scholarly journals The Role of Economic Factors in the Choice of Medical Providers in Rwanda

2016 ◽  
Vol 8 (2(J)) ◽  
pp. 65-78
Author(s):  
Charles Mulindabigwi Ruhara ◽  
Josue Mbonigaba
Keyword(s):  
Health Care ◽  
Health Services ◽  
Low Income ◽  
Service Providers ◽  
Care Facility ◽  
Health Facilities ◽  
Economic Factors ◽  
Financial Barriers ◽  
Use Of Health Services

The purpose of this paper is to investigate the role of economic factors in choosing alternative service providers and to recommend suitable measures that could be taken to improve the use of health services in Rwanda. The study uses a multinomial logit framework and employs the Integrated Household Living Conditions Survey (EICV2) conducted in 2005 by the National Institute of Statistics of Rwanda (NISR). To handle the problem of endogeneity, we estimate a structural model. The results indicate that health insurance is an important factor in the choice of health facilities. User fees are major financial barriers to health care access in Rwanda. The results suggest that as household income increases, patients shift from public to private health facilities where quality is assumed to be high. A number of policy recommendations emerge from these findings. First, as insurance is an important factor in choosing a health care facility, policies that reduce health care costs to patients would substantially increase the use of health services. Second, since an increase in income allows the patient to shift to private facilities, the government should consider subsidizing private health facilities to enable access to care in private sector facilities by low-income households. Finally, since distance affects access to health care in Rwanda, there is a need to improve geographical accessibility to health facilities across regions by upgrading and expanding transportation and health infrastructures.

scholarly journals An overview of the role of government in the organisation and provision of health services in Japan

1996 ◽  
Vol 19 (2) ◽  
pp. 75 ◽  
Author(s):  
Christopher Walker
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Private Sector ◽  
Service Providers ◽  
Care Delivery ◽  
Insurance Coverage ◽  
Role Of Government ◽  
Australian Health

This article is illustrated with reference to health services in the Tokyo Prefecture.It seeks to describe the role of government in the organisation and provision of healthservices in Japan. It is based on experiences gained from a three-month placementat the Tokyo Metropolitan Government Bureau of Public Health in late 1994.Wherever possible the article identifies similarities and differences between theJapanese and Australian health care systems. Part of the analysis has been to identifyareas where opportunities exist for Australian health service providers to developfurther cooperation with particular sectors of the Japanese health system and alsowhere the potential for the export of health services may exist.The health systems of Australia and Japan have points of similarity anddifference. Essentially both systems operate within the context of a compulsoryuniversal health insurance system. However, unlike Australia, the bulk of serviceprovision in Japan is left to the private sector, while government retains the primaryrole of regulator. It is interesting to observe that while the Australian health caresystem is currently exploring options to expand the service range and level ofparticipation of private sector services in health care delivery (within the context ofuniversal health insurance), the Japanese health care system appears to be examiningoptions through which further government intervention can improve service accessand service efficiency. Japan presents opportunities to observe the benefits anddisadvantages of predominantly private sector provision within the context ofuniversal health insurance coverage.

Health-seeking cultural patterns in the use of available healthcare services among refugee groups in south-central Kentucky

2020 ◽  
Vol 16 (1) ◽  
pp. 12-21
Author(s):  
Chika Ejike ◽  
Grace Lartey ◽  
Randy Capps ◽  
David Ciochetty
Keyword(s):  
Health Care ◽  
Health Services ◽  
Care Facility ◽  
Well Being ◽  
Healthcare Services ◽  
Health Seeking ◽  
Content Type ◽  
Refugee Population ◽  
South Central ◽  
Use Of Health Services

Purpose Refugees resettle in the USA every year to escape genocide, famine, civil wars and crises in their countries. The diverse cultural identities of the refugee population in south-central Kentucky make it essential to research into their health-care usage patterns. The purpose of this study is to examine the health-seeking patterns of refugees in relation to their culture and the usage of available health services. Design/methodology/approach This is a descriptive correlational study that culled 110 refugees who completed self-administered or interviewer-administered semi-structured questionnaires. Questionnaires were translated into four different languages. T-tests and ANOVA assessed differences between variables. Findings Findings indicate that a demographic factor such as refugees’ nationality plays a role in both the access and use of health services [F (5, 98) = 4.29, p < 0.001]. Refugees’ beliefs and social factors such as acculturation (t = −2.03, p < 0.04) and having health insurance (t = −3.35, p <0.001) also affect the use of health services. The level of cultural competency of the health-care facility or provider as depicted by the presence of interpreters (t = 1.92, p < 0.05) was associated with increased use of the health services provided. Research limitations/implications The sample of refugees is only representative of the general refugee population in south-central Kentucky; hence, there is inadequate generalization. Originality/value Cultural diversity should be included in the health and policymaking debates that surround the refugee population of south-central Kentucky to ensure their well-being.

