Contextualizing Healthcare Needs of the Transgender Community in Kerala

2022 ◽  
pp. 672-690
Author(s):  
Jayasree A. K. ◽  
Bindu M. V.
Keyword(s):  
Social Acceptance ◽  
Healthcare Access ◽  
Present Situation ◽  
Healthcare Services ◽  
Social Recognition ◽  
Legal Service ◽  
Security Measures ◽  
Healthcare Needs ◽  
The Supreme Court ◽  
Before And After

Kerala witnessed a transformation in recent times in the case of social acceptance of the transgender community. Participation in HIV/AIDS projects gave them some social recognition. There was a turning point in the situation when the Supreme Court judgement came in 2014 on National Legal Service Authority vs Government of India. It started to formulate policies and welfare schemes to support the transgender community. Following this, the Kerala government drafted the Transgender Policy in 2015. The present situation is much improved. Yet there is not much improvement in healthcare services. There is no protocol or guidelines for treatment, which may result in practice without quality assurance and high cost. This chapter is an attempt to review the situation of the transgender community in Kerala before and after the transgender policy to look into achievements and gaps in security measures, including healthcare access.

Contextualizing Healthcare Needs of the Transgender Community in Kerala

2020 ◽  
pp. 242-260
Author(s):  
Jayasree A. K. ◽  
Bindu M. V.
Keyword(s):  
Social Acceptance ◽  
Healthcare Access ◽  
Present Situation ◽  
Healthcare Services ◽  
Social Recognition ◽  
Legal Service ◽  
Security Measures ◽  
Healthcare Needs ◽  
The Supreme Court ◽  
Before And After

Kerala witnessed a transformation in recent times in the case of social acceptance of the transgender community. Participation in HIV/AIDS projects gave them some social recognition. There was a turning point in the situation when the Supreme Court judgement came in 2014 on National Legal Service Authority vs Government of India. It started to formulate policies and welfare schemes to support the transgender community. Following this, the Kerala government drafted the Transgender Policy in 2015. The present situation is much improved. Yet there is not much improvement in healthcare services. There is no protocol or guidelines for treatment, which may result in practice without quality assurance and high cost. This chapter is an attempt to review the situation of the transgender community in Kerala before and after the transgender policy to look into achievements and gaps in security measures, including healthcare access.

scholarly journals Development and Initial Evaluation of a Nurse-Led Healthcare Clinic for Homeless and At-Risk Populations in Tasmania, Australia: A Collaborative Initiative

2021 ◽  
Vol 18 (23) ◽  
pp. 12770
Author(s):  
Grace Bennett-Daly ◽  
Maria Unwin ◽  
Ha Dinh ◽  
Michele Dowlman ◽  
Leigh Harkness ◽  
...  
Keyword(s):  
Healthcare Access ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Public Healthcare ◽  
Staff Perceptions ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
At Risk Populations ◽  
Barriers To Healthcare Access ◽  
Primary Healthcare Providers

People who are homeless experience significantly poorer health than the general population and often face multifaceted challenges engaging with public healthcare services. Mission Health Nurse-led Clinic (MHNC) was established in 2019 to meet the healthcare needs of this marginalised population in Launceston, Tasmania. This study examines barriers to healthcare access amongst individuals who experience homelessness, client and staff perceptions of the MHNC services and explored opportunities for service expansion. Descriptive statistics were drawn from administrative data, and all interviews were thematically analysed. A total of 426 presentations were reported for 174 individuals experiencing homelessness over 26 months. The median client age was 42 years and 60.9% were male; A total of 38.5% were homeless or lived in a supported accommodation. The predominant reasons for clinic visits included prescription requests (25.3%) and immunisations (20.1%). A total of 10 clients and 5 City Mission staff were interviewed with three themes emerging from the findings: personal vulnerability, disconnectedness and acceptability of the MHNC. The MHNC services were reported to be highly appreciated by all clients. Mental health and allied health, extra operating hours and maintaining the flexibility of walk-in appointments were suggested as expansion areas for the service and were highlighted as ways to increase engagement for improved health outcomes. Continued partnerships with interprofessional primary healthcare providers would contribute to addressing unmet healthcare needs in this vulnerable population.

