IMPLEMENTASI PROGRAM BANTUAN PEMERINTAH ASURANSI NELAYAN BPAN DI KECAMATAN TANGGETADA KABUPATEN KOLAKA

The purpose of this study is to analyze the implementation of the Fisherman Insurance Government Program in Tanggetada District, Kolaka Regency. This study uses a qualitative descriptive type of research that provides an overview of all the problems regarding the implementation of the Fisherman Insurance Government Assistance (BPAN) program in Tanggetada District, Kolaka Regency. The results, discussion and conclusions of this study indicate that there are four critical factors that affect the success of the implementation process. The first is communication, where the socialization of BPAN has not gone well, because information about the BPAN program has not been distributed properly to all fishermen in Tanggetada sub-district. Second, natural resources, where there is no socialization budget incentive for employees or extension workers. The third disposition, where the implementation of the Fisherman Insurance Government Assistance program, from the service is not committed because they have not felt the benefits as promised to provide welfare for themselves and their families, there is no democratic nature of the implementer because there are still fishermen who do not get a fisherman insurance card. The fourth is the bureaucratic structure, where the Fisherman Insurance Government Assistance program has SOPso that the implementation has a reference, namely the service is expected to be able to cooperate in the issuance process and the fishermen's insurance claim process.Keywords: Fisherman Insurance; Government Assistance; Implementation AbstrakTujuan penelitian ini adalah menganalisis Implementasi Program Pemerintah Asuransi Nelayan di Kecamatan Tanggetada Kabupaten Kolaka. Penelitian ini menggunakan jenis penelitian deskriptif kualitatif yaitu memberikan gambaran seluruh permasalahannya tentang implementasi program Bantuan Pemerintah Asuransi Nelayan (BPAN) di Kecamatan Tanggetada Kabupaten Kolaka. Hasil penelitian, pembahasan dan kesimpulan dari penelitian ini menunjukan bahwa terdapat empat critical factors yang mempengaruhi keberhasilan proses implementasi. Pertama komunikasi, dimana dalam sosialisasi BPAN belum berjalan dengan baik, karena informasi tentang program BPAN belum tersalurkan dengan baik kepada seluruh nelayan di kecamatan tanggetada. Kedua sumber daya alam, dimana dalam insentif anggaran sosialisasi yang dilakukan oleh pegawai maupun penyuluh tidak ada. Ketiga disposisi, dimana pelaksanaa program Bantuan Pemerintah Asuransi Nelayan, dari dinas tidak bersikap komitmen karena belum merasakan manfaat seperti yang dijanjikan memberikan kesejahtraan bagi dirinya dan keluarganya, tidak adanya sifat demokratis dari pelaksana karena masih ada nelayan yang tidak mendapatkan kartu asuransi nelayan. Keempat struktur birokrasi, dimana program Bantuan Pemerintah Asuransi Nelayan memiliki SOP agar pelaksanaannya memiliki acuan, yaitu dinas diharpakan dapat menjalin kerjasama dalmam proses penerbitan dan proses klaim asuransi nelayan. Kata Kunci: Asuransi Nelayan; Bantuan Pemerintah; Implementasi

Strategies for supplying face masks to the population of Taiwan during the COVID-19 pandemic

Background The use of face masks has become ubiquitous in Taiwan during the early COVID-19 pandemic. A name-based rationing system was established to enable the population of Taiwan to purchase face masks. This study is to assess the extent and fairness of face mask supply to the public in Taiwan. Methods The weekly face marks supplies were collected from name-based rationing system administrative statistics included national health insurance card and e-Mask selling record. National registered population statistics by age, gender, and district were collected from department of statistics ministry of the interior. The number of COVID-19 non-imported cases of Taiwan was collected from Taiwan centers of disease control. Results A total of 146,831,844 person times purchase records from February 6, 2020, to July 19, 2020, the weekly average face mask supply is 0.5 mask (per person) at the start of name-based rationing system, and gradually expanded to the maximum 5.1 masks (per person). Comparing the highest weekly total face mask supply (from Apr 9, 2020, to Apr 15, 2020) in aged 0–9 -, 10–19 -, 20–29 -, 30–39 -, 40–49 -, 50–59 -, 60–69 -,70–79 -, 80–89 -, 90–99, and > 100 years to the register population showed similar distribution between mask supplied people and total population (all standardized difference < 0.1). Conclusion The masks supply strategies has gradually escalated the number of face masks for the public, it not only has dominant decreased the barrier of acquiring face mask, but a fair supply for total population use of Taiwan.

