scholarly journals Healthcare inequities and barriers to access for homeless individuals: a qualitative study in Barcelona (Spain)

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Andrés Cernadas ◽  
Ángela Fernández
Keyword(s):  
Qualitative Study ◽  
Health Services ◽  
Healthcare Workers ◽  
Service Providers ◽  
Universal Access ◽  
Healthcare Services ◽  
Medical Professional ◽  
Homeless Population ◽  
Public Health Services ◽  
Structured Interviews

Abstract Background In Spain, homeless individuals have lower perceived quality of health than the rest of the population and their life expectancy is 30 years lower than the national average. While the Spanish health system provides universal access and coverage, homeless individuals do not access or use public care enough to maintain their health. The objective of this study is to determine if homeless individuals can access public health services in conditions of equality with the rest of the population, as established in healthcare legislation, and to better understand the causes of observed inequalities or inequities of access. Methods A detailed qualitative study was carried out in the city of Barcelona (Spain) from October 2019 to February 2020. A total of nine open and in-depth interviews were done with homeless individuals along with seven semi-structured interviews with key informants and two focus groups. One group was composed of eight individuals who were living on the street at the time and the other consisted of eight individuals working in healthcare and social assistance. Results The participants indicated that homeless individuals tend to only access healthcare services when they are seriously ill or have suffered some kind of injury. Once there, they tend to encounter significant barriers that might be 1) administrative; 2) personal, based on belief that that will be poorly attended, discriminated against, or unable to afford treatment; or 3) medical-professional, when health professionals, who understand the lifestyle of this population and their low follow-through with treatments, tend towards minimalist interventions that lack the dedication they would apply to other groups of patients. Conclusions The conclusions derived from this study convey the infrequent use of health services by homeless individuals for reasons attributable to the population itself, to healthcare workers and to the entire healthcare system. Accordingly, to reduce inequities of access to these services, recommendations to healthcare service providers include adapting facilities to provide more adequate care for this population; increasing sensitivity/awareness among healthcare workers; developing in situ care systems in places where the homeless population is most concentrated; and establishing healthcare collaboration agreements with entities that work with this population.

scholarly journals Do community scorecards improve utilisation of health services in community clinics: experience from a rural area of Bangladesh

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
S. M. A. Hanifi ◽  
Aazia Hossain ◽  
Asiful Haidar Chowdhury ◽  
Shahidul Hoque ◽  
Mohammad Abdus Selim ◽  
...  
Keyword(s):  
Health Services ◽  
Rural Area ◽  
Service Providers ◽  
Healthcare Providers ◽  
Community Support ◽  
Healthcare Services ◽  
Public Health Services ◽  
Community Clinics ◽  
Community Awareness ◽  
The Government

Abstract Background The government of Bangladesh initiated community clinics (CC) to extend the reach of public health services and these facilities were planned to be run through community participation. However, utilisation of CC services is still very low. Evidence indicates community score card is an effective tool to increase utilisation of services from health facility through regular interface meeting between service providers and beneficiary. We investigated whether community scorecards (CSC) improve utilisation of health services provided by CCs in rural area of Bangladesh. Methods This study was conducted from December 2017 to November 2018. Three intervention and three control CCs were selected from Chakaria, a rural sub-district of Bangladesh. CSC was introduced with the Community Groups and Community Support Groups in intervention CCs between January to October 2018. Data were collected through observation of CCs during operational hours, key informant interviews, focus group discussions, and from DHIS2. Utilisation of CC services was compared between intervention and control areas, pre and post CSC intervention. Results Post CSC intervention, community awareness about CC services, utilisation of clinic operational hours, and accountability of healthcare providers have increased in the intervention CCs. Utilisation of primary healthcare services including family planning services, antenatal care, postnatal care and basic health services have significantly improved in intervention CCs. Conclusion CSC is an effective tool to increase the service utilization provided by CCs by ensuring community awareness and participation, and service providers’ accountability. Policy makers and concerned authorities may take necessary steps to integrate community scorecard in the health system by incorporating it in CCs.

scholarly journals Knowledge, Attitudes and Expectations of Physicians with Respect to Palliative Care in Ecuador: A Qualitative Study

2020 ◽  
Vol 17 (11) ◽  
pp. 3906 ◽  
Author(s):  
Viviana Dávalos-Batallas ◽  
Vinita Mahtani-Chugani ◽  
Carla López-Núñez ◽  
Víctor Duque ◽  
Fatima Leon-Larios ◽  
...  
Keyword(s):  
Palliative Care ◽  
Health Policy ◽  
Qualitative Study ◽  
Health Services ◽  
Human Resources ◽  
Thematic Analysis ◽  
Medical Professional ◽  
Structured Interviews ◽  
Unequal Distribution

