scholarly journals Healthcare Access Experiences Among Indigenous Women in Northern Rural Thailand: A Focused Ethnographic Study

2018 ◽  
Vol 7 (1) ◽  
Author(s):  
Onouma Thummapol ◽  
Sylvia Barton ◽  
Tanya Park
Keyword(s):  
Cultural Practices ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Ethnographic Study ◽  
Indigenous Women ◽  
Health Conditions ◽  
Structured Interviews ◽  
Women's Lives ◽  
Rural Thailand

Introduction: Persistent inequities in health and access to healthcare services for indigenous women living in Thailand remain a significant challenge. This study provides narrative accounts of Indigenous women’s experiences accessing healthcare in northern and rural Thailand and explores the complexity of culture and its interaction with multiple intersecting influences on health behaviours.Methods: A focused ethnographic study was conducted to understand and describe the culture of health behaviors and other cultural phenomena. We recruited 21 female participants aged 20-41 years between March and April of 2017. In-depth semi-structured interviews conducted in Thai were used to explore the experiences of the participants living in a northern rural village. Data analysis was informed and guided by Roper and Shapira’s framework for ethnographic analysis.Results: Seven themes presented across three phases of experience (pre-access, making choices, and encountering difficulties) revealed an in-depth understanding of the Indigenous women’s lives, the broader sociocultural context in which they lived, and the challenges they faced when accessing healthcare. Analysis of data showed that the participants did not have equal access to healthcare and often disproportionately experienced discriminatory practices and negative attitudes of mainstream healthcare providers.Conclusions: This is the only study to date that discusses healthcare access challenges experienced by Indigenous women living in a northern rural Thai village. There is an urgent need to focus on citizenship, employment, and general health conditions; gender, familial, and labor roles; specific health conditions, wellness, and cultural practices; the seeking of healthcare services; healthcare provider relationships; the ability to access needed care; and optimization of self-care. Future efforts to improve healthcare access and reduce disease burden might benefit from these findings and allow for the development of more effective strategies, programs, and policies.

scholarly journals Paradoxes of Mentoring: An Ethnographic Study of a Mentoring Programme for Highly-educated Women with Migrant Backgrounds

2019 ◽  
Vol 11 (2) ◽  
pp. 275-297
Author(s):  
Tytti Steel ◽  
Anna-Maija Lämsä ◽  
Marjut Jyrkinen
Keyword(s):  
Cultural Awareness ◽  
Cultural Practices ◽  
Negative Impact ◽  
Working Life ◽  
Ethnographic Study ◽  
Foreign Born ◽  
Job Seekers ◽  
Structured Interviews ◽  
Cultural Meanings ◽  
Highly Educated

This article explores paradoxes that emerge in the mentoring of highly-educated, female, foreign-born job-seekers in Finland. Theoretically, the study is linked to the growing body of research scrutinising the integration or discrimination of migrants in working life. It analyses cultural practices and ideas that are visible and affect the mentoring interaction. On a more practical level, the paper determines how the mentors and mentees experience the mentoring, and how intercultural mentoring could be improved in order to promote mentees’ employment. The article is based on ethnography and 11 semi-structured interviews. Two major paradoxes and their links to cultural meanings were identified: the over-emphasised focus on Finnish language (the language paradox), and the myth of the strong Finnish woman (the support paradox). These can be seen as having aspects of both cultural awareness and situation-specific awareness. Using situation-specific awareness, some mentors understood the best way forward was to break the rules of the mentoring programme and not to use Finnish in all communication. This enabled a more equal setting for professional discussions. In some rare cases, when the mentors did not use situation-specific awareness, a vicious circle emerged and mentees felt even worse about their abilities and working life opportunities. Similarly, although the myth of the strong Finnish woman can be an empowering and positive model for the mentee, it can have a negative impact on the mentor, enabling undercurrents in the mentoring discussions which can be experienced as harsh and even hostile. This, instead of encouraging and supporting, can result in the undermining and ‘othering’ of the mentee.

scholarly journals Visual Impairment Prevalence, Causes, and Role of Healthcare Access: A Systematic Review and Meta-Analysis in Iran

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Mehrdad Afarid ◽  
Hossein Molavi Vardanjani ◽  
Hamideh Mahdaviazad ◽  
Marzieh Alamolhoda ◽  
Saman Farahangiz
Keyword(s):  
Systematic Review ◽  
Visual Impairment ◽  
Low Vision ◽  
Meta Analysis ◽  
Healthcare Access ◽  
Random Effect ◽  
Public Health Problem ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Pooled Prevalence