The Electronic Health Insurance Card for Asylum-Seekers in Berlin: Effects on the Local Health System

Background: In debates on asylum-seekers’ access to healthcare it is frequently claimed that restrictions are necessary to prevent unduly high health service utilization and costs. Within Germany, healthcare provision for asylum-seekers varies across the different states. Berlin’s authorities removed some barriers to healthcare for asylum-seekers by introducing an electronic health insurance card (HIC) in 2016. We used the HIC introduction in Berlin as an opportunity to investigate the effects of improved healthcare access for asylum-seekers on the local health system. Methods: The study applied a mixed-methods design. A cost analysis compared expenses for outpatient and inpatient health services for asylum-seekers before and after the HIC introduction, based on aggregate claims data and information on expenses for humanitarian healthcare provision that were retrieved from the Berlin authorities. Semi-structured interviews with 12 key informants explored organizational effects like administrative workloads and ethical dilemmas for staff. We performed a content analysis and used respondent validation to enhance the accuracy and trustworthiness of our results. Results: The HIC has reduced bureaucratic complexity and administrative workloads; it has enabled unprecedented financial transparency and control; and it has mitigated ethical tensions. All the while, average per person expenses for outpatient health services have declined since the HIC introduction. However, our cost analysis also indicates a rise in the utilization and costs of inpatient care. Conclusion: The HIC introduction in Berlin suggests that the removal of barriers to healthcare for asylum-seekers can create win-win-situations by reducing administrative workloads, advancing financial transparency, and mitigating ethical tensions, whilst cutting the costs of outpatient healthcare provision. Removing barriers to healthcare thus appears to be a more prudent policy choice than maintaining mechanisms of restriction and control. However, high inpatient care utilization and costs warrant further research.

A qualitative study on mixed experiences of discrimination and healthcare access among HIV-positive immigrants in Spain

Background Immigrants are disproportionally impacted by HIV infection in Europe and in Spain. Immigrants are also identified as a vulnerable population during economic crises. Various socioeconomic barriers hinder HIV-positive immigrants from accessing healthcare services in the host country. As a result of the 2008 financial crisis, Spain has implemented multiple austerity measures, one of which was the enactments of Royal Decree Law (RDL) 16/2012 and Royal Decree (RD) 1192/2012 which abolished universal healthcare coverage. In this context, this study examined: 1) Participants’ mixed experiences in accessing health care after the enactment of 2012 RDL and RD, and 2) Distress felt by the participants and their experiences as HIV-positive immigrants living in Spain. Methods Participants were recruited through a nongovernmental organization (NGO) during routine visits at the center. A total of 12 participants were interviewed to reach data saturation. Participants were HIV-positive immigrants living in Spain for 1 or more years, allowing for substantial experience with navigating the healthcare system. Thematic analysis was performed to identify common themes in participants’ experiences living as HIV-positive individuals in Spain and in accessing healthcare. Results Four primary themes were identified. The primary systemic barrier to accessing health care encountered by participants was the inability to fulfill the requirement of having proof of registration in an Autonomous Community for the required time period, thus not being able to apply for a public health insurance card and utilize free care services. Participants identified a positive impact of third party (NGO, social worker, friend/family member) guidance on their experience of applying for a public health insurance card. Participants expressed experiencing emotional or physical (eg, side effects of medication) distress in adapting to life as HIV-positive individuals. Participants also identified experiencing discrimination while living as HIV-positive immigrants in Spain. Conclusions HIV-positive immigrants are underserved in Spain. They encounter systemic barriers while accessing healthcare services, and experience fear and/or discrimination. The study underscores the role of NGOs in helping HIV-positive immigrants navigate the healthcare system. More research is needed on comprehensive approaches to address healthcare needs of HIV-positive immigrants in Spain.

