Access to Health Services

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Health Status and Access to Health Services in Indian Slums

Health Status and Access to Health Services in Indian Slums

This paper analyzes the state of health and access to health services among the urban poor in In- dia. Analysis is based on data from a primary survey conducted among 2000 households, covering 10,929 individuals from four cities of India. Summary statistics and regressions (using STATA) are used for data analysis. Results show lack of government facilities and services, a very high prefe- rence for private health facilities, high expenses especially in private but also in public facilities, and a perception that private facilities are offering high quality services as important concerns. An econometric analysis of the determinants of acute illness indicates the insufficiency of basic amenities like sanitation, garbage disposal and potable water. Together with the lack of availabil- ity of government health facilities in the vicinity, these results indicate continued vulnerability of the urban poor, and the need for urgent government action.
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Equality and its implications: A focus on access to health services

Equality and its implications: A focus on access to health services

resources alone would solve or lessen a number of problems because the population would not have to use judicial means to have access to a service they areentitled to by law. Let us now analyze the positive and negative aspects of judicialization of the right to health. Among the positive points, we highlight the judicialization as a promotion of the principle of dignity of human beings because the State is not providing its citizens with minimum conditions of existence. In fact, inefficient access to health care is a reality. Another point is the social pressure on Public Management, which before the process is obliged to ensure this right and rethink in the future means to improve and make this access to health services work. Immediate efficacy and judicialization as the only way to guarantee this right in this particular case are also considered positive aspects. As for the negative aspects, the benefit of individual demands to the detriment of the collective ones stand out. The benefit is for a small (but growing) part of society that has access to information and the necessary means to appeal to Justice, to the detriment of other resources spent with all other people who use the SUS without awareness of judicial resources. It also disregards the principle of independence and harmony of powers. It is worth noting that the judicial disregard of social determinants is also a negative aspect when only one isolated case is analyzed (as previously mentioned). Likewise, inefficient provision of basic health services and judicialization appear, in increasing numbers, as means of remedying this deficiency.
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Telemedicine: Remote Access to Health Services and Information

Telemedicine: Remote Access to Health Services and Information

Delivering health services directly or providing needed information does not always require the user to have sophisticated equipment. The Con- nect System at Cleveland State University uses a computer and voice mail system to monitor drug- using pregnant patients, patients in drug treat- ment, and mothers of newborns. This system is for nonemergencies, and patients access it using a touchtone telephone and a password. It is used to communicate with caregivers, and the computer calls the patient if there is a message waiting. Those without a telephone can call in on a regular basis to collect messages. There is also a Commu- nity Health Rap line that will find an expert to an- swer questions. Telephone Pals will connect patients with others who share a common health condition. Home Monitoring allows a clinician to call a child’s parent at regular intervals to ask a se- ries of questions. Answers are sent directly to the clinician, who will contact the parents if there is a need for action. Appointment and medication re- minders are also sent. Research showed that send- ing reminders for immunizations resulted in 82 percent of patients in the experimental group keeping their appointments, compared with 69 percent for the control group. The resulting immu- nization rates were 68 percent for the experimen- tal group, compared with 45.5 percent for the control group. This is in a community in which only 4 percent graduated high school and 40 per-
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Social Support and Access To Prenatal Health Services Among Pregnant Teenagers

Social Support and Access To Prenatal Health Services Among Pregnant Teenagers

This study makes use of both theoretical perspectives to try to understand the relationship between social support and access to health services. The study posits that maternal stress is an aetiological factor in poor pregnancy outcomes (Oakley,1990). But the problem is likely to be intensified in adolescent pregnancy, especially if occurs outside social recognized bounds (Omololu,1994). Social support influences pregnancy outcomes by eliciting a positive prenatal health behavior (buffering hypothesis) and/or by directly acting as a buffer to the stress of pregnancy (direct effect hypothesis). A pregnant girl’s access to prenatal health care services is hypothesized to be a function of her access to social support which is conditioned by her socio-demographic characteristics and her social network structure. These in turn are influenced by the wider socio-cultural context of values and belief systems regarding social support, as well as changes in supportive networks as a result of demographic and socio-economic factors such as migration, urbanization, wage employment and individualism.
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Barriers To Health Services Access For Trans People In Florianópolis, Brazil

