scholarly journals Does Decentralization Improve Provision of Health Services? Evidence from Kisumu and Makueni Counties in Kenya

2018 ◽  
Author(s):  
Racheal Omukhulu Makokha
Keyword(s):  
Health Care ◽  
Health Services ◽  
Access To Health Care ◽  
Health Care Services ◽  
Public Services ◽  
Published Data ◽  
County Governments ◽  
Care Services ◽  
Access To Health ◽  
The Impact

The last five decades have seen uncountable debates on the impact of decentralization on provision of public services. While it has evidently improved public service delivery in some countries, it has worsened it in others. Kenya implemented devolution in 2013 in the hope of bringing public services nearer to the people. Health was one of the services identified. Yet, the local media has reported negative impact of devolution on provision of health services since 2013. This study sought to look at the actual effect of devolution on access to health care services by analysing secondary quantitative data from the government published data, official statistics, international development agencies’ surveys and reports. Two county governments; Kisumu and Makueni were chosen to represent the urban and rural populations respectively. Contrary to the wider literature on health decentralization, this study found out that devolution did not worsen access to health care services in Kenya. The study attributed this to the nature of devolution adopted in the country where the county governments have considerable authority, decision-making power and responsibility over their counties.

scholarly journals Barriers to accessing health care services: A qualitative study of migrant construction workers in a Southwestern Indian city

2020 ◽  
Author(s):  
Maija Santalahti ◽  
Kumar Sumit ◽  
Mikko Perkiö
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Construction Workers ◽  
Access To Health Services ◽  
Care Access ◽  
Care Services ◽  
Access To Health

Abstract Background: This study examined access to health care in an occupational context in an urban city of India. Many people migrate from rural areas to cities, often across Indian states, for employment prospects. The purpose of the study is to explore the barriers to accessing health care among a vulnerable group – internal migrants working in the construction sector in Manipal, Karnataka. Understanding the lay workers’ accounts of access to health services can help to comprehend the diversity of factors that hinder access to health care. Methods: Individual semi-structured interviews involving 15 migrant construction workers were conducted. The study applied theory-guided content analysis to investigate access to health services among the construction workers. The adductive analysis combined deductive and inductive approaches with the aim of verifying the existing barrier theory in a vulnerable context and further developing the health care access barrier theory. Results: This study’s result is a revised version of the health care access barriers model, including the dimension of trust. Three known health care access barriers – financial, cognitive and structural, as well as the new barrier (distrust in public health care services), were identified among migrant construction workers in a city context in Karnataka, India. Conclusions: Further qualitative research on vulnerable groups would produce a more comprehensive account of access to health care. The socioeconomic status behind access to health care, as well as distrust in public health services, forms focal challenges for any policymaker hoping to improve health services to match people’s needs.

Right to health and access to health-care services for refugees in Turkey

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
N. Ela Gokalp Aras ◽  
Sertan Kabadayi ◽  
Emir Ozeren ◽  
Erhan Aydin
Keyword(s):  
Public Health ◽  
Health Care ◽  
Institutional Theory ◽  
Access To Health Care ◽  
Health Care Services ◽  
Public Health Care ◽  
Content Type ◽  
Care Services ◽  
Access To Health ◽  
The Impact

Purpose This paper aims to provide a comprehensive understanding of factors that contribute to refugees’ exclusion from health-care services. More specifically, using institutional theory, this paper identifies regulative pillar-, normative pillar- and cultural/cognitive pillar-related challenges that result in refugees having limited or no access to health-care services. Design/methodology/approach The paper draws on both secondary research and empirical insights from two qualitative fieldwork studies totaling 37 semi-structured meso-level interviews, observations and focus groups in three Turkish cities (Izmir, Ankara and Edirne), as well as a total of 42 micro-level, semi-structured interviews with refugees and migrants in one large city (Izmir) in Turkey. Findings This study reveals that systematically stratified legal statuses result in different levels of access to public health-care services for migrants, asylum seekers or refugees based on their fragmented protection statuses. The findings suggest access to health-care is differentiated not only between local citizens and refugees but also among the refugees and migrants based on their legal status as shaped by their country of origin. Originality/value While the role of macro challenges such as laws and government regulations in shaping policies about refugees have been examined in other fields, the impact of such factors on refugee services and well-being has been largely ignored in service literature in general, as well as transformative service research literature in particular. This study is one of the first attempts by explicitly including macro-level factors to contribute to the discussion on the refugees’ access to public health-care services in a host country by relying on the institutional theory by providing a holistic understanding of cognitive, normative and regulative factors in understanding service exclusion problem.

scholarly journals Challenges in accessing health care services : Canadian children living in mixed-status families

