Providing medical care for suspected human trafficking victims: Perceptions among a cohort of health care providers in Myanmar

2020 ◽  
Author(s):  
Sybil Zachariah ◽  
Ashish Sharma ◽  
Corey B Bills ◽  
Htoo Ma (Tony) Ohn ◽  
Rebecca Walker

Abstract Background: Myanmar is a source country for men, women, and children who are subject to human trafficking and forced labor. Given that human trafficking and forced labor victims frequently experience physical and mental health concerns, healthcare practitioners have a unique opportunity to identify and assist victims. This study aims to understand the attitudes, perspectives, and levels of comfort for healthcare providers in caring for victims of human trafficking. It also seeks to understand the types of additional educational resources that could better equip medical personnel to improve care for survivors of human trafficking.Methods: A 20-question survey collected data anonymously from a convenience sample of healthcare providers that attended a one-day emergency care conference in Yangon, Myanmar.Results: While a significant number (70%) of medical professionals surveyed reported that they feel the problem of abuses for labor or sex in the community was "serious" or "very serious", a majority of them felt neutral or uncomfortable about identifying patients that are currently being abused in some way. Only 2% of respondents felt comfortable identifying victims of abuse. Over half of the healthcare workers surveyed indicated they would be interested in attending conferences, symposia, or lectures specific to human trafficking and receiving training in identifying victims and assisting victims of exploitation.Conclusions: Health care providers in Myanmar consider labor and sex trafficking as a significant problem in their community, but do not feel adequately trained to identify and help victims of exploitation. Given that even brief educational interventions can increase providers knowledge and self-reported recognition of human trafficking victims, there is a window of opportunity in Myanmar to provide training to currently practicing health providers.

Author(s):  
Kim M Unertl ◽  
Colin G Walsh ◽  
Ellen Wright Clayton

Abstract Objective Human trafficking is a global problem taking many forms, including sex and labor exploitation. Trafficking victims can be any age, although most trafficking begins when victims are adolescents. Many trafficking victims have contact with health-care providers across various health-care contexts, both for emergency and routine care. Materials and Methods We propose 4 specific areas where medical informatics can assist with combatting trafficking: screening, clinical decision support, community-facing tools, and analytics that are both descriptive and predictive. Efforts to implement health information technology interventions focused on trafficking must be carefully integrated into existing clinical work and connected to community resources to move beyond identification to provide assistance and to support trauma-informed care. Results We lay forth a research and implementation agenda to integrate human trafficking identification and intervention into routine clinical practice, supported by health information technology. Conclusions A sociotechnical systems approach is recommended to ensure interventions address the complex issues involved in assisting victims of human trafficking.


2019 ◽  
Vol 31 (2) ◽  
pp. 131

In Myanmar, the main challenge to provide quality healthcare by Universal Health Care approach is documented as low health services coverage with substantial wealth-based inequality. To achieve the effective health care system, strong medical care system is essential. Understanding on challenges and needs in provision of medical services among patients and health care providers is critical to provide quality care with desirable outcomes. The aim of the study was to explore the patients’ and health care providers’ perceptions on the challenges in provision of medical services at the Mandalay General Hospital. This was a qualitative study conducted at the tertiary level hospital (Mandalay General Hospital). The data was collected by using focus group discussions and in-depth interviews with hospitalized patients or attendants, healthcare providers such as medical doctors, nurses, laboratory scientists and hospital administrators in March 2017. The qualitative data was analyzed using themes by themes matrix analysis. Most patients were satisfied with the care provided by the doctors because they believed that they received quality care. However, some patients complained about long waiting time for elective operation, congested conditions in the ward, burden for investigations outside the hospital for urgent needs and impolite manners of general workers. Healthcare providers reported that they had heavy workload due to limited human and financial resources in the hospital, poor compliances with hospital rules and regulation among patients and attendants, and inefficient referral practices from other health facilities. Other challenges experienced by healthcare providers were lack of ongoing training to improve knowledge and skills, limited health infrastructure and inadequate medicinal supplies. The findings highlighted the areas needed to be improved to provide quality health care at the tertiary level hospital. The challenges and problems encountered in this hospital can be improved by allocating adequate financial and human resources. The systematic referral system and hospital management guidelines are needed to reduce workload of health staff.


