scholarly journals Treatment challenges for alcohol service users in Kampala, Uganda

2017 ◽  
Vol 6 (1) ◽  
pp. 27-35 ◽  
Author(s):  
David Kalema ◽  
Wouter Vanderplasschen ◽  
Sofie Vindevogel ◽  
Peter K Baguma ◽  
Ilse Derluyn
Keyword(s):  
Service Providers ◽  
Qualitative Interviews ◽  
Alcohol Treatment ◽  
Capital City ◽  
Treatment Center ◽  
Service Users ◽  
Individual Level ◽  
Treatment Participation ◽  
Sub Saharan ◽  
The Individual

Kalema, D., Vanderplasschen, W., Vindevogel, S., Baguma, P., & Derluyn, I. (2017). Treatment challenges for alcohol service users in Kampala, Uganda. The International Journal Of Alcohol And Drug Research, 6(1), 27-35. doi:http://dx.doi.org/10.7895/ijadr.v6i1.240Background and Aims: Enhancing treatment participation of persons with substance use disorders is a challenge worldwide. Obstacles keeping people from entering or continuing treatment are well documented in Western countries, but such knowledge is scarce in majority countries that face particular challenges when implementing alcohol policies. This study aimed at identifying factors challenging treatment participation in Uganda, a Sub-Saharan country with a considerable alcohol problem.Methods: Data were collected during 30 in-depth, qualitative interviews on treatment challenges with 20 service providers and 10 male service users, who were recruited at one public and one private alcohol treatment center in the Ugandan capital city, Kampala. Men comprise about 90% of the total number of service users in these centers. Interview data were analyzed thematically, using Nvivo software, and were categorized around three levels of treatment challenges: societal, institutional, and personal challenges.Findings: Interview findings showed several treatment challenges relating to institutional aspects like inadequate human resources, overall insufficiency of services, and the treatment philosophy of available services. Respondents identified stigma and cultural interference as important challenges at the societal level, while limited awareness about addiction and denial of problems can be situated at the individual level.Conclusions: Institutional, societal, and personal challenges keep persons with AUD from participating in alcohol treatment in public and private services in Uganda. Alcohol regulation, sensitization, and prevention are needed to raise awareness at the societal and individual level, while appropriate training and additional financial resources may help to overcome institutional challenges.

scholarly journals Facilitating User Involvement in Activation Programmes: When Carers and Clerks Meet Pawns and Queens

2014 ◽  
Vol 44 (2) ◽  
pp. 235-254 ◽  
Author(s):  
ANNE BRITT DJUVE ◽  
HANNE C. KAVLI
Keyword(s):  
Human Factor ◽  
Service Providers ◽  
Qualitative Interviews ◽  
User Involvement ◽  
Individual Characteristics ◽  
Service Users ◽  
Ideal Types ◽  
Number Of Factors ◽  
User Influence ◽  
The Individual

AbstractUser involvement has become an explicit goal within social service provision. Even so, the term remains ambiguous, and its implementation troublesome. Implementation theory lists a number of factors influencing bureaucratic behaviour; in this paper we investigate the ‘human factor’. Our ambition is to provide a framework for analysis of user influence in activation programmes that includes the individual characteristics of both service users and service providers. Building on theoretical insights from the literature on activation and agency, we develop a framework that distinguishes between two ideal types of service users: Pawns and Queens, and two types of service providers: care-oriented Carers and rule-oriented Clerks. This framework is then applied to identify key challenges for the interaction between users and caseworkers in two challenging situations: when service users express little or no agency and when they express agency that is incompatible with the overall goals of the programme. We find that Carers show pronounced reluctance to overrule the choices made by service users even when they have conflicting views – and tend to postpone decisions when they interact with Pawns. Clerks tend to overrule the decisions of Queens when they have conflicting views, and to make decisions on behalf of Pawns. The analysis draws on data collected from 126 qualitative interviews with service providers and participants in the Norwegian Introductory Programme for immigrants and a survey of 320 caseworkers.

Restraint use in psychiatric emergency services: Intentions of staff vs consumer experiences in Singapore

2020 ◽  
Author(s):  
Daniel Poremski ◽  
Josephine Tham ◽  
Peizhi Wang ◽  
Doris Koh ◽  
Jayaraman Hariram ◽  
...  
Keyword(s):  
Emergency Services ◽  
Service Providers ◽  
Qualitative Interviews ◽  
Phenomenological Approach ◽  
Psychiatric Emergency ◽  
Service Users ◽  
Physical Restraints ◽  
Psychiatric Emergency Services ◽  
Restraint Use ◽  
The Individual