Funding models and expenditures with primary healthcare in Salvador, Bahia, Brazil metropolitan area

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Vivas ◽  
M Duarte ◽  
A Pitta ◽  
B Christovam
Keyword(s):  
Public Health ◽  
Metropolitan Area ◽  
Primary Healthcare ◽  
Healthcare Services ◽  
Ministry Of Health ◽  
Healthcare Budget ◽  
Health Budget ◽  
The Public ◽  
Before And After ◽  
The Government

Abstract Background The government investments in quality primary healthcare are the basis to strengthening the health systems and monitoring the public expenditure in this area is a way to assess the effectiveness and efficiency of the public health policies. The Brazil Ministry of Health changed, in 2017, the method of onlending federal resources to states and cities seeking to make the public funds management more flexible. This change, however, suppressed mandatory investments in primary healthcare. This research aims to determine the difference of expenditures on primary healthcare in Salvador, Bahia, Brazil metropolitan area before and after this funding reform, seeking to verify how it can impact the quality of primary healthcare services and programs. Methods This is an ecological time-series study that used data obtained in the Brazil Ministry of Health budget reports. The median and interquartile range of expenditures on primary healthcare (set as the percentage of total public health budget applied in primary care services and programs) of the 13 cities in the Salvador metropolitan area were compared two years before and after the reform. Results The median of expenditures on primary healthcare in Salvador metropolitan area was 25.5% (13,9% - 32,2%) of total public health budget before and 24.8% (20.8% - 30.0%) of total public health budget after the reform (-0.7% difference). Seven cities decreased the expenditures on primary healthcare after the reform, ranging from 1.2% to 10.8% reduction in the primary healthcare budget in five years. Conclusions Expenditures on primary healthcare in Salvador metropolitan area decreased after the 2017 funding reform. Seven of 13 cities reduced the government investments on primary healthcare services and programs in this scenario. Although the overall difference was -0.7%, the budget cuts ranged from 1.2% to 10.8% in the analyzed period and sample. More studies should assess these events in wide areas and with long time ranges. Key messages Public health funding models can impact the primary healthcare settings regardless of the health policy. Reforms in the funding models should consider the possible benefits before implementation. Funding models and methods that require mandatory investments in primary healthcare may be considered over more flexible ones.

scholarly journals Factors influencing decision making for implementing e-health in light of the COVID-19 outbreak in Gulf Cooperation Council countries

2021 ◽  
Author(s):  
Fahad M Al-Anezi
Keyword(s):  
Decision Making ◽  
United Arab Emirates ◽  
Healthcare Access ◽  
Demographic Factors ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Gulf Cooperation Council ◽  
Factors Influencing ◽  
Electronic Health ◽  
Novel Coronavirus

Abstract Background Electronic health (e-health) approaches such as telemedicine, mobile health, virtual healthcare and electronic health records are considered to be effective in increasing access to healthcare services, reducing operational costs and improving the quality of healthcare services during the coronavirus disease 2019 (COVID-19) outbreak, a pandemic resulting from the spread of a novel coronavirus discovered in December 2019. In this context, the aim of this study was to identify the most important factors influencing decision making on the implementation of e-health in Gulf Cooperation Council (GCC) member states (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates), which are in the process of digitizing healthcare services. Methods This study reviewed the literature to identify the important factors influencing decision making on e-health. In addition, a questionnaire-based survey was conducted in order to identify the most important criteria to be considered in decision making on e-health. The survey link was forwarded to 978 healthcare practitioners and 42 experts (purposive sampling), from which a final sample of 892 (864 practitioners and 28 experts) was achieved, reflecting a response rate of 87.45%. Results Of the 44 factors identified under seven themes (strategic, quality, management, technology, function characteristics, economic, sociocultural and demographic factors), 22 factors were identified to be the most important criteria. Conclusions Findings from this study suggest that decision making in relation to e-health is a complex process that requires consideration of various factors. It was also found that attention should be paid to sociocultural and demographic factors, which may need to be considered in increasing healthcare access during the COVID-19 outbreak.

scholarly journals Oral rehydration therapies in Senegal, Mali, and Sierra Leone: a spatial analysis of changes over time and implications for policy

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Kirsten E. Wiens ◽  
Lauren E. Schaeffer ◽  
Samba O. Sow ◽  
Babacar Ndoye ◽  
Carrie Jo Cain ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Healthcare Access ◽  
Scale Up ◽  
National Policy ◽  
Geostatistical Model ◽  
Oral Rehydration ◽  
Severe Diarrhea ◽  
Before And After ◽  
Changes Over Time ◽  
Over Time

