scholarly journals Shame, Stigma, HIV

2021 ◽  
Vol 27 (2-3) ◽  
pp. 47-75
Author(s):  
Luna Dolezal
Keyword(s):  
Health Services ◽  
Lived Experience ◽  
Gay Men ◽  
Chronic Illnesses ◽  
Effective Delivery ◽  
Philosophical Framework ◽  
Care Practices ◽  
Affective Climate ◽  
Living With Hiv ◽  
Delivery Of Health Services

The affective climate often associated with HIV prevention and care practices is often dominated by negative emotions such as shame, fear and suspicion which arise because of HIV’s historical stigma. This article explores the experiential consequences of this affective climate and the continued stigma associated with HIV, through a focus on the experience of shame anxiety which can be under- stood as the chronic anticipation of shame or shameful exposure. Exploring first- person narratives of gay men living with HIV, the article gives an account of how shame anxiety is central to understanding how stigma causes harm, especially in experiences of chronic illnesses such as HIV. Using a philosophical framework, through phenomenology, it will be demonstrated how shame anxiety manifests in bodily lived experience through the structure of the “horizon”. The article will finish with reflections on how shame anxiety can act as a barrier to the effective delivery of health services for those with stigmatised chronic illnesses and, fur- thermore, why the experience of shame anxiety might be useful to consider when delivering health services.

Major Barriers to Effective Delivery of Health Services in Nigeria

1983 ◽  
Vol 4 (1) ◽  
pp. 5-16 ◽  
Author(s):  
P. Bassey Williams ◽  
Moses A. Omishakin
Keyword(s):  
Health Services ◽  
Health Planning ◽  
Consumer Involvement ◽  
Service Organizations ◽  
Health Decision Making ◽  
Care Recipients ◽  
Health Decision ◽  
Comprehensive Health ◽  
Effective Delivery ◽  
Delivery Of Health Services

Major barriers to effective delivery of health services associated with health service organizations, professionals, and care recipients in Nigeria are reviewed. Discussed are: lack of health planning efforts by health agencies; problems of health services accessibility; poor public health image; and inadequate health manpower and training programs. Remedies suggested include comprehensive health planning and consumer involvement in community health decision-making.

scholarly journals Analysis of health seeking behaviour on effective delivery of health services under capitation scheme in Kenya

2019 ◽  
Vol 8 (6) ◽  
pp. 129-136
Author(s):  
Priscilla Nduku Wangai ◽  
Amos Njuguna ◽  
Joseph Ngugi
Keyword(s):  
Health Service ◽  
Health Services ◽  
Health Service Delivery ◽  
Health Seeking Behaviour ◽  
Health Seeking ◽  
Effective Delivery ◽  
Negative Effect ◽  
Measures Of Effectiveness ◽  
Delivery Of Health Services

Under capitation health scheme, a member freely selects a health facility from which to seek health services. There is no restriction of the number of times a member seeks health services from the facility within the contract period. This has affected delivery of health service under capitation contracting. This paper documents a quantitative analysis of the effect of health seeking behaviour on effective delivery of health services. Since human behaviour is assumed to be a natural phenomena, a philosophical view of positivism wаs аdopted in this research. Accordingly, a scientific approach was used to deduce the influence of health seeking behaviour on the metrics of effectiveness. Out of 1152 health facilities accredited to offer primary healthcare in Kenya, data was collected from a sample of 297 health units using closed ended questionnaires. Logit regression analysis on the data revealed that congestion in out-patient department had a negative effect on quality of health services delivered but a positive effect on accessibility and affordability of the services. Increased frequency of consultation had a negative effect on all the three measures of effectiveness; quality, accessibility and affordability of health service delivery. Corresponding odds ratios were 0.173, 1.105 and 1.295 respectively.

Access to Healthcare in Europe

2020 ◽  
Author(s):  
André den Exter ◽  
Keith Syrett
Keyword(s):  
Health Services ◽  
Healthcare Systems ◽  
Access To Healthcare ◽  
Regulatory Framework ◽  
European Healthcare ◽  
Key Characteristics ◽  
To Receive ◽  
Delivery Of Health Services

This chapter describes the main features of European healthcare systems. The chapter identifies key characteristics of these systems: the organisation, financing, and delivery of health services, and the main actors. It then questions what the systems cover, who are eligible to receive healthcare, when patients receive healthcare, and the physician’s duty to provide care. In addition to highlighting the applicable regulatory framework, this chapter also describes some general trends.

scholarly journals Building trust and enhancing localization to improve access to women’s health services in Afghanistan