Barriers To Health Services Access For Trans People In Florianópolis, Brazil

The World Health Organization has opposed to pathologization; an example is that in 2015 it launched an important report entitled "Sexual Health, Human Rights and the Law". This report emphasizes the importance of respect for human rights, access to hormone therapy, sex-change surgery, and other necessary treatments to ensure the health protection of trans people. This document also notes that transgender people worldwide are turning away from health services after seeking a service and being rejected or mistreated 13 . In addition, it emphasizes that internationally, the academic training of health professionals is not enough to educate people able to fully deal with the health care of trans people. In conclusion, the challenges are global, and there are few services in the world that deal with the health of the transgender population in a non-pathological, confidential, and supportive way that prioritize decisions made by the individual being treated.
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Barriers in physical access to maternal health services in rural Ethiopia

Barriers in physical access to maternal health services in rural Ethiopia

In rural Africa little is known about how travel time to health facilities is distributed among women of repro- ductive age and whether those who live far from a health facility have similar socio-demographic characteristics to those who live nearby. The paper fills this knowledge gap by reporting on the analysis of risk factors influen- cing poor access to health facilities in rural Ethiopia. Our findings demonstrated that both education and ma- ternal age were significantly associated with travel time to both the main district health centre and the nearest health post. These associations persisted after adjust- ment for the other socio demographic characteristics considered in this study, namely, household wealth and parity. This finding is not consistent with finding of previous study in Ethiopia which indicate no associ- ation between age and use of maternal health services [26]. Reason for this inconsistent findings may be due to the fact that the previous study [26] measured the actual use of maternal services while we measured the physical accessibility of maternal health services. In the univariable model parity was a risk factor; however, the strength of evidence for this association reduced once the strong confounding effect of age was taken into account in the multivariable model.
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Migrant’s access to preventive health services in five EU countries

Migrant’s access to preventive health services in five EU countries

The data available from some EU countries suggest the presence of inequalities in health care use, since migrants tends to have a greater reliance on emergency services, be- cause of inadequate access to other services, such as pri- mary and/or specialist care [17]. Particularly worrisome are the low utilization rates of antenatal and paediatric care, and preventive services [18]. High quality studies based on comparable data and adjusting for selected factors are needed to make valid decisions on how to secure equity in the access of migrant to health services. [17]. This study aimed at comparing access to preventive health services be- tween migrants and national populations, while considering some factors that may confound or interact with the rela- tionship between access to PHSs and migrant status.
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Improving access to school health services as perceived by school professionals

Improving access to school health services as perceived by school professionals

services include approachability, acceptability, availabil- ity, affordability and appropriateness of care [19]. The triage system specifically targeted the improvement of two aspects of access to preventive health services: approachability and the appropriateness of care. ‘ Ap- proachability ’ refers to consumers ’ ability to gain access to the service and to identify the existence of some form of service, and the terms also refers to the fact that a ser- vice can be reached, and the fact that it has an impact on health. ‘ Appropriateness ’ of care relates to the ad- equacy of the health services provided and this is linked to the willingness to use the services [19]. Acceptability, availability and affordability are less relevant for prevent- ive services like SHS, which should be offered to whole populations of children proactively. This manuscript addresses the following research question: what is the impact on the school professionals ’ perception of the approachability and appropriateness of SHS support for primary-school children when the triage approach is used rather than the usual approach?
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Assessment inequality in access to public cardiovascular health services in Iran

Assessment inequality in access to public cardiovascular health services in Iran

The aforementioned results represent an initial empirical approximation, the validity of which is limited for the following rea- sons. First, counting the number of cardiol- ogists and CCU beds is not an appropriate way to measure extant cardiovascular care and access to it (a more sufficient reliable measure in Iran is not available yet). Sec- ond, the methodology used to measure ine- quality is not perfect and biased with limi- tations in measuring inequality; for exam- ple, “utilizing the Gini coefficient showed that there is no significant inequality in the distribution of pubic cardiovascular health services in Iran, though, primary infor- mation on the distribution of beds and car- diologists showed that about one-fourth of the CCU beds are existed in Tehran, where one-sixth of the total population of Iran is living”. Such interpretations are helpful for providing an approximation of existing dis- tributions and can show some limitations of using inequality measures.
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Does rural residence limit access to mental health services?

Does rural residence limit access to mental health services?