Abstract Background Oral rehydration solution (ORS) is a simple intervention that can prevent childhood deaths from severe diarrhea and dehydration. In a previous study, we mapped the use of ORS treatment subnationally and found that ORS coverage increased over time, while the use of home-made alternatives or recommended home fluids (RHF) decreased, in many countries. These patterns were particularly striking within Senegal, Mali, and Sierra Leone. It was unclear, however, whether ORS replaced RHF in these locations or if children were left untreated, and if these patterns were associated with health policy changes. Methods We used a Bayesian geostatistical model and data from household surveys to map the percentage of children with diarrhea that received (1) any ORS, (2) only RHF, or (3) no oral rehydration treatment between 2000 and 2018. This approach allowed examination of whether RHF was replaced with ORS before and after interventions, policies, and external events that may have impacted healthcare access. Results We found that RHF was replaced with ORS in most Sierra Leone districts, except those most impacted by the Ebola outbreak. In addition, RHF was replaced in northern but not in southern Mali, and RHF was not replaced anywhere in Senegal. In Senegal, there was no statistical evidence that a national policy promoting ORS use was associated with increases in coverage. In Sierra Leone, ORS coverage increased following a national policy change that abolished health costs for children. Conclusions Children in parts of Mali and Senegal have been left behind during ORS scale-up. Improved messaging on effective diarrhea treatment and/or increased ORS access such as through reducing treatment costs may be needed to prevent child deaths in these areas.

scholarly journals Access and participation: What factors influence the provision and utilisation of health care services by children with learning disabilities?

2017 ◽  
Vol 41 (S1) ◽  
pp. S452-S452
Author(s):  
A. Rebowska
Keyword(s):  
Health Care ◽  
Learning Disabilities ◽  
Young People ◽  
Intellectual Disabilities ◽  
Health Care Services ◽  
Healthcare Services ◽  
Children And Young People ◽  
Care Services ◽  
Healthcare Needs ◽  
Wide Range

AimsThe aim of this literature review is to explore the range of factors that influence the degree of access to health care services by children and young people with learning disabilities.BackgroundChildren with learning disabilities are at increased risk of a wide range of health conditions comparing with their peers. However, recent reports by UK government as well as independent charities working with children and young people with learning disabilities demonstrated that they are at risk of poor health outcomes as a result of barriers preventing them from accessing most appropriate services.MethodsComprehensive searches were conducted in six databases. Articles were also obtained through review of references, a search of the grey literature, and contacting experts in the field. The inclusion criteria were for studies evaluating access to healthcare services, identification and communication of health needs, organisational aspects impacting on access and utilisation, staff attitudes where they impacted on access, barriers, discrimination in patients with intellectual disabilities age 0–18. The literature search identified a sample of 36 papers. The marked heterogeneity of studies excluded conducting a meta-analysis.ResultsBarriers to access included problems with identification of healthcare needs by carers and healthcare professionals, communication difficulties, the inadequacy of facilities, geographical and physical barriers, organisational factors such as inflexible appointment times, attitudes and poor knowledge base of healthcare staff.ConclusionThe factors identified can serve as a guide for managers and clinicians aiming to improve access to their healthcare services for children and young people with intellectual disabilities.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Global Perspective on Telemedicine for Parkinson’s Disease

2021 ◽  
pp. 1-8
Author(s):  
Ali Shalash ◽  
Meredith Spindler ◽  
Esther Cubo
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Multidisciplinary Care ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Global Perspective ◽  
Sensitive Information ◽  
Personal Connection ◽  
Healthcare Needs ◽  
Neurological Exam

Telemedicine programs are particularly suited to evaluating patients with Parkinson’s disease (PD) and other movement disorders, primarily because much of the physical exam findings are visual. Telemedicine uses information and communication technologist to overcome geographical barriers and increase access to healthcare services, and it is particularly beneficial for rural and underserved communities, groups that traditionally suffer from lack of access to healthcare. There is a growing evidence of the feasibility of telemedicine, cost and time savings, patients’ and physicians’ satisfaction, and its outcome and impact on patients’ morbidity and quality of life. In addition, given the unusual current situation with the COVID-19 pandemic, telemedicine has offered the opportunity to address the ongoing healthcare needs of patients with PD, to reduce in-person clinic visits, and human exposures (among healthcare workers and patients) to a range of infectious diseases including COVID-19. However, there are still several challenges to widespread implementation of telemedicine including the limited performance of parts of the neurological exam, limited technological savvy, fear of loss of a personal connection, or uneasiness about communicating sensitive information. On the other hand, while we are facing the new wave of COVID-19 pandemic, patients and clinicians are gaining increasing experience with telemedicine, facilitating equity of access to specialized multidisciplinary care for PD. This article summarizes and reviews the current state and future directions of telemedicine from a global perspective.

scholarly journals Are nurses meeting the needs of men in primary care?

