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1 – 10 of over 100000
Article
Publication date: 8 April 2021

N. Ela Gokalp Aras, Sertan Kabadayi, Emir Ozeren and Erhan Aydin

This paper aims to provide a comprehensive understanding of factors that contribute to refugees’ exclusion from health-care services. More specifically, using institutional…

Abstract

Purpose

This paper aims to provide a comprehensive understanding of factors that contribute to refugees’ exclusion from health-care services. More specifically, using institutional theory, this paper identifies regulative pillar-, normative pillar- and cultural/cognitive pillar-related challenges that result in refugees having limited or no access to health-care services.

Design/methodology/approach

The paper draws on both secondary research and empirical insights from two qualitative fieldwork studies totaling 37 semi-structured meso-level interviews, observations and focus groups in three Turkish cities (Izmir, Ankara and Edirne), as well as a total of 42 micro-level, semi-structured interviews with refugees and migrants in one large city (Izmir) in Turkey.

Findings

This study reveals that systematically stratified legal statuses result in different levels of access to public health-care services for migrants, asylum seekers or refugees based on their fragmented protection statuses. The findings suggest access to health-care is differentiated not only between local citizens and refugees but also among the refugees and migrants based on their legal status as shaped by their country of origin.

Originality/value

While the role of macro challenges such as laws and government regulations in shaping policies about refugees have been examined in other fields, the impact of such factors on refugee services and well-being has been largely ignored in service literature in general, as well as transformative service research literature in particular. This study is one of the first attempts by explicitly including macro-level factors to contribute to the discussion on the refugees’ access to public health-care services in a host country by relying on the institutional theory by providing a holistic understanding of cognitive, normative and regulative factors in understanding service exclusion problem.

Article
Publication date: 22 February 2022

Kayla Halsey, Salameh Alarood, Mohammed Nawaiseh and Ghazala Mir

Refugees commonly face inequitable access to health care services in their host country. This study aimed to identify factors influence refugee access to health services and to

Abstract

Purpose

Refugees commonly face inequitable access to health care services in their host country. This study aimed to identify factors influence refugee access to health services and to assess perceptions of barriers to health care for different refugee groups in Jordan.

Design/methodology/approach

In-depth interviews were combined with document analysis and analyzed using thematic and framework methods.

Findings

Findings highlighted inequitable access to health services between different refugee groups. Unlike Palestinian refugees from the West Bank, Palestinian refugees from Gaza faced financial barriers to access health care as a result of citizenship status, which affected their health insurance, referrals for health care and legal right to work. Syrian refugees similarly lacked Jordanian citizenship and health insurance and mainly depended on UNHCR for health services, though some were able to acquire work permits and pay for private care.

Originality/value

This study demonstrates a need for politically and economically appropriate policies to minimize the disparity of health care access among these refugee groups.

Details

International Journal of Migration, Health and Social Care, vol. 18 no. 1
Type: Research Article
ISSN: 1747-9894

Keywords

Article
Publication date: 19 December 2016

Rabia Ahmed, Cybele Angel, Rebecca Martel, Diane Pyne and Louanne Keenan

Incarcerated women have a disproportionate burden of infectious and chronic disease, in addition to substance use disorder and mental health illness, when compared to the general…

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Abstract

Purpose

Incarcerated women have a disproportionate burden of infectious and chronic disease, in addition to substance use disorder and mental health illness, when compared to the general population (Binswanger et al., 2009; Fazel et al., 2006; Fuentes, 2013; Kouyoumdjian et al., 2012). Women often enter the correctional system in poor health, making incarceration an opportunity to address health issues. The purpose of this paper is to explore the barriers to accessing health services that female inmates face during incarceration, the consequences to their health, and implications for correctional health services delivery.

Design/methodology/approach

Focus groups were conducted in Canadian correctional center with female inmates. Focus groups explored women’s experiences with accessing health services while incarcerated; the impact of access to health services on health during incarceration and in the community; and recommendations for improving access to health services. Thematic analysis was completed using N-vivo 10.

Findings

The women described multiple barriers to accessing health services that resulted in negative consequences to their health: treatment interruption; health disempowerment; poor mental and physical health; and recidivism into addiction and crime upon release. Women made three important recommendations for correctional health service delivery: provision of comprehensive health entry and exit assessments; improvement of health literacy; and establishment of health support networks. The recommendations were organized into an “Accessing Health Services Resource Manual” for incarcerated women.

Originality/value

There is a paucity of existing literature examining provision of health services for female inmates. These findings have relevancy for correctional and community health care providers and organizations that provide health services for this vulnerable population.

Details

International Journal of Prisoner Health, vol. 12 no. 4
Type: Research Article
ISSN: 1744-9200

Keywords

Article
Publication date: 1 March 2005

Dennis Wardman, Ken Clement and Darryl Quantz

To provide a picture of the access and use of health services by Aboriginal British Columbians living in both reserve and off‐reserve communities.

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Abstract

Purpose

To provide a picture of the access and use of health services by Aboriginal British Columbians living in both reserve and off‐reserve communities.

Design/methodology/approach

This project represents a collaborative effort between the University of British Columbia and multiple Aboriginal community partners. Between June and November 2003, 267 face‐to‐face interviews were conducted with Aboriginal persons in seven rural community organizations across the province.

Findings

This paper reports on the results of a survey of 267 Aboriginal clients. It was found that a substantial number of survey respondents accessed health services provided by an Aboriginal person. Although most respondents felt that services were available, they also identified a number of concerns. These revolved around the need to travel for services, as well as a lack of access to more specialized services. A number of self‐reported barriers to service were also identified. These findings have several policy implications and will be useful to service planners.