Purpose. Healthcare access is one of the determinants of visual impairment (VI), as a public health problem. The objective of this study was to estimate VI prevalence, related causes, and its correlation with access to physicians in Iran. Methods: This systematic review and meta-analysis include observational studies published in Iran. PubMed, Web of Science, Scopus, Google Scholar, and local databases were systematically searched by using the MeSH headings. Data on the provincial distribution of physicians, as an index of access to healthcare, was retrieved. A random-effect meta-analysis was performed to assess. Results. Eight articles were included. The pooled prevalence of blindness, low vision, and VI was 0.80% (95% CI: 0.61–0.99%), 2.92% (95% CI: 2.40–3.44%), and 5.57% (95% CI: 4.71–6.43%). Refractive errors were the most common causes of VI based on PVA with the pooled prevalence of 54.6% (95% CI: 43.4–65.8%). Based on BCVA, we found that the pooled prevalence of cataracts was 37.4% (95% CI: 29.5–45.3%) as the most common cause of VI. The results of metaregression showed that the greater number of general practitioners (GPs) ( P   value = 0.01 ) and pharmacists ( P   value = 0.024 ) per population were associated with a lower prevalence of blindness. Conclusion. Some of the main causes of visual impairment in Iran are preventable. Access to healthcare services may lead to early diagnosis of preventable causes of VI. Further well-designed studies and national surveys should be conducted to provide accurate data from different regions of Iran.

scholarly journals Perceptions about the accessibility of healthcare services among ethnic minority women: a qualitative study among Arab Bedouins in Israel

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Haneen Shibli ◽  
Limor Aharonson-Daniel ◽  
Paula Feder-Bubis
Keyword(s):  
Qualitative Study ◽  
Ethnic Minority ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Minority Women ◽  
Structured Interviews ◽  
Gender Barriers ◽  
Values And Beliefs ◽  
Accessibility Issues ◽  
And Gender

Abstract Background Access to healthcare services has major implications for vulnerable populations’ health. Socio-cultural and gender characteristics shape the utilization and access of healthcare services among ethnic minorities worldwide. One such vulnerable ethnic minority is the Arab Bedouin women in Israel. As women, they are marginalized in their community, where women do not have full equity and they experience multiple barriers to healthcare services The main objective of this study is to provide a nuanced, experiential, emic description of healthcare accessibility issues among Bedouin women in Israel. Identifying the barriers, they face in accessing healthcare may help healthcare policymakers make changes based on and tailored to Bedouin women’s needs. Methods A qualitative study included in-depth semi-structured interviews with 21 Arab Bedouin village residents, consisting of 14 women and 7 men. Eligible participants were Arab Bedouins over 18 years of age and who used healthcare services at least once in the last 5 years. The interviews were carried out in Arabic-Bedouin dialect and included demographic questions, open-ended questions that asked about participants’ perceptions regarding their experiences with healthcare services, including the factors that helped and hindered them in accessing these services and questions regarding suggestions for improving the accessibility of healthcare services based on the identified needs. Data collected were analyzed using thematic analysis. Study trustworthiness was ensured using audit, reflexivity, and peer debriefing. Results Arab Bedouin women experienced varied barriers while accessing healthcare services. This study uncovered how language, cultural and gender barriers intersect with other disadvantages ingrained in social norms, values and beliefs and affect the access of a minority women subgroup to healthcare services. The participants identified subgroups of Bedouin women (e.g. elderly Bedouin women) affected differently by these barriers. Conclusion Taking into consideration the identified needs and the Arab Bedouin women’s unique characteristics, along with adopting the intersectional approach should help improve access to healthcare services among such a vulnerable subgroup and other subgroups within minorities worldwide.

scholarly journals Access to Healthcare Following Serious Injury: Perspectives of Allied Health Professionals in Urban and Regional Settings

2021 ◽  
Vol 18 (3) ◽  
pp. 1230
Author(s):  
Jemma Keeves ◽  
Sandra C. Braaf ◽  
Christina L. Ekegren ◽  
Ben Beck ◽  
Belinda J. Gabbe
Keyword(s):  
Health Professionals ◽  
Allied Health ◽  
Healthcare Access ◽  
Healthcare Utilisation ◽  
Health Service Delivery ◽  
Access To Healthcare ◽  
Structured Interviews ◽  
Post Discharge ◽  
Allied Health Professionals ◽  
Serious Injury