AbstractBackground: Physical restraints applied at psychiatric emergency services are infrequent but concerning. Such measures are deleterious to the health of the individual and to the working alliance that exists between the individual and service providers. Aims: To juxtapose service users’ experiences of restraints at a psychiatric emergency service in Singapore with staff’s intention. Methods: Three qualitative interviews were conducted over a year with 44 frequent service users to query their experiences with services. The views of 26 emergency department staff were also obtained. We took a descriptive phenomenological approach to analyse the data.Results: Sixteen of 44 frequent service users report being restrained at emergency services. Service users’ experiences are incongruent with the staff’s meaning of restraints, which relates to safety. The experience of being restrained began with confusion, followed by fear and irritation, ending with embarrassment. Importantly, these emotions were unaddressed during debriefing, when service users were released. Conclusions: Staff must be mindful that their actions are not perceived as intended. Additional staff training may help staff better understand the way in which service users perceive the phenomenon of restraint. De-escalation must not be done in a way that introduces anger into situations where it had previously been absent.

scholarly journals The potential impacts of community drug checking within the overdose crisis: qualitative study exploring the perspective of prospective service users

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bruce Wallace ◽  
Thea van Roode ◽  
Flora Pagan ◽  
Dennis Hore ◽  
Bernadette Pauly
Keyword(s):  
Harm Reduction ◽  
Drug Market ◽  
Pilot Project ◽  
Service Users ◽  
Socioecological Model ◽  
Individual Level ◽  
Universal Approach ◽  
Drug Checking ◽  
Potential Benefits ◽  
The Individual

Abstract Background As drug checking becomes more integrated within public health responses to the overdose crisis, and potentially more institutionalized, there is value in critically questioning the impacts of drug checking as a harm reduction response. Methods As part of a pilot project to implement community drug checking in Victoria, BC, Canada, in-depth interviews (N = 27) were held with people who use or have used substances, family or friends of people who use substances, and/or people who make or distribute substances. Critical harm reduction and social justice perspectives and a socioecological model guided our analysis to understand the potential role of drug checking within the overdose crisis, from the perspective of prospective service users. Results Participants provided insight into who might benefit from community drug checking and potential benefits. They indicated drug checking addresses a “shared need” that could benefit people who use substances, people who care for people who use substances, and people who sell substances. Using a socioecological model, we identified four overarching themes corresponding to benefits at each level: “drug checking to improve health and wellbeing of people who use substances”, “drug checking to increase quality control in an unregulated market”, “drug checking to create healthier environments”, and “drug checking to mediate policies around substance use”. Conclusions Drug checking requires a universal approach to meet the needs of diverse populations who use substances, and must not be focused on abstinence based outcomes. As a harm reduction response, community drug checking has potential impacts beyond the individual level. These include increasing power and accountability within the illicit drug market, improving the health of communities, supporting safer supply initiatives and regulation of substances, and mitigating harms of criminalization. Evaluation of drug checking should consider potential impacts that extend beyond individual behaviour change and recognize lived realities and structural conditions.

scholarly journals Quantifying the under-estimation of cervical Cancer in remote regions of Tanzania

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mariah P. Gesink ◽  
Robert M. Chamberlain ◽  
Julius Mwaiselage ◽  
Crispin Kahesa ◽  
Kahima Jackson ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Low Income ◽  
Population Based ◽  
Capital City ◽  
Low Income Countries ◽  
Treatment Center ◽  
Large Country ◽  
Number Of Patients ◽  
Sub Saharan ◽  
Radiotherapy Treatment

Abstract Background Cervical cancer is the most common cancer among women in Sub-Saharan countries, including Tanzania. While early detection and diagnosis are available in some parts of this large country, radiotherapy has been only available at the Ocean Road Cancer Institute (ORCI), in the capital city of Dar es Salaam and is just starting in a few regions. Methods The objective of this study was to compare the observed incidence of cervical cancer for the two remote regions of Mwanza in western Tanzania and Mbeya in southern Tanzania, based on their patients treated at the ORCI from 2011 to 2014. Results: The number patients referred and treated at ORCI were (120 from Mwanza, and 171 from Mbeya, representing 24.6 and 32.8% of the patients histopathologically confirmed in the two sites, respectively. The results showed significant underestimation of cervical cancer in the two regions. The vast majority of patients who were histopathologically-confirmed in their local regions (73.92% from Mwanza and 65.1% from Mbeya), but did not receive the needed radiotherapy treatment at the ORCI. The estimated incidence for the two regions based on the number of patients treated at the ORCI were underestimated by 53.9% for Mwanza and 68.9% for Mbeya. Conclusions Local establishment of radiotherapy treatment facilities in remote regions in Tanzania and similar other low-income countries is essential for providing effective treatment and improving survival of diagnosed cervical cancer patients. Linkage between the records of local remote hospitals and the main cancer treatment center in the capital city can also help support the emerging the population-based cancer registry at ORCI.