scholarly journals Factors Affecting Interests of Adolescent Visit in Poly PKPR (Health Care Service) Public Health Gondang Legi Malang District

2020 ◽  
Vol 4 (1) ◽  
pp. 78-85
Author(s):  
Evi Kurniawati ◽  
Nurwijayanti Nurwijayanti ◽  
Agusta Dian Ellina
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Health Center ◽  
Service Providers ◽  
Health Workers ◽  
Youth Care ◽  
Care Health ◽  
Return Visits

A person's interest in services is related to the ability of these service providers to provide care. Interest in adolescents to take advantage of adolescent health care services is influenced by several factors, including perceptions, peers and the role of health workers in the service at puskesmas. The purpose of this study was to analyze the factors that influence the interest of teenage return visits at the PKPR (Youth Caring Health Services) Gondang Legi Health Center in Malang Regency. The design of this study was an observational quantitative study with a cross sectional approach with the focus of the research directed to be analyzing perceptions, the role of peers and the role of health workers on the interest of teenage return visits at the PKPR (Youth Care Health Services) Gondang Legi Public Health Center Malang Regency with a population of 167 respondents and a sample of 113 respondents taken by accidental sampling technique. The findings found that the majority of respondents had less categories of perception as many as 57 respondents (50.4%). In addition, the majority of respondents had the role of less peer categories of 45 respondents (51.3%). In addition, most respondents had the role of health workers in the good category of 59 respondents (52.2%). While the majority of respondents had a high interest category of 62 respondents (54.9%). The results of the study using the Logistic Regression Test showed that a p-value of 0,000 <0.05 then H1 was accepted so it was concluded that there was simultaneously the influence of perception, the role of peers and the role of health workers on the interest of teenage returnees in the PKPR (Youth Care Health Services) ) Gondang Legi Health Center in Malang Regency. The perspective of the patient regarding the available health services raises their perceptions. All friends will make an impact on individuals. And the provision of special services to adolescents through special treatment tailored to the desires, tastes and needs of adolescents has not been implemented

scholarly journals Women who have sex with women’s experiences with healthcare system in low-income countries: qualitative findings from Dar-es-Salaam, Tanzania

2021 ◽  
Vol 2 (3) ◽  
pp. 142-145
Author(s):  
Happiness P. Saronga ◽  
Jackline V. Mbishi ◽  
Saidah S. Bakar ◽  
Switbert R. Kamazima
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Health Care Providers ◽  
Low Income ◽  
Dar Es Salaam ◽  
Health Facilities ◽  
Low Income Countries ◽  
Care Providers ◽  
Public Health Facilities

Introduction: Women who have sex with women (WSW) have a right to access health care. Many studies have reported lower access to health services by sexual minorities in many parts of the world. This study explored WSW’s experiences in accessing health care in Tanzania with the intention of determining specific issues facing WSW when accessing health care services. Methods: This study was cross-sectional descriptive, and retrospective conduced in Dar-es-Salaam region, the largest commercial city in Tanzania. Study population included WSW aged 18 years and above who met inclusion criteria. Data was collected using focus group discussions (FGDs), in-depth interviews (IDIs), observation, and life stories. Data analysis applied thematic analysis. Results: Most WSW receive rightful health services from public and private health providers. However, transgender WSW face stigma, discrimination, and disrespect from some public health facilities. Private health care providers offer trust, privacy and confidentiality to WSW, although at a higher cost of services compared to public health facilities. Conclusion: Negative experiences with care may discourage WSW from seeking care or fully disclosing health concerns to providers limiting the extent of services offered.

scholarly journals Uptake of Health Services by People from the Dalit Community

2018 ◽  
Vol 1 (2) ◽  
pp. 1-6
Author(s):  
Raksha Thapa ◽  
E. Van Teijlingen ◽  
P. Regmi ◽  
V. Heaslip
Keyword(s):  
Health Care ◽  
Health Services ◽  
Low Income ◽  
Service Providers ◽  
Low Income Countries ◽  
Physical Factors ◽  
Service Usage ◽  
Health Care Centre ◽  
Medical Facilities ◽  
Trained Staff