Background: The worldwide need for palliative care is high, especially in mid- income countries like Ecuador, where the percentage of patients receiving such care is very small due to the scarcity of infrastructure and specialized personnel and to the unequal distribution in the country. The objective of this study is to explore the knowledge, attitudes and expectations related to palliative care of the physicians in Ecuador. Methods: A qualitative study based on 28 semi-structured interviews, from March 2014 to November 2016, with physicians working in four cities in Ecuador recruited through the snowball technique. Thematic analysis was developed supported by the ATLAS.ti software. Results: Five core themes were identified: (1) training, (2) health policy, (3) professionals’ activities, (4) health services and (5) development of palliative care in Ecuador. Conclusions: Strategies are needed which intensify the training of medical professional in palliative care, as well as avail the human resources and materials for providing it.

scholarly journals To Volunteer or Not? Perspectives towards Pre-Registered Nursing Students Volunteering Frontline during COVID-19 Pandemic to Ease Healthcare Workforce: A Qualitative Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6668
Author(s):  
Betsy Seah ◽  
Ben Ho ◽  
Sok Ying Liaw ◽  
Emily Neo Kim Ang ◽  
Siew Tiang Lau
Keyword(s):  
Nursing Students ◽  
Qualitative Study ◽  
Professional Identity ◽  
Healthcare Workers ◽  
Healthcare Services ◽  
Strategic Partnerships ◽  
Healthcare Workforce ◽  
Student Volunteer ◽  
Operational Processes

COVID-19 has caused a shortage of healthcare workers and has strained healthcare systems globally. Pre-registered healthcare students with training have a duty of care and can support the healthcare workforce. This study explored factors influencing the willingness of final-year nursing students to volunteer during the COVID-19 pandemic, the role of professional identity in volunteering as healthcare workers, and strategies to improve future volunteering uptakes and processes. A qualitative study using focus-group discussions was conducted. Final-year nursing students who volunteered, students who did not volunteer, and lecturers who supervised student volunteers were recruited. Interviews were conducted online, video-recorded, and transcribed verbatim. A thematic analysis was used. The themes were “wavering thoughts on volunteering”, “bringing out ‘the nurse’ in students through volunteering” and “gearing up to volunteer”. Findings suggested the need to look beyond the simplicity of altruism to the role of professional identity, operational, and motivational factors to explain nursing students’ decision to volunteer and their volunteer behavior. Providing accommodation, monetary and academic-related incentives, supporting the transitionary phase from students to “professional volunteers”, promoting cohesive and positive staff–student volunteer relationships, and establishing a volunteer management team are strategies identified to improve volunteering uptake and operational processes. Our findings advocate strategic partnerships between hospitals/communities and academic institutions in providing various healthcare services during pandemics.

scholarly journals Barriers to Physical Distancing among Healthcare Workers on an Academic Hospital Unit During the COVID-19 Pandemic

2021 ◽  
pp. 1-26
Author(s):  
Sara C. Keller ◽  
Sara Pau ◽  
Alejandra B. Salinas ◽  
Opeyemi Oladapo-Shittu ◽  
Sara E. Cosgrove ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Healthcare Workers ◽  
Tertiary Hospital ◽  
Peer Leaders ◽  
Human Factors Engineering ◽  
Structured Interviews ◽  
Hospital Unit ◽  
Positive Behaviors ◽  
Cognitive Aids ◽  
Close Proximity

Abstract Background: Physical distancing among healthcare workers (HCW) is an essential strategy in preventing HCW-to-HCW transmission of the SARS-CoV-2 virus. Objective: To understand barriers to physical distancing among HCW on an inpatient unit and identify strategies for improvement. Design: Qualitative study including observations and semi-structured interviews over three months. Setting: A non-COVID adult general medical unit in an academic tertiary hospital. Participants: HCWs based on the unit. Methods: We performed a qualitative study in which we (1) observed HCWs activities and proximity to each other on the unit during weekday shifts July-October 2020 and (2) conducted semi-structured interviews of HCWs to understand their experiences with and perspectives of physical distancing in the hospital. Qualitative data were coded based on a human factors engineering model. Results: We completed 25 hours of observations and 20 HCW interviews. High-risk interactions often occurred during handoffs of care at shift changes and patient rounds, where HCWs gathered regularly in close proximity for at least 15 minutes. Identified barriers included spacing and availability of computers, the need to communicate confidential patient information, and the desire to maintain relationships at work. Conclusions: Physical distancing can be improved in hospitals by restructuring computer workstations, work rooms, and breakrooms; applying visible cognitive aids; adapting shift times; and supporting rounds and meetings with virtual conferencing. Additional strategies to promote staff adherence to physical distancing include rewarding positive behaviors, having peer leaders model physical distancing, and encouraging additional safe avenues for social connection at a safe distance.