This study has limitations that affect generalization and interpretation of the results. The rural residents represented in this analysis did not live in Aboriginal reserve communities, remote communities, or Canada’s northern territories, and the findings cannot be generalized to these communities, which are likely to have more restricted access to mental health professionals. The numbers of rural residents seeking professional help were relatively small, resulting in large confidence intervals. Some of the predictor variables were likely to be correlated with location of residence, but interactions among location of residence and other predictors could not be evaluated due to the relatively small number of rural residents who sought professional care. Residence location was measured at the time the survey was completed and might have changed in the previous year. The professionals identified as non- specialists are likely to have a wide variety of training and experience in mental health service provision, whereas the specialists might or might not have experience in treating anxiety and mood disorders. Finally, the quality and effectiveness of mental health services were not examined, and if examined, they might reveal important differences between rural and urban Canada.
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Access to children and young people’s mental health services: 2018

Access to children and young people’s mental health services: 2018

Unfortunately, in the past a proper understanding of the existing patterns of demand and service provision has not been possible due to the lack of regular, reliable, and consistent reporting of mental health demand and service access. Policy makers have pledged to improve the collection and publication of mental health data to inform debate and lead to more informed policy making. But promises about improved data and accountability have not, so far, been matched by the delivery of consistent and transparent data reporting. The Education Policy Institute has sought to improve the understanding of children's mental health prevalence and access issues by securing data from individual service providers and publishing this, as far as possible at a consolidated national level. This latest report looks at the increased demand for children's mental health services; what
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The Impact of Health Card Program on Access to Reproductive Health Services: An Indonesian Experience

The Impact of Health Card Program on Access to Reproductive Health Services: An Indonesian Experience

Health card program aims to protect the poor in Indonesia during the Asian economic crisis. Health cards were targeted and allocated exclusively to the poor that would provide free access to public health services. The impact of health card program to reproductive health services was rarely discussed by previous studies that pay more attention on health card utilization for both inpatient and outpatient. Using Indonesian family life survey (IFLS) data 1997-2000 from RAND Corporation, this study aims to evaluate the impact of health card program during Asian economic crisis on access to reproductive health services and answer the question whether who had health card really have better access to reproductive health services. Discussion in this paper limit on antenatal care, place of delivery and contraceptive use which are only reproductive health components that covered by health card program. Using combination between descriptive analysis and multivariate analysis, this study found that the health cards were not well targeted and distributed. The study also found that, generally, there is no significant effect of health card ownership to access to reproductive health services.
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Corruption Impede Access to Public Health Services in Benin

Corruption Impede Access to Public Health Services in Benin

Abstract: Health care is one of the indispensable factors contributing to the improvement of productivity and the welfare of human capital. Indeed, most developed countries focus on improving the health status of populations. Despite significant improvements in the health status of human capital, there are disparities in equal access to health care. This finding is fundamentally linked to the structuring, organization and functioning of public hospitals in developing countries. The purpose of this article is to analyze the effect of corruption behavior on access to health care in public hospitals in Benin. The methodological approach adopted in this work explains the probability, for a user in contact with the health services of public hospitals, of developing corrupt behaviors [1, 2]. The estimation of selection model, based on survey data from users of public hospitals in Benin, shows that corruption behavior facilitates access to health care for applicant. But taking collectively, they slow down the normal functioning of health care services, create a congestion effect and increase the vulnerability of users of public health hospitals. In addition, the estimation results reveal a negative and significant effect between drug diversion and corrupt behavior on the one hand and the fact of not having social security coverage decreases the probability of developing corruption behaviors other. The study recommends, on the one hand, the establishment of surveillance mechanisms for public hospital actors and, on the other hand, an increase in penalties for corrupt behavior.
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Barriers to Access and Utilization of Maternal and Infant Health Services in Migori, Kenya

Barriers to Access and Utilization of Maternal and Infant Health Services in Migori, Kenya

It is estimated that 150,000 African women die each year from causes related to pregnancy and childbearing, and that the lifetime risk of dying from maternal causes for African women is in the order of one in twenty five. In Kenya, an estimated 7,700 women die each year as a result of pregnancy-related causes (Republic of Kenya, 2010).Maternal mortality and morbidity can be reduced through access to appropriate health care during pregnancy and delivery however in sub-Saharan Africa women continue to face limited access to such services (Essendiet.al, 2011). In order to reduce the risk of maternal and infant morbidity and mortality, especially in places where the general socio-economic status is low, access and utilization of the obstetric services is an effective means (Ochakoet.al, 2011). Lack of access to appropriate obstetric care, especially during labor, compounds the risk of adverse fetal outcomes such as death or disability (Luleet.al, 2005). Improving maternal and infant health continues to be a major challenge such that a woman living in sub-Saharan Africa has a 1 in 31 chance of dying during pregnancy or childbirth, as compared to 1 in 4,300 in a high-income country (Zereet.al, 2011). In developing countries, less than 50% of deliveries occur in health facilities therefore skilled birth assistance is not utilized in such deliveries. Access to and use of health services is low in Africa, and this is reflected in the poor maternal health indicators (Kayongo et.al, 2006). It still has the highest proportion of under- five deaths, with 1 in 91 children dying before their fifth birthday (UNDP, 2009).
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Barriers Limiting Youth Access to Reproductive Health Services by Primary Health Care Facilities in Nigeria