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F R Rab ◽  
S S Stranges ◽  
A D Thind ◽  
S S Sohani
Keyword(s):  
Health Care ◽  
Health Services ◽  
Vulnerable Populations ◽  
Time Trend ◽  
Health Workers ◽  
Healthcare Services ◽  
Delivery Of Healthcare ◽  
Care Services ◽  
Women And Children ◽  
Delivery Of Health Services

Abstract Background Over 34 million people in Afghanistan have suffered from death and devastation for the last four decades as a result of conflict. Women and children have borne the brunt of this devastation. Afghanistan has some of the poorest health indicators in the world for women and children. In the midst of armed conflict, providing essential healthcare in remote regions in the throws of conflict remains a challenge, which is being addressed the Mobile Health Teams through Afghan Red Crescent (ARCS). To overcome socio-cultural barriers, ARCS MHTs have used local knowledge to hire female staff as part of the MHTs along with their male relatives as part of MHT staff. The present study was conducted to explore the impact of engaging female health workers as part of MHTs in conflict zones within Afghanistan on access, availability and utilization of maternal and child health care. Methods Quantitative descriptive and time-trend analysis were used to evaluate impact of introduction of female health workers. Qualitative data is being analyzed to assess the possibilities and implications of engaging female health workers in the delivery of health services. Results Preliminary results show a 96% increase in uptake of services for expectant mothers over the last four years. Average of 18 thousand services provided each month by MHTs, 70% for women and children. Service delivery for women and children significantly increased over time (p < 0.05) after inclusion of female health workers in MHTs. Delivery of maternity care services showed a more significant increase (p < 0.001). Time trend and qualitative analyses is ongoing. Conclusions Introduction of female health workers significantly improved uptake of health care services for women and children especially in extremely isolated areas controlled by armed groups in Afghanistan. Engaging with local stakeholders is essential for delivery of health services for vulnerable populations in fragile settings like Afghanistan. Key messages Understanding cultural norms results in socially acceptable solutions to barriers in delivery of healthcare services and leads to improvements in access for women and children in fragile settings. Building local partnerships and capacities and using local resources result in safe, efficient and sustainable delivery of healthcare services for vulnerable populations in fragile settings.

scholarly journals Gendered Experiences of Living with HIV in Australia

Sexes ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 244-255
Author(s):  
Vicki Hutton
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Case Reports ◽  
Economic Status ◽  
Geographic Location ◽  
Geographic Region ◽  
Gender And Sexuality ◽  
Economic Consequences ◽  
People Living With Hiv ◽  
Living With Hiv

Globally, women represent more than half the people living with HIV. This proportion varies by country, with an over-representation of HIV among men who have sex with men (MSM) in some regions. For example, in Australia, MSM account for over 60% of transmissions, with heterosexual sex accounting for almost a quarter of transmissions. Irrespective of geographic region, there is evidence that women can have a different lived experience of HIV due to their unequal social and economic status in society, while MSM can have a different lived experience depending on the laws and customs of their geographic location. Gender differences related to risk factors, stigma, access to services, mental health, health-related quality of life and economic consequences have been consistently reported globally. This paper explores the subjective lived experience of gender and sexuality disparities among three individuals living with HIV in Australia: a male who identified as gay, and a male and female who each identified as heterosexual. Analysis of themes from these three case reports indicated discernible differences by gender and sexuality in four areas: access to medical services, social support, stigma and mental health. It is argued that knowledge and understanding of potential gender and sexuality disparities must be factored into supportive interventions for people living with HIV in Australia.

The voice of others: Identity, alterity and gender normativity among gay men in Israel

2012 ◽  
Vol 41 (2) ◽  
pp. 187-211 ◽  
Author(s):  
Erez Levon
Keyword(s):  
Lived Experience ◽  
Gay Men ◽  
Macro Level ◽  
Male Sexuality ◽  
Gay Identity ◽  
Social Categories ◽  
Gay Male ◽  
And Gender ◽  
The Relationship ◽  
The Voice

AbstractThis article presents an analysis of a slang variety, called oxtšit, as it is described and used by a cohort of gay men in Israel. Unlike many previous analyses of gay slang, I argue that the men described do not use the variety to help construct and affirm an alternative gay identity, but rather that they use it as a form of in-group mockery through which normative and nonnormative articulations of Israeli gay male sexuality are delineated. It is suggested that this discussion has implications for sociolinguistic understandings of “groupness” more broadly, and particularly the relationship between macro-level social categories (like “gay”) and individual lived experience. (Gay slang, Israel, vari-directional voicing, identity/alterity)*

Gay Men Living with HIV/AIDS

2006 ◽  
Vol 5 (3-4) ◽  
pp. 9-24 ◽  
Author(s):  
Gregory E. Harris ◽  
Kevin G. Alderson
Keyword(s):  
Gay Men ◽  
Living With Hiv ◽  
Hiv Aids
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