Studies and reports on uptake of health services in Nepal and other low-income countries often focus on limitations due to physical factors, such as travel distance to health facility, or lack of medical facilities or electricity at the health care centre or focus on resources, such as lack of service providers, or lack of appropriately trained staff. In this editorial article, we highlight the importance of discrimination as a reason for people not seeking available health care. Discrimination is particularly a barrier to service usage among the most deprived people in society, such as the Dalit community in Nepal and South Asia more generally. We discuss the caste-based discrimination in Nepal and its effects on health outcomes of those groups who experience such discrimination.

scholarly journals Health Status and Quality of Health Care Services of Congolese Refugees in Nakivale, Uganda

2016 ◽  
Vol 5 (3) ◽  
pp. 39
Author(s):  
Amegovu K. Andrew
Keyword(s):  
Health Status ◽  
Health Services ◽  
Resource Constraints ◽  
Service Providers ◽  
Geographic Origin ◽  
Health Service Delivery ◽  
Health Facilities ◽  
Cross Sectional ◽  
Adequate Food

Physical and emotional wellness, as well as access to healthcare, are foundations for successful resettlement. Without feeling healthy, it is difficult to work, to go school, or take care of a family. Many factors can affect refugee health, including geographic origin and refugee camp conditions. Refugees may face a wide variety of acute or chronic health issues (Office of Refugee Resettlement, ORR Annual Report to Congress 2014; http://www.acf.hhs.gov). Resettlement of refugees in Uganda is usually supported by concerted efforts of UNHCR, Governments through the Office of the Prime Minister, OPM with support from host communities, local and international Non-Governmental Organizations. Due to resource constraints and local factors, immigrants are often subjected to poor living conditions which coupled with inadequacy inessential medical supplies might significantly affects quality of care and health service delivery and hence, rendering refugees to poor health status. This study was conducted from 2013-2014 to assess the determinants of health status of Congolese refugees living in Nakivale refugee settlement, in Isingiro district- South Western Uganda. A cross-sectional study design was used involving mixed techniques of both qualitative and quantitative KAP survey. The study focussed on Congolese refugee population in Nakivale Refugee settlement. 2401 key informants’ interviews and 8 focus group discussions respectively were conducted targeting service providers and beneficiaries/Congolese refugees in this case. The data was analysed using SPSS ver.20, 2011. Although majority (97%) of respondents sought medical services from established health facilities, findings confirm a high level of ill health prevalence among Congolese refugees in Nakivale camp, however, the difference in health services and perceived health status in camp versus the one in DRcongo is insignificant ( p=0.000) with respondents perceiving their health status as worse than when they were their own Country before the resettlement. Identified key challenges affecting access &amp; uptake of available health services includes: language barrier; inadequate drugs; and the long distances to access health facilities. The health status of refugees could be improved by addressing the challenges related to language, drug supplies in addition to humanising conditions of shelter, providing appropriate waste disposal facilities while proving adequate food rations and clean &amp; safe drinking water.

scholarly journals How do caregivers of children with congenital heart diseases access and navigate the healthcare system in Ethiopia?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sugy Choi ◽  
Heesu Shin ◽  
Jongho Heo ◽  
Etsegenet Gedlu ◽  
Berhanu Nega ◽  
...  
Keyword(s):  
Health Care ◽  
Cardiac Surgery ◽  
Health Care System ◽  
Low Income ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Heart Defects ◽  
Care Facility ◽  
Long Distance ◽  
Care System

Abstract Background Surgery can correct congenital heart defects, but disease management in low- and middle-income countries can be challenging and complex due to a lack of referral system, financial resources, human resources, and infrastructure for surgical and post-operative care. This study investigates the experiences of caregivers of children with CHD accessing the health care system and pediatric cardiac surgery. Methods A qualitative study was conducted at a teaching hospital in Ethiopia. We conducted semi-structured interviews with 13 caregivers of 10 patients with CHD who underwent cardiac surgery. We additionally conducted chart reviews for triangulation and verification. Interviews were conducted in Amharic and then translated into English. Data were analyzed according to the principles of interpretive thematic analysis, informed by the candidacy framework. Results The following four observations emerged from the interviews: (a) most patients were diagnosed with CHD at birth if they were born at a health care facility, but for those born at home, CHD was discovered much later (b) many patients experienced misdiagnoses before seeking care at a large hospital, (c) after diagnosis, patients were waiting for the surgery for more than a year, (d) caregivers felt anxious and optimistic once they were able to schedule the surgical date. During the care-seeking journey, caregivers encountered financial constraints, struggled in a fragmented delivery system, and experienced poor service quality. Conclusions Delayed access to care was largely due to the lack of early CHD recognition and financial hardships, related to the inefficient and disorganized health care system. Fee waivers were available to assist low-income children in gaining access to health services or medications, but application information was not readily available. Indirect costs like long-distance travel contributed to this challenge. Overall, improvements must be made for district-level screening and the health care workforce.