Strategies for Supplying Face Masks to the Population of Taiwan During the COVID-19 Pandemic.

Background The use of face masks has become ubiquitous in Taiwan during the early COVID-19 pandemic. A name-based rationing system was established to enable the population of Taiwan to purchase face masks. This study is to assess the extent and fairness of face mask supply to the public in Taiwan. Methods The weekly face marks supplies were collected from name-based rationing system administrative statistics included national health insurance card and e-Mask selling record. National registered population statistics by age, gender, and district were collected from department of statistics ministry of the interior. The number of COVID-19 non-imported cases of Taiwan was collected from Taiwan centers of disease control. Results A total of 146,831,844 person times purchase records from February 6, 2020, to July 19, 2020, the weekly average face mask supply is 0.5 mask (per person) at the start of name-based rationing system, and gradually expanded to the maximum 5.1 masks (per person). Comparing the highest weekly total face mask supply (from Apr 9, 2020, to Apr 15, 2020) in aged 0–9 -, 10–19 -, 20–29 -, 30–39 -, 40–49 -, 50–69 -, 60–69 -,70–79 -, 80–89 -, 90–99, and > 100 years to the register population showed similar distribution between mask supplied people and total population (all standardized difference < 0.1). Conclusions The masks supply strategies has gradually escalated the number of face masks for the public, it not only has dominant decreased the barrier of acquiring face mask, but a fair supply for total population use of Taiwan.

Bringing EU citizens together or pulling them apart? The European Health Insurance Card, east–west mobility and the failed promise of European social integration

Although the European Health Insurance Card (EHIC) was meant to bring Europeans together, this study shows that it is amplifying social inequalities across regions and classes. First, we evaluate the effects of east–west EHIC mobility, and of Eastern Europeans’ participation in it, on the practice of EU social citizenship rights to access cross-border care along spatial (east–west) and social class divides. We then assess the impact of these mobilities on healthcare resources in Western and Eastern Europe. Our findings show that the EHIC reinforces rather than reduces the spatially and socially uneven access to social citizenship rights to cross-border care. Moreover, EHIC patient outflows from Eastern to Western Europe result in a much higher relative financial burden for the budgets of Eastern European states than outflows from Western to Eastern Europe do for Western European countries. As a result, east–west EHIC mobility is reproducing rather than reversing healthcare inequalities between the two regions. Hence, the EHIC does not fulfil its promise of European social integration – not, however, because it creates a burden on Western European welfare states as often argued in Eurosceptic tabloids, but because it increases social inequalities both inside and between richer and poorer EU member states.

Mobile outreach testing for COVID-19 in twenty homeless shelters in Toronto, Canada

BackgroundIt is unclear what the best strategy is for detecting COVID-19 among homeless shelter residents and what individual factors are associated with positivity.MethodsWe conducted a retrospective chart audit obtaining repeated cross-sectional data from outreach testing done at homeless shelters between April 1st and July 31st, 2020 in Toronto, Canada. We compared the positivity rate for shelters tested because of an outbreak (at least one known case) versus surveillance (no known cases). A patient-level analysis examined differences in demographic, health, and behavioural characteristics of residents who did and did not test positive for COVID-19.FindingsOne thousand nasopharyngeal swabs were done on 872 unique residents at 20 shelter locations. Among the 504 tests done in outbreak settings, 69 (14%) were positive and 1 (0.2%) was indeterminate. Among the 496 tests done for surveillance, 11 (2%) were positive and none were indeterminate. Shelter residents who tested positive were significantly less likely to have a health insurance card (54% vs 72%, p=0.03) or have visited another shelter in the last 14 days (0% vs 18%, p<0.01) compared to those who tested negative; There was no association between COVID-19 positivity and medical history (p=0.40) or symptoms (p=0.43).InterpretationOur findings support testing of asymptomatic shelter residents for COVID-19 when a positive case is identified at the same shelter but suggest limited utility of testing all shelter residents in the absence of a known case. Visiting another shelter in the last 14 days is associated with a decreased risk of COVID-19 positivity.

