Not a Problem at All or Excluded by Oneself, Doctors and the Law? Healthcare Workers’ Perspectives on Access to HIV-Related Healthcare Among Same-Sex Attracted Men in Tanzania

2021 ◽  
Author(s):  
Alexander Ishungisa Mwijage ◽  
Mucho Michael Mizinduko ◽  
Samuel Lazarus Likindikoki ◽  
Dan Dan Wolf Meyrowitsch ◽  
Elia John Mmbaga ◽  
...  
Keyword(s):  
Focus Group ◽  
Work Experience ◽  
Healthcare Workers ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Structural Barriers ◽  
Same Sex ◽  
Focus Group Discussions ◽  
Group Discussions

Abstract Background: Same-sex attracted men in Tanzania are disproportionately affected by HIV. Drawing on qualitative research, the present study explores healthcare providers’ perspectives on access to HIV-related healthcare services among same-sex attracted men. Methods: A qualitative study was carried out among healthcare workers in in the cities of Dar es Salaam and Tanga in Tanzania between August 2018 and October 2019. Fieldwork entailed qualitative interviewing, focus group discussions and participant observation. A purposive sampling strategy was used to select study participants who varied with respect to age, education level, work experience, and the type and location of the facilities they worked in. Twenty-four interviews and six focus group discussions were conducted.Results: This paper describes four different discourses that were identified among healthcare workers with respect to their perception of access to healthcare services for SSAM. One held that access to healthcare was not a major problem at all, another that some SSAM did not utilize healthcare services although they were available, a third that some healthcare workers prevented SSAM from gaining access to healthcare and a fourth that healthcare for gender and sexual minority persons was made difficult by structural barriers. Conclusion: Although these are four rather different takes on the prevailing circumstances with respect to healthcare access for SSAM, we suggest that they may all be ‘true’ in the sense that they grasp and highlight different aspects of the same realities.

scholarly journals Qualitative exploration of sociocultural determinants of health inequities of Dalit population in Dhaka City, Bangladesh

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e022906 ◽  
Author(s):  
Ashraful Kabir ◽  
Mathilde Rose Louise Maitrot ◽  
Ahsan Ali ◽  
Nadia Farhana ◽  
Bart Criel
Keyword(s):  
Health Status ◽  
Focus Group ◽  
Health Inequalities ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Dhaka City ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Key Informant ◽  
Depth Interviews

ObjectivesIn recent years, Bangladesh has made remarkable advances in health outcomes; however, the benefits of these gains are unequally shared among citizens and population groups. Dalits (jaatsweepers), a marginalised traditional working community, have relatively poor access to healthcare services. This study sought to explore the sociopolitical and cultural factors associated with health inequalities among Dalits in an urban setting.DesignAn exploratory qualitative study design was adopted. Fourteen in-depth interviews, five focus group discussions and seven key informant interviews were conducted. The acquired data were analysed using an iterative approach which incorporated deductive and inductive methods in identifying codes and themes.SettingsThis study was conducted in two sweeper communities in Dhaka city.ParticipantsParticipants were Dalit men and women (in-depth interviews, mean age±SD 30±10; and focus group discussions), and the community leaders and non-governmental organisation workers (key informant interviews).ResultsThe health status of members of these Dalit groups is determined by an array of social, economic and political factors. Dalits (untouchables) are typically considered to fall outside the caste-based social structure and existing vulnerabilities are embedded and reinforced by this identity. Dalits’ experience of precarious access to healthcare or poor healthcare is an important manifestation of these inequalities and has implications for the economic and social life of Dalit populations living together in geographically constrained spaces.ConclusionsThe provision of clinical healthcare services alone is insufficient to mitigate the negative effects of discriminations and to improve the health status of Dalits. A better understanding of the precise influences of sociocultural determinants of health inequalities is needed, together with the identification of the strategies and programmes needed to address these determinants with the aim of developing more inclusive health service delivery systems.