scholarly journals The transformative service paradox: the dilemma of wellbeing trade-offs

2020 ◽  
Vol 31 (4) ◽  
pp. 637-663
Author(s):  
Rebekah Russell–Bennett ◽  
Rory Mulcahy ◽  
Kate Letheren ◽  
Ryan McAndrew ◽  
Uwe Dulleck
Keyword(s):  
Laboratory Experiment ◽  
Qualitative Interviews ◽  
Implicit Assumption ◽  
Trade Off ◽  
Content Type ◽  
Individual Level ◽  
Trade Offs ◽  
Physical Wellbeing ◽  
The Individual ◽  
Future Implication

PurposeA transformative service aims to improve wellbeing; however, current approaches have an implicit assumption that all wellbeing dimensions are equal and more dimensions led to higher wellbeing. The purpose of this paper is to present evidence for a new framework that identifies the paradox of competing wellbeing dimensions for both the individual and others in society – the transformative service paradox (TSP).Design/methodology/approachData is drawn from a mixed-method approach using qualitative (interviews) and quantitative data (lab experiment) in an electricity service context. The first study involves 45 household interviews (n = 118) and deals with the nature of trade-offs at the individual level to establish the concept of the TSP. The second study uses a behavioral economics laboratory experiment (n = 110) to test the self vs. other nature of the trade-off in day-to-day use of electricity.FindingsThe interviews and experiment identified that temporal (now vs. future) and beneficiary-level factors explain why individuals make wellbeing trade-offs for the transformative service of electricity. The laboratory experiment showed that when the future implication of the trade-off is made salient, consumers are more willing to forego physical wellbeing for environmental wellbeing, whereas when the “now” implication is more salient consumers forego financial wellbeing for physical wellbeing.Originality/valueThis research introduces the term “Transformative Service Paradox” and identifies two factors that explain why consumers make wellbeing trade-offs at the individual level and at the societal level; temporal (now vs. future) and wellbeing beneficiary.

Health literacy and its effects on well-being: how vulnerable healthcare service users integrate online resources

2020 ◽  
Vol 34 (5) ◽  
pp. 697-715
Author(s):  
Justine Virlée ◽  
Allard C.R. van Riel ◽  
Wafa Hammedi
Keyword(s):  
Quality Of Life ◽  
Health Literacy ◽  
Healthcare Service ◽  
Health Resources ◽  
Well Being ◽  
Service Users ◽  
Content Type ◽  
Individual Level ◽  
The Individual

Purpose This study aims to develop a better understanding of how online health community (OHC) members with different health literacy (HL) levels benefit from their participation, through the analysis and comparison of their resource integration (RI) processes. It investigates through a RI lens how the vulnerability of community members – captured as their level of HL – affects the benefits they derive from participation. Design/methodology/approach Quantitative and qualitative methods were used to investigate the effects of healthcare service users’ vulnerability. Data were collected about their profiles and levels of HL. Furthermore, 15 in-depth interviews were conducted. Findings The study demonstrates how low levels of HL act as a barrier to the integration of available online health resources. Participation in OHCs appears less beneficial for vulnerable users. Three types of benefits were identified at the individual level, namely, psychological quality-of-life, physical quality-of-life and learning. Benefits identified at the community level were: content generation and participation in the development of the community. Originality/value This study has implications for the understanding of how service users’ activities affect their own outcomes and how the vulnerability of users could be anticipated and considered in the design of the community.

scholarly journals How education mitigates the realisation of fertility intentions: Is sub-Saharan Africa different?

2018 ◽  
Author(s):  
Melanie Channon ◽  
SARAH HARPER
Keyword(s):  
Educational Achievement ◽  
Fertility Transition ◽  
Population Level ◽  
Fertility Intentions ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Individual Level ◽  
Highly Educated ◽  
Sub Saharan ◽  
The Individual

The gap between achieved fertility and fertility ideals is notably higher in sub-Saharan Africa (SSA) than elsewhere, relating to both under- and overachievement of fertility ideals. We consider the extent to which the relationship between fertility ideals and achieved fertility is mitigated by educational achievement. Further, we consider if the effect of education acts differently in SSA, and thereby hypothesise how increasing levels of education in SSA may decrease fertility.We use 227 Demographic and Health Surveys from 57 countries worldwide to look at population- and individual-level measures of achieving fertility ideals. Population level measures are used to assess whether the correspondence between fertility intentions and achievements differ by level of education. We then look at the individual-level determinants of both under- and overachieving fertility intentions. An average of 40% of women in SSA underachieve their stated fertility intentions compared to 26% in non-SSA countries. Furthermore, the educational gradient of underachievement is different in SSA where higher levels of education are not related to better correspondence between fertility intentions and achievements. We argue that the phenomenon of underachieving fertility ideals (or unrealized fertility) may be of particular importance for the ongoing fertility transition throughout SSA, especially for highly educated groups.