Barriers to accessing healthcare exist following serious injury. These issues are not well understood and may have dire consequences for healthcare utilisation and patients’ long-term recovery. The aim of this qualitative study was to explore factors perceived by allied health professionals to affect access to healthcare beyond hospital discharge for people with serious injuries in urban and regional Victoria, Australia. Twenty-five semi-structured interviews were conducted with community-based allied health professionals involved in post-discharge care for people following serious injury across different urban and regional areas. Interview transcripts were analysed using thematic analysis. Many allied health professionals perceived that complex funding systems and health services restrict access in both urban and regional areas. Limited availability of necessary health professionals was consistently reported, which particularly restricted access to mental healthcare. Access to healthcare was also felt to be hindered by a reliance on others for transportation, costs, emotional stress and often lengthy time of travel. Across urban and regional areas, a number of factors limit access to healthcare. Better understanding of health service delivery models and areas for change, including the use of technology and telehealth, may improve equitable access to healthcare.

scholarly journals Comparison of Association Between Divorce and Access to Healthcare Services Among Married Immigrants

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 514-514
Author(s):  
Suyeong Bae ◽  
James Graham ◽  
Sanghun Nam ◽  
Ickpyo Hong
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Minority Population ◽  
Service Access ◽  
Family Dissolution ◽  
History Of ◽  
Multicultural Family

Abstract The number of married immigrants is increasing in Korea, and family dissolution is also growing in this population. Although divorce could impact immigrants' health status, it is unclear whether they have difficulties accessing healthcare and medical services. Thus, we examined whether divorce in married immigrants is independently associated with access to healthcare services. A retrospective analysis of 11,778 adults who participated in the 2018 National Multicultural Family Survey. We used three different covariate adjustment methods (multivariate logistic regression, inverse probability of treatment weighting, 1:1 greedy propensity score matching) to examine the association between divorce and access to healthcare services after accounting for various demographic and clinical characteristics. Overall, 5.8% (n = 691) of married immigrants reported a history of divorce. The divorce group included 107 (15.5%) males and 584 (84.5%) females, with an average age of 45.17 years (SD = 10.9). The non-divorced group included 1992 males (18.0%) and 9095 (82.0%) females, with an average age of 39.1 years (SD = 10.5). After propensity score matching, all variables were balanced (all p>0.05). Individuals who experienced divorce were more likely to have difficulties in healthcare service access than those who did not experience divorce (adjusted odds ratio 1.423, 95% CI [1.075, 1.882]). Our findings revealed that divorce increased the risk of limited healthcare services among immigrants in Korea. Healthcare policymakers should be aware of the healthcare access issues in this minority population. In addition, to improve the lifestyles of minority populations, it is necessary to study their overall lives.

scholarly journals An Ethnographic study of unhealthy alcohol use in a Danish Emergency Department

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ditte Maria Sivertsen ◽  
Ulrik Becker ◽  
Ove Andersen ◽  
Jeanette Wassar Kirk
Keyword(s):  
Alcohol Use ◽  
Health Care Professionals ◽  
Cultural Practices ◽  
Qualitative Content Analysis ◽  
Ethical Reasoning ◽  
Cultural Analysis ◽  
Ethnographic Study ◽  
Structured Interviews ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol

Abstract Background Emergency Departments (EDs) are important arenas for the detection of unhealthy substance use. Screening, Brief Intervention, and Referral to Treatment (SBIRT) for unhealthy alcohol use has been used in some ED settings with funding support from external sources. However, widespread sustained implementation is uncommon, and research aimed at understanding culture as a determinant for implementation is lacking. This study aims to explore cultural practices concerning the handling of patients with unhealthy alcohol use admitted to an ED. Methods An ethnographic study was conducted in an ED in the Capital Region of Denmark. The data consists of participant observations of Health Care Professionals (HCPs) and semi-structured interviews with nurses. Data was collected from July 2018 to February 2020. A cultural analysis was performed by using Qualitative Content Analysis as an analytic tool. Results 150 h of observation and 11 interviews were conducted. Three themes emerged from the analysis: (1) Setting the scene describes how subthemes “flow,” “risky environment,” and “physical spaces and artefacts” are a part of the contextual environment of an ED, and their implications for patients with unhealthy alcohol use, such as placement in certain rooms; (2) The encounter presents how patients’ and HCPs’ encounters unfold in everyday practice. Subtheme “Professional differences” showcases how nurses and doctors address patients’ alcohol habits differently, and how they do not necessarily act on the information provided, due to several factors. These factors are shown in remaining sub-themes “gut-feeling vs. clinical parameters,” “ethical reasoning,” and “from compliance to zero-tolerance”; and (3) Collective repertoires shows how language shapes the perception of patients with unhealthy alcohol use, which may cause stigma and stereotyping. Subthemes are “occupiers” and “alcoholic or party animal?”. Conclusions Unhealthy alcohol use in the ED is entangled in complex cultural networks. Patients with severe and easily recognizable unhealthy alcohol use—characterized by an alcohol diagnosis in the electronic medical record, intoxication, or unwanted behavior—shape the general approach and attitude to unhealthy alcohol use. Consequently, from a prevention perspective, this means that patients with less apparent unhealthy alcohol use tend to be overlooked or neglected, which calls for a systematic screening approach.