2017 ◽  
Vol 23 (4) ◽  
pp. 319
Author(s):  
Del Lovett ◽  
Bodil Rasmussen ◽  
Carol Holden ◽  
Patricia M. Livingston
Keyword(s):  
Health Services ◽  
Healthcare Access ◽  
Men’S Health ◽  
Men's Health ◽  
Service Access ◽  
Access To Health Services ◽  
Financing System ◽  
Healthcare Needs ◽  
Comprehensive Primary Health Care ◽  
Access To Health

Meeting men’s health needs by improving healthcare service access is a key objective of comprehensive primary health care. The aims of this qualitative study were to explore the perception of nurses in men’s health services and to describe men’s expectation of the nurse. The comparative component identifies the barriers and facilitators to improved access to health services. A purposive sample of 19 nurses and 20 men was recruited from metropolitan and regional settings in the state of Victoria, Australia, and each participant was interviewed individually or as part of three focus groups. The main findings were: nurses and men were unclear on the role of the nurse in men’s health; and health promotion provided by nurses was predominantly opportunistic. Both participant groups indicated barriers to healthcare access related to: the culture and environment in general practice; limitation of Australia’s Medicare healthcare financing system; out-of-pocket costs, waiting time and lack of extended hours; and men not wanting to be perceived as complainers. Facilitators related to: positive inter-professional relations; effective communication; personal qualities; and level of preparedness of nurse education. The findings demonstrate a need for the role to be better understood by both men and nurses in order to develop alternative approaches to meeting men’s healthcare needs.

scholarly journals The expression of vulnerability through infant mortality in the municipality of Embu

2008 ◽  
Vol 126 (5) ◽  
pp. 262-268 ◽  
Author(s):  
Renato Nabas Ventura ◽  
Rosana Fiorini Puccini ◽  
Nilza Nunes da Silva ◽  
Edina Mariko Koga da Silva ◽  
Eleonora Menicucci de Oliveira
Keyword(s):  
Infant Mortality ◽  
Prenatal Care ◽  
Care Delivery ◽  
Healthcare Access ◽  
Secondary Data ◽  
Healthcare Services ◽  
Primary Data ◽  
Access To Health Services ◽  
One Year

CONTEXT AND OBJECTIVE: Infant mortality expresses a set of living, working and healthcare access conditions and opens up possibilities for adopting interventions to expand equity in healthcare. This study aimed to investigate vulnerability and the consequent differences in access to health services and occurrences of deaths among infants under one year of age in the municipality of Embu. DESIGN AND SETTING: This was a descriptive study in the municipality of Embu. METHODS: Primary data were collected through interviews with the families of children living in the municipality of Embu who died in the years 1996 and 1997 before reaching one year of age. Secondary data were obtained from death certificates. The variables collected related to living conditions, income, occupation, prenatal care, delivery and the healthcare provided for children. These data were compared with the results obtained from a study carried out in 1996. RESULTS: Statistically significant differences were found with regard to income, working without a formal employment contract and access to private health plans among the families of the children who died. There were also differences in access to and quality of prenatal care, frequency of low birth weight and neonatal intercurrences. CONCLUSIONS: The employment/unemployment situation was decisive in determining the degree of family stability and vulnerability to the occurrence of infant deaths, in addition to the conditions of access to and quality of healthcare services.

scholarly journals Application of the Omaha System in the Determination of Healthcare Needs of Individuals Receiving Home Healthcare Services

2017 ◽  
Vol 3 (1) ◽  
pp. 1-8
Author(s):  
Betül Aktaş ◽  
Medine Yilmaz ◽  
Nazife Kaplan ◽  
Banu Çankiri
Keyword(s):  
Healthcare Services ◽  
Home Healthcare ◽  
Healthcare Needs ◽  
Omaha System
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