A Qualitative Study of Systemic Barriers Encountered by HIV-Positive Immigrants in Spain

Background: Immigrants are disproportionally impacted by HIV infection in Europe and in Spain. Immigrants are also identified as a vulnerable population during economic crises. Various socioeconomic barriers hinder HIV-positive immigrants from accessing healthcare services in the host country. As a result of the 2008 financial crisis, Spain has implemented multiple austerity measures, one of which was the enactments of Royal Decree Law (RDL) 16/2012 and Royal Decree (RD) 1192/2012 which abolished universal healthcare coverage. In this context, this study examined systemic barriers encountered by the participants while accessing health care after the enactments of 2012 RDL and RD. The study also researched distress felt by the participants and their experiences as HIV-positive immigrants living in Spain. Methods: Participants were recruited through a nongovernmental organization (NGO) during routine visits at the their center. A total of 12 participants were interviewed to reach data saturation. Participants were HIV-positive immigrants living in Spain for 1 or more years, allowing for substantial experience with navigating the healthcare system. Thematic analysis was performed to identify common themes in participants’ experiences living as HIV-positive individuals in Spain and confronting systemic barriers to healthcare access. Results: Four primary themes were identified. Participants identified experiencing emotional or physical (eg, side effects of medication) distress in adapting to life as HIV-positive individuals. Participants also expressed experiencing discrimination while living as HIV-positive immigrants in Spain. The primary systemic barrier to accessing health care encountered by participants was the inability to fulfill the requirement of having proof of registration in an Autonomous Community for the required time period, thus not being able to apply for a public health insurance card and utilize free care services. Participants identified a positive impact of third party (NGO, social worker, friend/family member) guidance on their experience of applying for a public health insurance card.Conclusions: HIV-positive immigrants are underserved in Spain. They encounter systemic barriers while accessing healthcare services, and experience fear and/or discrimination. The study underscores the role of NGOs in helping HIV-positive immigrants navigate the healthcare system. More research is needed on comprehensive approaches to address healthcare needs of HIV-positive immigrants in Spain.

Outcomes of the Health Insurance Card Scheme on Migrants’ Use of Health Services in Ranong Province, Thailand

In 2002, Thailand achieved Universal Health Coverage for all citizens; however, it remains the case that undocumented migrants are not fully covered. The Health Insurance Card Scheme (HICS) of the Ministry of Public Health is the key policy aiming to cover undocumented migrants. This study examined the impact of this policy on the utilisation rate of public health facilities among HICS beneficiaries including undocumented migrants. Facility-based individual records between 2011 and 2015 were purposively retrieved from one provincial hospital, one district hospital, and two health centres in one of the most densely migrant-populated provinces in Thailand. Poisson regression was conducted on inpatient (IP) utilisation, while negative binomial regression was conducted on outpatient (OP) utilisation. Of 74,722 admissions, 19.0% were insured by HICS. About 14.0% of the outpatient records were for HICS beneficiaries. Overall, the HICS utilisation rate in migrants was lower than in Thai patients. Being insured with the HICS significantly increased OP utilisation by 1.7%, and IP utilisation by 11.1% (relative to uninsured). Disease status was the most important factor that positively influenced the utilisation rate. Further studies that explore the differences in health service utilisation among HICS beneficiaries with diverse economic backgrounds are recommended