scholarly journals ‘Sometimes you are forced to play God…’: a qualitative study of healthcare worker experiences of using continuous positive airway pressure in newborn care in Kenya

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e034668
Author(s):  
Helen M Nabwera ◽  
Jemma L Wright ◽  
Manasi Patil ◽  
Fiona Dickinson ◽  
Pamela Godia ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Focus Group ◽  
Airway Pressure ◽  
Healthcare Workers ◽  
Positive Airway Pressure ◽  
Scale Up ◽  
Newborn Care ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Key Informant

​ObjectiveTo explore the experiences of using continuous positive airway pressure (CPAP) in newborn care among healthcare workers in Kenya, and to identify factors that would promote successful scale-up.​Design and settingA qualitative study using key informant interviews and focus group discussions, based at secondary and tertiary level hospitals in Kenya.​ParticipantsHealthcare workers in the newborn units providing CPAP.​Primary and secondary outcome measureFacilitators and barriers of CPAP use in newborn care in Kenya.​Results16 key informant interviews and 15 focus group discussions were conducted across 19 hospitals from September 2017 to February 2018. Main barriers reported were: (1) inadequate infrastructure to support the effective delivery of CPAP, (2) shortage of skilled staff rendering it difficult for the available staff to initiate or monitor infants on CPAP and (3) inadequate knowledge and training of staff that inhibited the safe care of infants on CPAP. Key facilitators reported were positive patient outcomes after CPAP use that increased staff confidence and partnership with caregivers in the management of newborns on CPAP. Healthcare workers in private/mission hospitals had more positive experiences of using CPAP in newborn care as the relevant support and infrastructure were available.​ConclusionCPAP use in newborn care is valued by healthcare workers in Kenya. However, we identified key challenges that threaten its safe use and sustainability. Further scale-up of CPAP in newborn care should ensure that staff members have ready access to optimal training on CPAP and that there are enough resources and infrastructure to support its use.EthicsThis study was approved through the appropriate ethics committees in Kenya and the UK (see in text) with written informed consent for each participant.

scholarly journals From chaos to control – experiences of healthcare workers during the early phase of the COVID-19 pandemic: a focus group study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fredrik Rücker ◽  
Maria Hårdstedt ◽  
Sekai Chenai Mathabire Rücker ◽  
Emma Aspelin ◽  
Alexander Smirnoff ◽  
...  
Keyword(s):  
Content Analysis ◽  
Focus Group ◽  
Healthcare Workers ◽  
Qualitative Content Analysis ◽  
Working Environment ◽  
Infection Prevention And Control ◽  
Hospital Inpatient ◽  
Work Situation ◽  
Focus Group Discussions ◽  
Group Discussions

Abstract Background The Coronavirus disease 2019 (COVID-19) pandemic has caused overwhelming challenges to healthcare systems worldwide. Healthcare workers (HCWs) have faced particular challenges: being exposed to the coronavirus SARS-CoV-2 and caring for patients having a new and potentially life-threatening disease. The aim of this study was to explore how HCWs in the Swedish healthcare system perceived their work situation during the first phase of the COVID-19 pandemic in 2020. Methods Focus group discussions and interviews with HCWs were performed from June to October 2020 in one Swedish healthcare region. A purposeful sampling approach was used to select a variety of professions (physicians, nurses, nurse aides and cleaners) and workplaces (hospital inpatient wards, emergency department, nursing home and home care service). Qualitative content analysis was used for data analysis. Results In total, 51 HCWs participated in eight focus group discussions and one HCW participated in an individual interview. The content analysis identified two main categories: ‘Concerns about the risk of infection and transmission of infection to others’, and ‘Transition from chaos to managing in a new and challenging work situation’. The findings revealed how HCWs perceived working conditions, including experiences of fear for personal health, confusion and uncertainty regarding personal protective equipment and infection prevention and control (PPE/IPC), and fear of infecting others. Both fearful and appreciating attitudes were achieved from the surrounding community. Helpful strategies for transition from chaos to control were lifted i.e. present and supportive leadership, and finding comfort and strength in the working team. Both helplessness and meaningfulness were described when caring for COVID-19 patients. Conclusions This study provides unique insights into HCWs experiences of an extremely challenging work situation during the first phase of the COVID-19 pandemic, including feelings of stress and insecurity in a chaotic and hazardous working environment. But there is also mitigation of these challenges and even positive experiences including feelings of safety and meaningfulness. To enhance safety among HCWs in healthcare crises such as the COVID-19 pandemic, the findings highlight the importance of avoiding confusion about PPE/IPC, having a supportive healthcare leadership and ensuring accurate information provision about virus transmission to the public.

