Advanced Access in Primary Health Care: experiences from Brazil and Canada

Access is the timely use of services in order to meet the needs of the user. As an alternative to the traditional model, the Advanced Access (AA) model appears in Canada , with schedules restricted to specific cases. Objectives: The purpose of this article is to analyze the existing scientific production about the Advanced Access model in Primary Health Care. Methods: Integrative literature review using the descriptors (1) “Health Care Accessibility” OR “Primary Health Care” AND and (2) "Advanced Access" in the PubMed, Scopus and BIREME databases. Selection criteria were studies published in the last five years, available in Portuguese, English or Spanish and dealing with the theme. Results: Eight studies were selected, six were grouped into two categories of analysis: “The Canadian experience with AA : a model in consolidation”; and “The Brazilian experience with AA: local experiments” and the other two contributed to enrich the discussion. The AA stands out to balance capacity and demand with physical infrastructure and adequate staff, both in the international arena, as the experiences of municipalities, improving the quality of APS. Conclusion: Studies that detail the AA in its practice, as well as the challenges and needs, can inspire other health units to study it and consider its implementation if it is appropriate for its context, aiming to improve the health and care of its population.

Developing and testing a framework for understanding refugees' job search processes

PurposeThis article outlines the development of the Refugee Job Search Process Framework (RJSPF), which was created to help identify barriers that refugees face when trying to find employment. The framework incorporates an interdisciplinary, multi-level approach to the job search, delving into research from migration studies and Industrial/Organizational psychology to outline factors that exist on both the side of the refugee applicant and the organization at each stage of the RJSPF. The authors also tested the RJSPF with Syrian refugees and service providers in Canada to examine the validity of each component of the model.Design/methodology/approachThe authors used a semi-structured format to interview refugees and service providers on their experiences in either trying to find employment or helping their refugee clients with the job search process. After transcribing the interviews, the data were independently coded, quantified, and analysed using Nvivo software to validate the RJSPF.FindingsThe majority of the RJSPF either had high or moderate support from the interviews. The authors also identified 6 broader themes using thematic analysis, which include language fluency, credential recognition, Canadian experience “catch 22”, cultural incongruencies, employer exploitation, and mental health for successful employment.Originality/valueThe RJSPF is a new integration of disparate theories of job search experiences in a literature that lacks an organizing framework and perspective on the unique challenges refugees face in this area compared to other newcomers. In doing so, the authors use an interdisciplinary, multi-level approach that extends the nomological network of barriers facing refugees, therefore informing future research and practice.