2009 ◽  
Vol 16 (3) ◽  
pp. 148-154 ◽  
Author(s):  
CA Graham ◽  
WO Kwok ◽  
YL Tsang ◽  
TH Rainer

Objective To explore why patients in Hong Kong seek medical advice from the emergency department (ED) and to identify the methods by which patients would prefer to be updated on the likely waiting time for medical consultation in the ED. Methods The study recruited 249 semi-urgent and non-urgent patients in the ED of Prince of Wales Hospital from 26th September 2005 to 30th September 2005 inclusive. A convenience sample of subjects aged ≥15 years old in triage categories 4 or 5 were verbally consented and interviewed by research nurses using a standardized questionnaire. Results From 1715 potential patients, 249 were recruited ad hoc (mean age 44 years [SD18]; 123 females). About 63% indicated that an acceptable ED waiting time was less than or equal to two hours, and 88% felt that having individual number cards and using a number allocation screen in the ED waiting area would be useful. Perceived reasons for attending the ED rather than other health care providers such as primary health care or the general outpatient clinic (GOPC) included: a desire for more detailed investigations (56%); a perception that more professional medical advice was given in the ED (35%); patients were under the continuing care of the hospital (19%); and patients were referred to the ED by other health care professionals (11%). Notably, 26% of participants had considered attending the GOPC prior to attending the ED. Patients educated to tertiary level expected a shorter waiting time than those educated to lesser degrees (p=0.026, Kruskal-Wallis test). Suggestions were made on how to provide a more pleasant ED environment for the wait for consultations, which included the provision of a television screen with sound in the waiting area (43%), more comfortable chairs (37%) and health care promotion programs (32%). Conclusion Patients chose ED services because they believed they would receive more detailed investigations and more professional medical advice than available alternatives. Clear notification of the likely waiting times and enhancement of comfort before consultation are considered desirable by patients. Enhanced public education about the role of the ED and making alternatives to ED care more accessible may be useful in reducing inappropriate ED attendances in Hong Kong.


2017 ◽  
Vol 11 (4) ◽  
pp. 910-919 ◽  
Author(s):  
Carrie Lee ◽  
John L. Oliffe ◽  
Mary T. Kelly ◽  
Olivier Ferlatte

Gay men are a subgroup vulnerable to depression and suicidality. The prevalence of depression among gay men is three times higher than the general adult population. Because depression is a known risk factor for suicide, gay men are also at high risk for suicidality. Despite the high prevalence of depression and suicidality, health researchers and health care providers have tended to focus on sexual health issues, most often human immunodeficiency virus in gay men. Related to this, gay men’s health has often been defined by sexual practices, and poorly understood are the intersections of gay men’s physical and mental health with social determinants of health including ethnicity, locale, education level, and socioeconomic status. In the current article summated is literature addressing risk factors for depression and suicidality among gay men including family acceptance of their sexual identities, social cohesion and belonging, internalized stigma, and victimization. Barriers to gay men’s help seeking are also discussed in detailing how health care providers might advance the well-being of this underserved subgroup by effectively addressing depression and suicidality.


2013 ◽  
Vol 3 (2) ◽  
pp. 154-159
Author(s):  
Janet Perkins ◽  
Aminata Bargo ◽  
Cecilia Capello ◽  
Carlo Santarelli

Assuring the provision of person-centred care is critical in maternal and newborn health (MNH). As a component of the national strategy to improve MNH, Burkina Faso Ministry of Health, supported by Enfants du Monde, La Fondation pour le Développement Communautaire/Burkina Faso and UNFPA, is implementing the World Health Organization’s (WHO) framework for Working with Individuals, Families and Communities (IFC) to improve MNH. As a first step in district implementation, participatory community assessments were conducted. These assessments consistently revealed that poor interactions with healthcare providers posed one important barrier preventing women from seeking MNH services. In order to address this barrier, healthcare providers were trained to improve their interpersonal skills and in counselling women. During 2011-12 a total of 175 personnel were trained over a 5-day course developed using a WHO manual. The course was met with enthusiasm as providers expressed their need and desire for such training. Immediate post-test results revealed an impressive increase in knowledge and anecdotal evidence suggests that training has influenced provider’s behaviours in their interactions with women. In addition, health care providers are taking concrete action to build the capabilities of women to experience pregnancy and birth safely by engaging directly with communities.  While early findings are promising, an evaluation will be necessary to measure how the training has influenced practices, whether this translates into a shift of perceptions at community level and ultimately its contribution toward promoting person-centred care in Burkina Faso.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242604
Author(s):  
Marian Loveday ◽  
Sindisiwe Hlangu ◽  
Jennifer Furin