scholarly journals “It builds your confidence… you’ve done well”: Healthcare workers’ experiences of participating in a low-dose, high-frequency training to improve newborn survival on the day of birth in Ghana

2019 ◽  
Vol 3 ◽  
pp. 1470
Author(s):  
Amos Asiedu ◽  
Allyson R. Nelson ◽  
Patricia P. Gomez ◽  
Hannah Tappis ◽  
Fred Effah ◽  
...  
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
High Frequency ◽  
Healthcare Workers ◽  
Low Dose ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Training Approach ◽  
Depth Interviews ◽  
Maternal And Newborn

Background: The majority of newborn deaths occur during the first week of life, and 25‒45% occur within the first 24 hours. A low-dose, high-frequency (LDHF) training approach was introduced in 40 hospitals in Ghana to improve newborn survival. The aim of this qualitative study was to explore healthcare workers’ experiences with the LDHF approach to in-service training. Methods: A total of 20 in-depth interviews and nine focus group discussions were conducted in 2016 in three regions of Ghana with healthcare workers who participated in implementation of the LDHF training approach. In-depth interviews were conducted with 20 master mentors and peer practice coordinators; 51 practicing doctors, midwives and nurses participated in focus group discussions. Data were analyzed using a thematic analysis approach. Results: Healthcare workers reflected on the differences between the LDHF approach and past learning experiences, highlighting how the skills-based team training approach, coupled with high-frequency practice and mobile mentoring, built their competency and confidence. As participants shared their experiences, they highlighted relationships established between Master Mentors and healthcare workers, and motivation stemming from pride in contributing to reductions in maternal and newborn deaths as critical factors in improving quality of care at participating health facilities. Conclusion: This nested qualitative study documents experiences of healthcare workers and mentors involved in implementation of a multi-faceted intervention that effectively improved maternal and newborn care at health facilities in Ghana. The way the intervention was implemented created an environment conducive to learning within the hospital setting, thus providing an opportunity for professional growth and quality improvement for all staff working in the maternity ward.

scholarly journals Opportunities for improving patient experiences among medical travellers from Canada’s far north: a mixed-methods study

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e030885 ◽  
Author(s):  
Kate Kerber ◽  
Fariba Kolahdooz ◽  
Meeka Otway ◽  
Melinda Laboucan ◽  
Se Lim Jang ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Cultural Awareness ◽  
Health Workers ◽  
Patient Experiences ◽  
Access To Healthcare ◽  
Community Advisory Board ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Key Informant

