011 ◽  
Vol 18 (4) ◽  
pp. 413-422 ◽  
Author(s):  
Diego Fornaciari ◽  
Arthur Vleugels ◽  
Stefaan Callens ◽  
Kristof Eeckloo

AbstractThe Belgian healthcare system consists of a complex of more or less autonomous groups of healthcare providers. It is the responsibility of the government to ensure that the fundamental right to qualitative healthcare is secured through the services they provide. In Belgium, the regulatory powers in healthcare are divided between the federal state and the three communities. Both levels, within their area of competence, monitor the quality of healthcare services. Unique to the Belgian healthcare system is that the government that providers are accountable to is not always the same as the government that is competent to set the criteria. The goal of this article is to provide an overview of the main mechanisms that are used by the federal government and the government of the Flemish community to monitor healthcare quality in hospitals. The Flemish community is Belgian’s largest community (6.2 million inhabitants). The overview is followed by a critical analysis of the dual system of quality monitoring.


2021 ◽  
Vol 27 (4) ◽  
pp. 267-278
Author(s):  
Somayyeh Zakerabasali ◽  
Seyed Mohammad Ayyoubzadeh ◽  
Tayebeh Baniasadi ◽  
Azita Yazdani ◽  
Shahabeddin Abhari

Objectives: Despite the growing use of mobile health (mHealth), certain barriers seem to be hindering the use of mHealth applications in healthcare. This article presents a systematic review of the literature on barriers associated with mHealth reported by healthcare professionals.Methods: This systematic review was carried out to identify studies published from January 2015 to December 2019 by searching four electronic databases (PubMed/MEDLINE, Web of Science, Embase, and Google Scholar). Studies were included if they reported perceived barriers to the adoption of mHealth from healthcare providers’ perspectives. Content analysis and categorization of barriers were performed based on a focus group discussion that explored researchers’ knowledge and experiences.Results: Among the 273 papers retrieved through the search strategy, 18 works were selected and 18 barriers were identified. The relevant barriers were categorized into three main groups: technical, individual, and healthcare system. Security and privacy concerns from the category of technical barriers, knowledge and limited literacy from the category of individual barriers, and economic and financial factors from the category of healthcare system barriers were chosen as three of the most important challenges related to the adoption of mHealth described in the included publications.Conclusions: mHealth adoption is a complex and multi-dimensional process that is widely implemented to increase access to healthcare services. However, it is influenced by various factors and barriers. Understanding the barriers to adoption of mHealth applications among providers, and engaging them in the adoption process will be important for the successful deployment of these applications.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
M. H. D. Bahaa Aldin Alhaffar ◽  
Sandor Janos

AbstractTen years of the Syrian war had a devastating effect on Syrian lives, including millions of refugees and displaced people, enormous destruction in the infrastructure, and the worst economic crisis Syria has ever faced. The health sector was hit hard by this war, up to 50% of the health facilities have been destroyed and up to 70% of the healthcare providers fled the country seeking safety, which increased the workload and mental pressure for the remaining medical staff. Five databases were searched and 438 articles were included according to the inclusion criteria, the articles were divided into categories according to the topic of the article.Through this review, the current health status of the Syrian population living inside Syria, whether under governmental or opposition control, was reviewed, and also, the health status of the Syrian refugees was examined according to each host country. Public health indicators were used to summarize and categorize the information. This research reviewed mental health, children and maternal health, oral health, non-communicable diseases, infectious diseases, occupational health, and the effect of the COVID − 19 pandemic on the Syrian healthcare system. The results of the review are irritating, as still after ten years of war and millions of refugees there is an enormous need for healthcare services, and international organization has failed to respond to those needs. The review ended with the current and future challenges facing the healthcare system, and suggestions about rebuilding the healthcare system.Through this review, the major consequences of the Syrian war on the health of the Syrian population have been reviewed and highlighted. Considerable challenges will face the future of health in Syria which require the collaboration of the health authorities to respond to the growing needs of the Syrian population. This article draws an overview about how the Syrian war affected health sector for Syrian population inside and outside Syria after ten years of war which makes it an important reference for future researchers to get the main highlight of the health sector during the Syrian crisis.


Author(s):  
Eleni Mytilinaiou ◽  
Vassiliki Koufi ◽  
Flora Matamateniou ◽  
George Vassilacopoulos

Healthcare delivery is a highly complex process involving a broad range of healthcare services, typically performed by a number of geographically distributed and organizationally disparate healthcare providers requiring increased collaboration and coordination of their activities in order to provide shared and integrated care. Under an IT-enabled, patient-centric model, health systems can integrate care delivery across the continuum of services, from prevention to follow-up, and also coordinate care across all settings. In particular, much potential can be realized if cooperation among disparate healthcare organizations is expressed in terms of cross-organizational healthcare processes, where information support is provided by means of Personal Health Record (PHR) systems. This chapter assumes a process-oriented PHR system and presents a security framework that addresses the authorization and access control issues arisen in these systems. The proposed framework ensures provision of tight, just-in-time permissions so that authorized users get access to specific objects according to the current context. These permissions are subject to continuous adjustments triggered by the changing context. Thus, the risk of compromising information integrity during task executions is reduced.