scholarly journals Public Reproductive Health Facilities: A Client-Satisfaction Survey

2016 ◽  
Vol 9 (2) ◽  
pp. 208
Author(s):  
Fariba Moradi ◽  
Zohreh Balaghi ◽  
Mohsen Moghadami ◽  
Hassan Joulaei ◽  
Najaf Zare
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Quality Of Health Care ◽  
Client Satisfaction ◽  
Service Providers ◽  
Health Facilities ◽  
Health Centers ◽  
Significant Difference ◽  
Improvement Programs

<p><strong>INTRODUCTION:</strong> Understanding clients’ perspectives on quality improvement programs is essential to achieve the goals of health services. Determining client satisfaction could help decision makers to implement programs fit to their needs as perceived by service providers and clients. This study aimed to assess the level of satisfaction among women attending health centers regarding the services received in governmental health facilities in Shiraz, southern Iran.</p><p><strong>METHOD:</strong> This cross-sectional study was performed in 24 urban health centers. Using systematic random sampling method, 8 clinics were assigned to each group. Then questionnaires were distributed among 240 married women in 15-49 year-old age group who had referred to selected clinics for receiving some services. For data analysis, SPSS version 15 software and Chi-square statistical procedure were used to evaluate clients’ satisfaction.</p><p><strong>RESULTS:</strong> Data showed that 101 out of 240 respondents were completely satisfied with the personnel as well as the health center. Furthermore, satisfaction was found to be the highest among clients of those centers ranked as middle class socioeconomic status, while no significant difference was found between centers based on their socioeconomic status.</p><p><strong>CONCLUSION: </strong>The results of the present study would enable policy-makers to effectively improve the quality of health care, keeping a balance between providers’ and patients’ perspectives on the quality of health care.</p>

scholarly journals The role of health care workers in collaborating with traditional healers in primary health care. Part 1

1997 ◽  
Vol 2 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Rosemare Troskie
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Plan ◽  
Health Care Workers ◽  
Full Text ◽  
Traditional Healers ◽  
Primary Health ◽  
Care Workers

The Reconstruction and Development Plan as well as the National Health Plan of the ANC supports the reorganisation of health services. OpsommingDie Heropbou en Ontwikkelingsprogram sowel as die Nasionale Gesondheidsplan van die ANC staan die herorganisasie van gesondheidsdienste voor. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

scholarly journals Management of services in total quality management implemented and non-implemented health facilities

2021 ◽  
Vol 6 (4) ◽  
pp. 689-696
Author(s):  
Muhsina Begum ◽  
Ashees Kumar Saha ◽  
Sheuly Begum ◽  
Nasima Akhter ◽  
Pritikona Borua ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Management ◽  
Total Quality Management ◽  
Health Care Providers ◽  
Service Providers ◽  
Health Facilities ◽  
Working Environment ◽  
Care Providers ◽  
Total Quality ◽  
Medical College

5S-CQI-TQM is a management technique that is aimed at bringing satisfaction of staff as well as the patients through improvement of working environment. A cross-sectional comparative study was carried out among 226 respondents who were selected purposively from the selected study place from 1st January to 31st December 2017. Among 226 respondents, 113 were taken from Dhaka Medical College and another 113 were taken from Mugdha Medical College. Among 113 respondents, 56 respondents were health care providers and 57 respondents were health care receivers. The purpose of this study to compare the management of services in Total Quality Management implemented (Dhaka Medical College and Hospital) and non-implemented (Mugdha Medical College and Hospital) health facilities. A Semi-structured interviewer administered questionnaire and an observational check list were developed to collect the data. Separate questionnaire was used for health care providers and health care receivers. The statistical analysis was conducted using SPSS (statistical package for social science) version 20 statistical software. Significant statistical differences were found between TQM implemented and TQM non-implemented hospital regarding workload (p=0.043), hospital authority always seriously consider staff’s suggestions for the improvement of quality of service (p<0.001), employees always respect to each other in the hospital (p<0.001) and 35 (62.5%) service providers expressed satisfactory opinion regarding management of the hospital. Asian J. Med. Biol. Res. December 2020, 6(4): 689-696

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