ObjectivesThis paper explores patient experiences and identifies barriers and opportunities for improving access to healthcare for patients from the Canadian north who travel to receive medical care in a Southern province.DesignA mixed-methods, cross-sectional study involved one-on-one interviews, focus group discussions and key informant interviews.Participants52 one-on-one interviews with Northwest Territories (NWT) patients and patient escorts and two focus group discussions (n=10). Fourteen key informant interviews were conducted with health workers, programme managers and staff of community organisations providing services for out-of-province patients. A Community Advisory Board guided the development of the questionnaires and interpretation of results.ResultsRespondents were satisfied with the care received overall, but described unnecessary burdens and bureaucratic challenges throughout the travel process. Themes relating to access to healthcare included: plans and logistics for travel; level of communication between services; clarity around jurisdiction and responsibility for care; indirect costs of travel and direct costs of uninsured services; and having a patient escort or advocate available to assist with appointments and navigate the system. Three themes related to healthcare experiences included: cultural awareness, respect and caring, and medical translation. Respondents provided suggestions to improve access to care.ConclusionsPatients from NWT need more information and support before and during travel. Ensuring that medical travellers and escorts are prepared before departing, that healthcare providers engage in culturally appropriate communication and connecting travellers to support services on arrival have the potential to improve medical travel experiences.

scholarly journals SUNAT PEREMPUAN DALAM PERSPEKTIF BUDAYA, AGAMA DAN KESEHATAN (STUDI KASUS DI MASYARAKAT DESA BADDUI KECAMATAN GALESONG KABUPATEN TAKALAR SULAWESI SELATAN)

2016 ◽  
Vol 11 (2) ◽  
pp. 103-111
Author(s):  
Islamiyatur Rokhmah ◽  
Umu Hani Edi Nawangsih
Keyword(s):  
Focus Group ◽  
Data Reduction ◽  
Healthcare Workers ◽  
Qualitative Method ◽  
Female Circumcision ◽  
Focus Group Discussions ◽  
Religion And Health ◽  
Group Discussions ◽  
Depth Interviews

This study aimed to obtain information about the process circumcision women, the influence of tradition and religion as well as the views of healthcare workers wearing sunat women in rural sub-district Baddui Galesong Takalar. This study uses a qualitative method, the retrieval of data using in-depth interviews and Focus Group Discussions (FGD). Analysis of the data by means of descriptive steps: data reduction, categorization and analysis-interpretation. The study showed villagers Bodia still believe that female circumcision should be done. This is influenced by factors of cultural and religious interpretations. If seen the female circumcision is still not sterile and harmful to women's reproductive health.Keywords: female circumcision, culture, religion and health perspective

scholarly journals Stakeholders’ Perceptions on Shortage of Healthcare Workers in Primary Healthcare in Botswana: Focus Group Discussions

PLoS ONE ◽  
2015 ◽  
Vol 10 (8) ◽  
pp. e0135846 ◽  
Author(s):  
Oathokwa Nkomazana ◽  
Robert Mash ◽  
Sheila Shaibu ◽  
Nthabiseng Phaladze
Keyword(s):  
Focus Group ◽  
Primary Healthcare ◽  
Healthcare Workers ◽  
Focus Group Discussions ◽  
Group Discussions

scholarly journals Social-Ecological Barriers to Access to Healthcare for Adolescents: A Scoping Review

2021 ◽  
Vol 18 (8) ◽  
pp. 4138
Author(s):  
Whitney Garney ◽  
Kelly Wilson ◽  
Kobi V. Ajayi ◽  
Sonya Panjwani ◽  
Skylar M. Love ◽  
...  
Keyword(s):  
United States ◽  
Scoping Review ◽  
Healthcare Access ◽  
Insurance Coverage ◽  
Healthcare Services ◽  
The United States ◽  
Access To Healthcare ◽  
Structural Barriers ◽  
Social Ecological ◽  
Ecological Barriers

Access to healthcare for adolescents is often overlooked in the United States due to federal and state-sponsored insurance programs such as Medicaid and the Children’s Health Insurance Program. While these types of programs provide some relief, the issue of healthcare access goes beyond insurance coverage and includes an array of ecological factors that hinder youths from receiving services. The purpose of this scoping review was to identify social-ecological barriers to adolescents’ healthcare access and utilization in the United States. We followed the PRISMA and scoping review methodological framework to conduct a comprehensive literature search in eight electronic databases for peer-reviewed articles published between 2010 and 2020. An inductive content analysis was performed to thematize the categories identified in the data extraction based on the Social-Ecological Model (SEM). Fifty studies were identified. Barriers across the five SEM levels emerged as primary themes within the literature, including intrapersonal-limited knowledge of and poor previous experiences with healthcare services, interpersonal-cultural and linguistic barriers, organizational-structural barriers in healthcare systems, community-social stigma, and policy-inadequate insurance coverage. Healthcare access for adolescents is a systems-level problem requiring a multifaceted approach that considers complex and adaptive behaviors.