Barriers Limiting Youth Access to Reproductive Health Services by Primary Health Care Facilities in Nigeria

Abstract Youth represent a tremendously valuable asset to the society therefore working with them to make a healthy transition to adulthood is critical to the world‘s development now and in the future. The issue of youth-friendly health service has become a matter of concern as many young people still do not have access to such in the country. The community survey was designed to generate increased understanding of the barriers that limit youth access to sexual and reproductive health services(SRH) offered by Primary Health Care (PHC) facilities in Nigeria. Stratified and Purposive Sampling with qualitative and quantitative research methodology was adopted. Qualitative data were obtained through 12 Focus Group Discussions (FGDs) and 48 Key Informant Interviews (KIIs). For the quantitative component, an interviewer-administered questionnaire was used to elicit information from 300 randomly selected adolescents and youth. The mean age of respondents was 18.9 ± 4.4 years. Reported barriers to youth ' s access to SRH services were lack of awareness (67.3%), cost of services (46.7%), negative attitude of health care providers (39.7%) and fear of parents and what people will say (32.0%). The results shows that community mobilization for awareness creation and support on SRH issues (59.3%), will support youth to better access SRH services in PHC facilities
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Exploring inequalities in access to and use of maternal health services in South Africa

Exploring inequalities in access to and use of maternal health services in South Africa

Despite the policy efforts to improve availability and affordability of health care, there have been severe prob- lems with implementation of some of these policies, as well as with the training, distribution and motivation of health care workers [20]. Indeed, some of the policies, par- ticularly the free care for pregnant women and young chil- dren, contributed to declining staff morale as it was intro- duced without engagement with frontline health workers and increased staff workloads as demand increased with- out corresponding increases in real resources to meet those demands [21,22]. This is particularly true for rural areas. As our results show, the acceptability dimension represents a barrier to service access. The quantitative results highlight how a greater proportion of patients in rural sites felt that the health worker was too busy. The same was felt for HIV positive patients across all four sites. The qualitative results highlight how one bad experience of health services (e.g. being turned away from ANC ser- vices due to coming on the “wrong day”) can translate into not wanting to return to a health facility for delivery. Poor staff engagements with patients range from shout- ing at patients during labour (reported by 17% of patients) to highly insensitive behaviour towards patients who had experienced stillbirths.
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No. 54: Medical Xenophobia: Zimbabwean Access to Health Services in South Africa

No. 54: Medical Xenophobia: Zimbabwean Access to Health Services in South Africa

The paper is organized into five sections. Section Two positions debates about the migration of skilled health professionals within a wider literature that discusses the international mobility of talent. Section Three reviews research on the global circulation of health pro- fessionals, focusing in particular upon debates relating to the experience of countries in the developing world. Section Four moves the focus from international to South African issues and provides new empirical mate- rial drawn from the survey of recruitment patterns and key interviews undertaken with health sector recruiters operating in South Africa. Section Five addresses the questions of changing policy interventions in South Africa towards the outflow of skilled health professionals and the recruitment of foreign health professionals to work in South Africa. The larities at government hospitals including (a) asylum seekers and refu- gees being required to pay a large deposit to access medical services; (b) hospital front line staff and their superiors refusing or being unable to recognize asylum seeker permits, refugee permits and refugee identity documents; (c) refusal to treat children of asylum seekers and refugees; (d) refusal of pre-natal and post natal care; and (e) refusal to issue ART to foreign patients regardless of the type of documentation they pos- sess. 63 Insults and public degradation by hospital staff are common. 64
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Mapping access to health services as a strategy for planning: access to primary care for older people in regional Queensland

Mapping access to health services as a strategy for planning: access to primary care for older people in regional Queensland

Map of Mackay depicting distribution of Statistical Area Level 1 SA1 units with high proportions of Map of Townsville depicting distribution of Statistical Area Level 1 SA1 units with hi[r]

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Young Adults With Special Health Care Needs: Prevalence, Severity, and Access to Health Services

Young Adults With Special Health Care Needs: Prevalence, Severity, and Access to Health Services

Health care needs of disabled young adults and access to care are analyzed using the 1984 National Health Interview Survey, a nationally representative sample of 10 394 randomly selected[r]

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