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 Breaking Barriers to Healthcare Access: A Multilevel Analysis of Individual- and Community-Level Factors Affecting Women’s Access to Healthcare Services in Benin

2021 ◽  
Vol 18 (2) ◽  
pp. 750
Author(s):  
Betregiorgis Zegeye ◽  
Ziad El-Khatib ◽  
Edward Kwabena Ameyaw ◽  
Abdul-Aziz Seidu ◽  
Bright Opoku Ahinkorah ◽  
...  
Keyword(s):  
Low Income ◽  
Economic Status ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Community Level ◽  
Low Income Countries ◽  
Outcome Variable ◽  
National Education ◽  
Individual Level

Background: In low-income countries such as Benin, most people have poor access to healthcare services. There is scarcity of evidence about barriers to accessing healthcare services in Benin. Therefore, we examined the magnitude of the problem of access to healthcare services and its associated factors. Methods: We utilized data from the 2017–2018 Benin Demographic and Health Survey (n = 15,928). We examined the associations between the demographic and socioeconomic characteristics of women using multilevel logistic regression. The outcome variable for the study was problem of access to healthcare service. Adjusted odds ratios (AORs) with 95% confidence intervals (95% CI) were estimated. Results: Overall, 60.4% of surveyed women had problems in accessing healthcare services. Partner’s education (AOR = 0.70; 95% CI; 0.55–0.89), economic status (AOR = 0.59; 95% CI; 0.47–0.73), marital status (AOR = 0.44; 95% CI; 0.39–0.51), and parity (AOR = 1.85; 95% CI; 1.45–2.35) were significant individual-level factors associated with problem of access to healthcare. Region (AOR = 5.24; 95% CI; 3.18–8.64) and community literacy level (AOR = 0.69; 95% CI; 0.51–0.94) were the main community-level risk factors. Conclusions: Enhancing husband education through adult education programs, economic empowerment of women, enhancing national education coverage, and providing priority for unmarried and multipara women need to be considered. Additionally, there is the need to ensure equity-based access to healthcare services across regions.

scholarly journals Self-reported diseases and their associated risk factors among camp-dwelling conflict-affected internally displaced populations in Nigeria

2020 ◽  
Author(s):  
Winifred Ekezie ◽  
Puja Myles ◽  
Rachael L Murray ◽  
Manpreet Bains ◽  
Stephen Timmons ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Outcomes ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Health Conditions ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Internally Displaced ◽  
Reported Data

ABSTRACT Background Conflict in Nigeria displaced millions of people, and some settled in camp-like locations within the country. Evidence on the association between living conditions and health outcomes among these populations are limited. This study investigated the risk factors associated with illnesses among camp-dwelling internally displaced persons (IDPs) in northern Nigeria. Methods A cross-sectional study was conducted in nine camps in 2016. Self-reported data on socio-demography, resource utilization and disease outcomes were collected. Association between health conditions and various factors, including sanitation and healthcare access, was investigated. Results Data from 2253 IDPs showed 81.1% (CI = 79.5–82.7) experienced one or more health conditions; however, over 20% did not access healthcare services. Most common diseases were malaria, fever, typhoid and diarrhoea. Multivariable logistic regression presented as adjusted odds ratios(aOR) and 95% confidence intervals(CIs) showed factors significantly associated with increased likelihood of illnesses included being female (aOR = 1.53;CI = 1.19–1.96), overcrowding (aOR = 1.07;CI = 1.00–1.36), long-term conditions (aOR = 2.72;CI = 1.88–3.94), outdoor defecation (aOR = 2.37;CI = 1.14–4.94) and presence of disease-causing vectors (aOR = 3.71;CI = 1.60–8.60). Conclusion Most diseases in the camps were communicable. Modifiable risk factors such as overcrowding and poor toilet facilities were associated with increased poor health outcomes. This evidence highlights areas of high priority when planning humanitarian public health interventions.

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