Dari Idealisme ke Pragmatisme: Pergeseran Paradigma dalam Pengembangan Hukum Ekonomi Syariah di Indonesia

2020 ◽  
Vol 14 (2) ◽  
pp. 191-210
Author(s):  
Addiarrahman Addiarrahman ◽  
Illy Yanti
Keyword(s):  
Focus Group ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Business World ◽  
Key Informants ◽  
The Public ◽  
Financial Products ◽  
Legal Consideration ◽  
Economic Law ◽  
Islamic Economic

This study seeks to understand the pragmatism of the development of sharia economic law, and its implications for Islamic financial products in Indonesia. The data comes from the results of interviews and focus group discussions with key informants from academics, practitioners, authorities, and the public. This research finds that pragmatism in the development of Islamic economic law is an approach that still dominates the DSN-MUI fatwas. The pragmatism style used is complex-eclectic pragmatism which is represented through makhārij al-fiqhiyyah, which is to choose a mild opinion by sticking to the strongest method or also called "taysīr al-manhajī". The use of this method is intended to ensure that the fatwa is truly able to answer the needs of the business world, as well as being in line with sharia principles. DSN-MUI also does not use maslahah as a legal consideration in a free or liberal way. Rather, it returns maslahah in consideration of the method, so that it is permissible to use the bay’ al-'inān contract only in a forced state (ḍarurah).

scholarly journals “Stages of change, smoking behavior and acceptability of a textmessaging intervention for tobacco cessation among cigarette, dokha and shishasmokers: A qualitative research study.”

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029144 ◽  
Author(s):  
Yusra Elhidaia Elobaid ◽  
Andrea Leinberger Jabari ◽  
Aisha Al Hamiz ◽  
Abdul Rizzak Al Kaddour ◽  
Sherif Bakir ◽  
...  
Keyword(s):  
Qualitative Research ◽  
Smoking Cessation ◽  
Focus Group ◽  
United Arab Emirates ◽  
Text Messaging ◽  
Tobacco Cessation ◽  
Text Messages ◽  
Controlled Study ◽  
Focus Group Discussions ◽  
Group Discussions

ObjectivesTo explore: (A) the underlying motivators and barriers to smoking cessation among young Arabic speaking smokers and (B) to examine the suitability and preferences for tobacco cessation interventions (specifically text messages) and study the possibility of enrollment methods for a randomised controlled study using text messages as an intervention for tobacco cessation.DesignQualitative research using focus group discussions and content analysis.Setting(s)Two universities, one of them is the first and foremost comprehensive national university in the United Arab Emirates (UAE). The third setting is the largest hospital in the UAE and the flagship institution for the public health system in the emirate of Abu Dhabi.ParticipantsSix focus group discussions with a total of 57 participants. Forty-seven men and 10 women. Fifty-three of them were current smokers.ResultsThe analysis of six focus groups was carried out. Main themes arose from the data included: preferences for tobacco cessation interventions and acceptability and feasibility of text messaging as tobacco cessation intervention. Different motives and barriers for quitting smoking including shisha and dokha were explored.ConclusionInterventions using text messaging for smoking cessation have not been used in the Middle East and they could potentially be effective; however, tailoring and closely examining the content and acceptability of text messages to be used is important before the conduction of trials involving their use. Social media is perceived to be more effective and influential, with a higher level of penetration into communities of young smokers.

Sign in / Sign up

Export Citation Format

Share Document