2021 ◽  
Author(s):  
Rachel Ayla Caplan
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Immigration Status ◽  
Uninsured Patients ◽  
Care Services ◽  
Access To Health ◽  
The Impact ◽  
Mixed Status Families ◽  
Mixed Status

Few studies have explored the prevalence of Canadian children with family members that have precarious legal status and the impact of parental immigration status on a child's access to health care in Canada. This quantitative research study uses a rights-based approach to discuss secondary data collected retrospectively between 2005-2009 at a medical clinic for uninsured patients in eastern Toronto, Ontario (n=128). Demographic, immigration, and health-related factors are presented, and parental immigration status and health-seeking behaviours are explored. Findings indicate that: many Canadian children (Canadian-born and naturalized Canadians) are uninsured; Canadian children who attend the clinic are sick, as opposed to accessing well-child check-ups; and, a group of Canadian children living in mixed-status families are accessing health care facilities for medically uninsured patients. This study highlights mixed-status families, and the potential impact on children's access to health care. This study helps fill the research gap regarding uninsured Canadian children. It is intended to increase community and professional awareness about impingements made in fulfilling Canadian children's right to access the "universal" health care services they have been promised. In turn, this research could inform future policy, practice, and research within health care, educational, and governmental domains.

scholarly journals Barriers to accessing health-care services: A qualitative study of migrant construction workers in a Southwestern Indian city

2020 ◽  
Author(s):  
Maija Santalahti ◽  
Kumar Sumit ◽  
Mikko Perkiö
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Construction Workers ◽  
Care Access ◽  
Care Services ◽  
Access To Health ◽  
Health Care Access Barriers

Abstract Background: This study examined access to health care in an occupational context in an urban city of India. Many people migrate from rural areas to cities, often across Indian states, for employment prospects. The purpose of the study is to explore the barriers to accessing health care among a vulnerable group – internal migrants working in the construction sector in Manipal, Karnataka. Understanding the lay workers’ accounts of access to health service can help to comprehend the diversity of factors that hinder access to health care. Methods: Individual semi-structured interviews involving 15 migrant construction workers were conducted. The study applied theory-guided content analysis to investigate access to health services among the construction workers. The adductive analysis combined deductive and inductive approaches with the aim of verifying the existing barrier theory in a vulnerable context and further developing the health-care access barrier theory. Results: This study’s result is a revised version of the health-care access barriers model, including the dimension of trust. Three known health-care access barriers – financial, cognitive and structural, as well as the new barrier (distrust in public health-care services), were identified among migrant construction workers in a city context in Karnataka, India.Conclusions: Further qualitative research on vulnerable groups would produce a more comprehensive account of access to health care. The socioeconomic status behind access to health care, as well as distrust in public health services, forms focal challenges for any policymaker hoping to improve health services to match people’s needs.

scholarly journals Challenges in accessing health care services : Canadian children living in mixed-status families

2021 ◽  
Author(s):  
Rachel Ayla Caplan
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Immigration Status ◽  
Uninsured Patients ◽  
Care Services ◽  
Access To Health ◽  
The Impact ◽  
Mixed Status Families ◽  
Mixed Status

Few studies have explored the prevalence of Canadian children with family members that have precarious legal status and the impact of parental immigration status on a child's access to health care in Canada. This quantitative research study uses a rights-based approach to discuss secondary data collected retrospectively between 2005-2009 at a medical clinic for uninsured patients in eastern Toronto, Ontario (n=128). Demographic, immigration, and health-related factors are presented, and parental immigration status and health-seeking behaviours are explored. Findings indicate that: many Canadian children (Canadian-born and naturalized Canadians) are uninsured; Canadian children who attend the clinic are sick, as opposed to accessing well-child check-ups; and, a group of Canadian children living in mixed-status families are accessing health care facilities for medically uninsured patients. This study highlights mixed-status families, and the potential impact on children's access to health care. This study helps fill the research gap regarding uninsured Canadian children. It is intended to increase community and professional awareness about impingements made in fulfilling Canadian children's right to access the "universal" health care services they have been promised. In turn, this research could inform future policy, practice, and research within health care, educational, and governmental domains.

scholarly journals Barriers to accessing health care services: A qualitative study of migrant construction workers in a Southwestern Indian city

2020 ◽  
Author(s):  
Maija Santalahti ◽  
Kumar Sumit ◽  
Mikko Perkiö
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Construction Workers ◽  
Care Access ◽  
Care Services ◽  
Access To Health ◽  
Health Care Access Barriers