Background There are few data on the on the care experiences of pregnant women with rifampicin-resistant TB. Objective To describe the treatment journeys of pregnant women with RR-TB—including how their care experiences shape their identities—and identify areas in which tailored interventions are needed. Methods In this qualitative study in-depth interviews were conducted among a convenience sample from a population of pregnant women receiving treatment for RR-TB. This paper follows COREQ guidelines. A thematic network analysis using an inductive approach was performed to analyze the interview transcripts and notes. The analysis was iterative and a coding system developed which focused on the care experiences of the women and how these experiences affected their perceptions of themselves, their children, and the health care system in which treatment was received. Results Seventeen women were interviewed. The women described multiple challenges in their treatment journeys which required them to demonstrate sustained resilience (i.e. to “be brave”). Care experiences required them to negotiate seemingly contradictory identities as both new mothers—“givers of life”—and RR-TB patients facing a complicated and potentially deadly disease. In terms of their “pregnancy identity” and “RR-TB patient identity” that emerged as part of their care experiences, four key themes were identified that appeared to have elements that were contradictory to one another (contradictory areas). These included: 1) the experience of physical symptoms or changes; 2) the experience of the “mothering” and “patient” roles; 3) the experience of the care they received for their pregnancy and their RR-TB; and 4) the experience of community engagement. There were also three areas that overlapped with both roles and during which identity was negotiated/reinforced and they included: 1) faith; 2) socioeconomic issues; and 3) long-term concerns over the child’s health. At times, the health care system exacerbated these challenges as the women were not given the support they needed by health care providers who were ill-informed or angry and treated the women in a discriminatory fashion. Left to negotiate this confusing time period, the women turned to faith, their own mothers, and the fathers of their unborn children. Conclusion The care experiences of the women who participated in this study highlight several gaps in the current health care system that must be better addressed in both TB and perinatal services in order to improve the therapeutic journeys for pregnant women with RR-TB and their children. Suggestions for optimizing care include the provision of integrated services, including specialized counseling as well as training for health care providers; engagement of peer support networks; provision of socioeconomic support; long-term medical care/follow-up for children born to women who were treated for RR-TB; and inclusion of faith-based services in the provision of care.


2021 ◽  
Author(s):  
Ismat Babiker ◽  
Mohamed K. Elnaeim ◽  
Awab K.Elnaeim

Abstract Objective: the objective of this study was to assess the awareness of the community in Sudan of which seizure type(s) should present to health care providers.Methods: This is a cross-sectional descriptive internet-based survey that was conducted in Sudan during the period from January to April 2018, using google forms. The survey consisted of demographic data (age, gender, educational level), a statement evaluating participants’ sources of obtaining information regarding epilepsy, a statement assessing awareness about the primary care provider for people with epilepsy (PWE), and a statement describing the symptomatology of different seizure types in simple Arabic, asking what description(s) participants thought should present to health care providers. We included participants residing in Sudan, and those with a college degree or higher education. Four hundred sixty-seven participants completed the survey.Results: 467 participants were included, of whom, 279 (60%) were females. The mean age of participants was 28 years. Two-thirds of participants obtained their information from non-scientific sources. 84% of the participants were aware that doctors are the primary health care providers for people with epilepsy.The majority (92.%) of participants were aware that patients with symptoms corresponding to the generalized tonic-clonic seizure description should present to doctors, compared with two-thirds of participants for focal seizure symptom description, and only 30.6 % of participants for absence seizure symptom description.Conclusion: This study demonstrated poor awareness about the necessity of presentation for focal and absence seizures. We hypothesize that this lack of awareness may contribute to the epilepsy treatment gap, and we recommend further studies to examine this hypothesis.


2021 ◽  
Vol 22 (3) ◽  
pp. 312-321
Author(s):  
J. Tonui ◽  
W. Chepkutto ◽  
J. Rotich

Coronavirus disease 2019 (COVID-19) pandemic began in December 2019 in Wuhan City China where it is believed to have been transmitted to humans from an unknown animal species. The public health, social and economic impact of the pandemic world over is detrimental. Health care providers at the frontline in the fight against COVID-19 are at the greatest risk of infection and so far, many have been infected and some have already died from the disease. Thus, it is imperative that healthcare providers have adequate knowledge of infectious diseases and microbial pathogens to comprehend the scale of risk for better recognition and response. Microbiological concepts of infection prevention and control, hand hygiene and aseptic techniques are essential in slowing down the spread of the virus. COVID-19 has proven that infectious agents can emerge from any region in the world and can spread rapidly with ominous consequences to all humanity. This narrative review discusses the role of college-learnt microbiology in health care provider preparedness for emerging infectious diseases in light of the current pandemic. Keywords: Emerging; Infections; Preparedness; Response; Microbiology; COVID-19; Training


Sign in / Sign up

Export Citation Format

Share Document