What makes an optimal delivery for PrEP against HIV: A qualitative study in MSM

2022 ◽  
pp. 095646242110608
Author(s):  
Janice Y. C. Lau ◽  
Ngai-Sze Wong ◽  
Krystal C. K. Lee ◽  
Tsz-Ho Kwan ◽  
Grace C. Y. Lui ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Service Providers ◽  
Effective Means ◽  
Qualitative Assessment ◽  
Theory Approach ◽  
Service Model ◽  
Structured Interviews ◽  
Sexually Transmitted ◽  
Ethnic Chinese ◽  
Sex With Men

Background Pre-exposure prophylaxis (PrEP) is an effective means of HIV prevention for men who have sex with men (MSM), a key population whose engagement is crucial for achieving effective public health outcomes. An optimal service model would be important in planning the implementation of PrEP in places where such service has not been established. Methods A qualitative study was conducted to delineate the attributes of an optimal PrEP service model for MSM in Hong Kong, a city where no formal PrEP programs existed. Twenty purposively sampled MSM who were enrollees of two pilot PrEP projects participated in the semi-structured interviews promoting story-telling. The coded data were thematically analyzed following Grounded Theory approach, focusing on uncovering a typology of the essential attributes of an optimal PrEP service model, and the reasons for such preferences. Results Participating MSM were all ethnic Chinese and aged 26 to 52 years. All had received PrEP from pilot projects in conjunction with periodic screening of sexually transmitted infections (STI), HIV antibody, and plasma creatinine. Four major themes emerged as regards the attributes of a preferred PrEP service: (i) comprehensiveness of HIV/STI and safety monitoring; (ii) convenient unitary service; (iii) stigma-free PrEP access and protecting confidentiality; and (iv) affordable price. Whereas regular provision of PrEP was acceptable to MSM, unaffordability and related stigma were the anticipated challenges for potential service providers. Conclusions The qualitative assessment of MSM’s preference for PrEP service delivery has yielded important information on the many facets of a desirable service model.

scholarly journals Informing the development of a pilot intervention to improve migrants’ healthcare assess in Brno, Czech Republic

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
N K Movsisyan ◽  
E Matuchova
Keyword(s):  
Czech Republic ◽  
Health Insurance ◽  
Social Integration ◽  
Service Providers ◽  
Universal Access ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Policy Framework ◽  
Visual Aids ◽  
Pilot Intervention

Abstract Background Third-country nationals have the least access to healthcare in the Czech Republic yet representing the largest group of migrants. This study aimed to inform the development of a pilot intervention to improve migrants’ healthcare access in Brno, Czech Republic, within the existing health policy framework. Methods A Metaplan© qualitative technique was applied to ensure the community participation, through separate sessions with social integration professionals and third countries nationals. Each group first identified issues in migrants’ healthcare, then suggested solutions to address these issues and prioritized these solutions. Results The professionals’ group included five representatives of social integration service providers and administrators. The majority of migrants were female, with higher education, ages 35-55 years, arrived in two years mainly from Ukraine, and not employed. The social integration professionals were more knowledgeable of healthcare policy and migrants’ rights and suggested a wider scope of solutions. The migrants underscored the role of reliable information as a critical tool in utilizing healthcare services. Both groups prioritized an open access to the information as a direct benefit to the users. Other suggestions included multilingual mobile applications, visual aids and translation services, bilingual doctors and universal access to public health insurance. The feasibility of these solutions varied and so their value as intervention models. Conclusions The future interventions should focus on health literacy in the migrant community. This would include the dissemination of multilingual information on health emergency, children vaccinations, health insurance and healthcare system, among other topics, and interactive trainings for migrants and social counselors, to improve self-efficacy in both groups.

Digital Health Innovation Ecosystems

2019 ◽  
Vol 8 (2) ◽  
pp. 1-14 ◽  
Author(s):  
Gloria Ejehiohen Iyawa ◽  
Marlien Herselman ◽  
Adele Botha
Keyword(s):  
Developing Countries ◽  
Qualitative Study ◽  
Digital Health ◽  
Healthcare Services ◽  
Structured Interviews ◽  
Innovation Ecosystem ◽  
Health Innovation ◽  
Innovation Ecosystems ◽  
Governmental Organizations ◽  
Key Participants

The purpose of this paper was to identify key participants, benefits, and challenges of a digital health innovation ecosystem in Namibia. The paper also aimed to identify strategies for implementing digital health innovation ecosystems in Namibia. This is a qualitative study that adopted semi-structured interviews in meeting the objectives of the study. The findings suggest that implementing digital health innovation ecosystems within the Namibian context will result in better processes of delivering healthcare services to patients. However, implementing such an ecosystem would require resources from both academic and governmental organizations. The need for skilled experts for managing the ecosystem would also be required. Hence, adopting the guidelines for implementing a digital health innovation ecosystem in developing countries, the study proposed guidelines which would make a digital health innovation ecosystem work for the Namibian context. The findings of this study can be used by healthcare managers within the Namibian context.

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