Abstract Background: This study examined access to health care in an occupational context in an urban city of India. Many people migrate from rural areas to cities, often across Indian states, for employment prospects. The purpose of the study is to explore the barriers to accessing health care among a vulnerable group – internal migrants working in the construction sector in Manipal, Karnataka. Understanding the lay workers’ accounts of access to health service can help to comprehend the diversity of factors that hinder access to health care. Methods: Individual semi-structured interviews involving 15 migrant construction workers were conducted. The study applied theory-guided content analysis to investigate access to health services among the construction workers. The adductive analysis combined deductive and inductive approaches with the aim of verifying the existing barrier theory in a vulnerable context and further developing the health care access barrier theory. Results: This study’s result is a revised version of the health care access barriers model, including the dimension of trust. Three known health care access barriers – financial, cognitive and structural, as well as the new barrier (distrust in public health care services), were identified among migrant construction workers in a city context in Karnataka, India. Conclusions: Further qualitative research on vulnerable groups would produce a more comprehensive account of access to health care. The socioeconomic status behind access to health care, as well as distrust in public health services, forms focal challenges for any policymaker hoping to improve health services to match people’s needs.

scholarly journals Barriers to accessing health care services: A qualitative study of migrant construction workers in a Southwestern Indian city

2020 ◽  
Author(s):  
Maija Santalahti ◽  
Kumar Sumit ◽  
Mikko Perkiö
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Construction Workers ◽  
Access To Health Services ◽  
Care Access ◽  
Care Services ◽  
Access To Health

Abstract Background: This study examined access to health care in an occupational context in an urban city of India. Many people migrate from rural areas to cities, often across Indian states, for employment prospects. The purpose of the study is to explore the barriers to accessing health care among a vulnerable group – internal migrants working in the construction sector in Manipal, Karnataka. Understanding the lay workers’ accounts of access to health services can help to comprehend the diversity of factors that hinder access to health care. Methods: Individual semi-structured interviews involving 15 migrant construction workers were conducted. The study applied theory-guided content analysis to investigate access to health services among the construction workers. The adductive analysis combined deductive and inductive approaches with the aim of verifying the existing barrier theory in a vulnerable context and further developing the health care access barrier theory. Results: This study’s result is a revised version of the health care access barriers model, including the dimension of trust. Three known health care access barriers – financial, cognitive and structural, as well as the new barrier (distrust in public health care services), were identified among migrant construction workers in a city context in Karnataka, India. Conclusions: Further qualitative research on vulnerable groups would produce a more comprehensive account of access to health care. The socioeconomic status behind access to health care, as well as distrust in public health services, forms focal challenges for any policymaker hoping to improve health services to match people’s needs.

scholarly journals Pathways to healthcare for migrants and vulnerable people inclusion: the experience of Genti di Pace

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Mancinelli ◽  
E Buonomo ◽  
F Mosaico ◽  
G Biondi ◽  
A Zampa ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Access To Health Care ◽  
Health Care Services ◽  
Access To Health Services ◽  
Public And Private ◽  
Care Services ◽  
Access To Health ◽  
Vulnerable People ◽  
Improve Health

Abstract Issue Chronic and acute diseases affects migrants and vulnerable people who often face barriers in accessing health care services. Here is the description of an innovative health center (HC) developed for identifying barriers and facilitating access to health care services of hard-to-reach (HTR) people in Rome. Description of the Problem The Community of Sant'Egidio together with the “Migrant Health Unit” of ASL Roma 1 has established an innovative HC program aimed to improve health outcomes in HTR urban population. One of the main Public Health challenge is to reduce inequalities among migrants and vulnerable people through improving access to health services. Data here analysed were collected during 2019. Results 897 migrants and vulnerable people received heath care assistance. 52.4% were females, mean age 40.7±21.4 ds, 16.3% aged under 18 years and 69.6% were between 18-64 years. Countries of provenance: 56.8% Eastern Europe (Bosnia and Romania), 16.8% South America and 15.2% North Africa. 3.2% were refugees. Among 1986 health interventions 56.3% were general medical visits, 35.4% prescriptions and free drugs distribution, 4.1% children growth controls and baby milk supplies, 3.6% specialist visits and only 0.3% were sending to the Emergency Room. Lessons Improving the access to health care services of migrants is both a public health and an economic goal. The increase in chronic-degenerative diseases underlines the need to facilitate access to health services, also through collaboration networks between public and private social. This allows continuity in treatment, which has great meaning of secondary prevention, as well as rationalization of resources, reducing an improper use of the Emergency Room, which provides occasional intervention, but does not integrate into an efficient/effective therapeutic path. Key messages Promoting health care services like this can reduce barriers, improve health outcomes in migrants and increase sustainability of the NHS. Improving access to public and private social health services is important especially in presence of chronic-diseases which require continuous therapies and examinations.

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