Participation and coping

2013 ◽  
Vol 17 (1) ◽  
pp. 22-34
Author(s):  
Rita Elisabeth Eriksen
Keyword(s):  
Everyday Life ◽  
Social Services ◽  
Preliminary Analysis ◽  
Qualitative Interviews ◽  
Analytical Framework ◽  
Social Contexts ◽  
Service Users ◽  
Mutual Dependence ◽  
Individual Level ◽  
And Coping

What implications might an understanding of a mutual dependence between the concepts of participation and coping have for professional engagement with service users? This article presents why participation is central to peoples’ lives and how service user coping with and personal participating in everyday life might be understood. Service users have access to personal and environmental resources and want to manage their everyday life as much as possible. To be able to cope they have to participate. An analytical framework was developed as a result of a study based on qualitative interviews with service users in Norway. A framework was constructed to explore how the service users participated and coped with their everyday life – both on an individual level and through interactions with their environment. This framework emerged from preliminary analysis and was then used in further analysis of the data. The study showed that professionals would be advised to build on the participation and coping that service users had established in their daily life as citizens as well as people using social services. Some service users expressed that the more social contexts they participated in, the better they experienced their coping.

Psykologer i kommunen: En kartlegging av tjenester for barn og unge med psykiske vansker

2021 ◽  
Vol 58 (6) ◽  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Children And Adolescents ◽  
Service Providers ◽  
Population Level ◽  
Clinical Psychologist ◽  
Service Users ◽  
Individual Level ◽  
Specialist Services ◽  
Common Problems

Background: Frontline mental health services for children and adolescents are receiving increased attention, and all Norwegian municipalities were required to hire a clinical psychologist by 2020. However, we know little about what role clinical psychologists have taken in frontline services in terms of the content of their service or how they differ from other frontline practitioners. Objective: The objective was to investigate what types of problems children and adolescents who receive help from frontline psychologists have, what type of help is being offered, what improvements are needed, and how the services provided by psychologists differ from those of other frontline service providers. Method: The current study is based on reports from 139 psychologists and 587 other professionals working with children and adolescents in frontline services. Results: The psychologists report emotional struggles and challenging life situations to be the most common problems among their service users. Most of the interventions delivered by psychologists are provided at individual level rather than at group or population level. Compared with other frontline practitioners, psychologists more often include parents in sessions with children and adolescents. Both psychologists and other professionals report a need for increased collaboration across services. Implications: The results suggest that improvements could involve strengthening collaboration between frontline and specialist services.

Economic Abuse: A Subtle but Common Form of Power and Control

2020 ◽  
pp. 088626052091626
Author(s):  
Kameri Christy ◽  
Tanice Welter ◽  
Kelly Dundon ◽  
Valandra ◽  
Ambra Bruce
Keyword(s):  
Partner Violence ◽  
Service Providers ◽  
Qualitative Interviews ◽  
Police Training ◽  
Distinct Type ◽  
Service Users ◽  
Economic Abuse ◽  
Frontline Workers ◽  
Professional Responses ◽  
Study Participants

Awareness of and responses to intimate partner violence against women (IPV-W) have been increasing steadily since the early 1970s. However, one of the most frequently used and effective strategies by abusive partners, economic abuse (EA), has received much less attention than physical or sexual abuse. In-depth qualitative interviews were conducted with IPV-W service users ( n = 15) and providers ( n = 24) in England to expand the knowledge-base and provide support regarding the reality and impact of EA, the economic barriers and supports experienced when trying to obtain help, and recommendations for remediating EA. Grounded theory procedures of open, axial, and selective coding techniques were utilized for data analysis. Five themes, (a) definitions and prevalence of EA, (b) service users experiences of EA, ( c) continued impact of EA, ( d) barriers to obtaining help, and (e) goals regarding finances, emerged with both groups. The theme professional responses to EA also surfaced for service providers, and service users discussed the additional theme of service users’ support when experiencing EA. The study participants’ recommendations include (a) identifying EA as a distinct type of IPV-W, (b) updating legal guideline to allow offenders of EA to be prosecuted, (c) encouraging banks to do more to assist victims of EA, and (d) updating police training and frontline workers to include EA. The narratives of the study participants underscore the import of collaboration with and involvement of IPV-W service user and provider stakeholders when developing and implementing policies, programs, and practices to prevent further EA and meet the distinctive needs of women who experience EA as a part of IPV-W.

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