2011 ◽  
pp. 2455-2464
Author(s):  
Shawna Sando

With rising and often unreasonable costs in the U.S. healthcare system, Americans are becoming more inclined to seek cheaper alternatives. In some cases, Americans do not have to search for such alternatives on their own because their employers are offering them incentives to receive care from a foreign institution. Employees can go abroad to countries, such as India, in order to receive medical services for prices that are at least half of what the procedure would cost in the U.S. This emerging market seems to be beneficial to all involved except U.S. healthcare providers; however, this outsourcing of healthcare services sends a powerful international message. It seems that the U.S. has a healthcare system that cannot adequately serve all economic classes of the American public. In contrast, though India has the proper facilities and professionals, there are concerns regarding malpractice litigation, postoperative care, and possible negative effects on the Indian public. Having given consideration to all affected constituencies, it seems that the outsourcing of medical procedures is in the best interest of lower- and middle-class Americans as well as medical professionals in India. In reality, though medical tourism is receiving much attention, it will most likely not be a pressing concern for the American market in the near future. A widening discrepancy in the Indian public may, however, be cause for nearer concern. This new trend does foreshadow a push for more preventative changes in the business of U.S. healthcare, such as the development of information technology specific to the growing international healthcare market. Whereas, it will initially be beneficial to send patients abroad, with the evolution of technology, the latter ideal will instead be to have medical professionals abroad that care for patients located in the U.S.


Author(s):  
Shawna Sando

With rising and often unreasonable costs in the U.S. healthcare system, Americans are becoming more inclined to seek cheaper alternatives. In some cases, Americans do not have to search for such alternatives on their own because their employers are offering them incentives to receive care from a foreign institution. Employees can go abroad to countries, such as India, in order to receive medical services for prices that are at least half of what the procedure would cost in the U.S. This emerging market seems to be beneficial to all involved except U.S. healthcare providers; however, this outsourcing of healthcare services sends a powerful international message. It seems that the U.S. has a healthcare system that cannot adequately serve all economic classes of the American public. In contrast, though India has the proper facilities and professionals, there are concerns regarding malpractice litigation, postoperative care, and possible negative effects on the Indian public. Having given consideration to all affected constituencies, it seems that the outsourcing of medical procedures is in the best interest of lower- and middle-class Americans as well as medical professionals in India. In reality, though medical tourism is receiving much attention, it will most likely not be a pressing concern for the American market in the near future. A widening discrepancy in the Indian public may, however, be cause for nearer concern. This new trend does foreshadow a push for more preventative changes in the business of U.S. healthcare, such as the development of information technology specific to the growing international healthcare market. Whereas, it will initially be beneficial to send patients abroad, with the evolution of technology, the latter ideal will instead be to have medical professionals abroad that care for patients located in the U.S.


2017 ◽  
Vol 17 (1) ◽  
pp. 7-28
Author(s):  
Robert Muharremi

The paper outlines the current healthcare sector reform process in Kosovo and the challenges to its implementation. The reform attempts to introduce modern public management principles into Kosovo’s healthcare sector, including a purchaser–provider split, performance incentives, and performance-based contracting, as well as a reorganisation of healthcare service delivery with a view to improving effectiveness and efficiency. This is the first major reform of the healthcare sector since Kosovo declared independence in 2008, and it intends to replace the healthcare system established by the United Nations between 1999 and 2008. Kosovo’s earlier healthcare system had been characterised by decentralised decision-making, but was re-established by the UN in the form of an emergency healthcare system after the UN was deployed to administer Kosovo in 1999. The reform envisages separating healthcare regulators from healthcare providers and healthcare purchasers. Kosovo Hospital and University Clinical Services is established as a new entity providing healthcare services, and a new Health Insurance Fund will become the healthcare purchaser. The Ministry of Health will be restricted to the functions of a regulator, divested of all administrative functions in favour of healthcare providers and purchasers. A major challenge lies in the limited capacities of the Kosovo Government to implement such an ambitious reform. This is also an attempt to introduce modern public management principles into a public administration which is dominated by traditional public administration principles. Lack of implementation capacities and contradictory public administration principles are the most important factors that may endanger the successful implementation of the reform.


2018 ◽  
Vol 237 ◽  
pp. 108-130
Author(s):  
Armin Müller

AbstractChina's healthcare system is governed by institutions that are mutually incompatible. Although healthcare providers are supposed to offer affordable curative care services and engage in public health and administrative work, they receive insufficient financial support from the state and rely on generating informal profits and grey income. The “institutional misfit” between this public welfare mandate and medical service providers’ market orientation is particularly pronounced in the case of township health centres (THCs), a generalist type of healthcare provider with a key role in China's healthcare system. Based on fieldwork in four county-level jurisdictions, this study explores how local governments and THCs interact to cope with institutional misfit. It sheds light on a large variety of informal practices pertaining to human resources, healthcare services, drug procurement, health insurance and capital investment. Local governments deliberately neglect regulatory enforcement and collude with THCs to generate informal profits, behaviour which undermines service quality and increases healthcare costs. The study also shows that while the New Healthcare Reform altered the informal and collusive practices, it has failed to harmonize the underlying institutional misfit. To date, we see only a reconfiguration rather than an abandoning of informal practices resulting from recent healthcare reforms.


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