Research limitations/implications

Several questions for additional research were identified including the need to establish an inventory of service problem areas and investigating service and benefit policy and community awareness issues.

Originality/value

This paper provides policy makers with knowledge on the rural Aboriginal population, a population that has faced long standing problems in accessing appropriate health services.

Details

Leadership in Health Services, vol. 18 no. 2
Type: Research Article
ISSN: 1366-0756

Keywords

Article
Publication date: 5 August 2022

Rachel Moreton, Jo Welford, Beth Collinson, Laura Greason and Chris Milner

This paper aims to explore the barriers to accessing mental health support for people experiencing multiple disadvantage along with some potential solutions for attempting to

Abstract

Purpose

This paper aims to explore the barriers to accessing mental health support for people experiencing multiple disadvantage along with some potential solutions for attempting to overcome these. It draws on evidence and learning from 12 voluntary sector-led partnerships in England funded by the National Lottery Community Fund’s Fulfilling Lives programme.

Design/methodology/approach

Qualitative research was undertaken with frontline staff, senior leaders, volunteers, beneficiaries and stakeholders from Fulfilling Lives partnerships. This comprised focus groups (21 participants) and individual face-to-face interviews (41 participants), both of which explored barriers and local solutions to accessing statutory mental health services. Following a thematic analysis of transcripts, research participants and stakeholders were invited to a face-to-face workshop to review and validate emerging findings (34 participants).

Findings

People experiencing multiple disadvantage face significant barriers in accessing support for their mental health. These include a complex system that is difficult to navigate, long waiting lists, high eligibility thresholds and models of support that lack flexibility. Fulfilling Lives partnerships have had the funding and the flexibility to trial different approaches. Promising solutions to barriers include the use of navigators, person-centred support and multi-agency networks and training. However, overcoming systemic barriers remains the most difficult challenge.

Originality/value

Fulfilling Lives was a rare example of substantial and long-term (eight years) funding to work with people experiencing multiple disadvantage. This provided a unique opportunity to try different approaches and gather learning. The programme evaluation provides insights into the experiences of people facing multiple disadvantage and those who support them and offers evidence-based suggestions for policy and practice.

Details

Housing, Care and Support, vol. 25 no. 3/4
Type: Research Article
ISSN: 1460-8790

Keywords

Article
Publication date: 11 December 2017

Gayatri Patel

In 2006, the United Nations’ Human Rights Council was tasked to establish a new human rights monitoring mechanism: the universal periodic review process. The purpose of this paper…

Abstract

Purpose

In 2006, the United Nations’ Human Rights Council was tasked to establish a new human rights monitoring mechanism: the universal periodic review process. The purpose of this paper is to examine the nature of discussions held in the process, over the two cycles of review in relation to women’s rights to access health care services.

Design/methodology/approach

This investigation is a documentary analysis of the reports of 193 United Nations’ state reports, over two cycles of review.

Findings

The primary findings of this investigation reveal that despite an apparent consensus on the issue, a deeper analysis of the discussions suggests that the dialogue between states is superficial in nature, with limited commitments made by states under review in furthering the protection of women’s right to access health care services in the domestic context.

Practical implications

Considering the optimism surrounding the UPR process, the findings reveal that the nature of discussions held on women’s rights to health care services is at best a missed opportunity to make a significant impact to initiate, and inform, changes to practices on the issue in the domestic context; and at worst, raises doubts as to whether the core aim of the process, to improve the protection and promotion of all human rights on the ground, is being fulfilled.

Originality/value

Deviating from the solely technocratic analysis of the review process in the existing literature, this investigation has considered the UPR process as a phenomenon of exploration in itself, and will provide a unique insight as to how this innovative monitoring mechanism operates in practice, with a particular focus on women’s right to access health care services.

Details

International Journal of Human Rights in Healthcare, vol. 10 no. 5
Type: Research Article
ISSN: 2056-4902

Keywords

Article
Publication date: 2 March 2020

Salma El-Gamal and Johanna Hanefeld

The influx of refugees and asylum-seekers over the past decade into the European Union creates challenges to the health systems of receiving countries in the preparedness and…

Abstract

Purpose

The influx of refugees and asylum-seekers over the past decade into the European Union creates challenges to the health systems of receiving countries in the preparedness and requisite adjustments to policy addressing the new needs of the migrant population. This study aims to examine and compare policies for access to health care and the related health outcomes for refugees and asylum-seekers settling both in the UK and Germany as host countries.

Design/methodology/approach

The paper conducted a scoping review of academic databases and grey literature for studies within the period 2010-2017, seeking to identify evidence from current policies and service provision for refugees and asylum-seekers in Germany and the UK, distilling the best practice and clarifying gaps in knowledge, to determine implications for policy.

Findings

Analysis reveals that legal entitlements for refugees and asylum-seekers allow access to primary and secondary health care free of charge in the UK versus a more restrictive policy of access limited to acute and emergency care during the first 15 months of resettlements in Germany. In both countries, many factors hinder the access of this group to normal health care from legal status, procedural hurdles and lingual and cultural barriers. Refugees and asylum-seeker populations were reported with poor general health condition, lower rates of utilization of health services and noticeable reliance on non-governmental organizations.

Originality/value

This paper helps to fulfill the need for an extensive research required to help decision makers in host countries to adjust health systems towards reducing health disparities and inequalities among refugees and asylum-seekers.

Details

International Journal of Migration, Health and Social Care, vol. 16 no. 1
Type: Research Article
ISSN: 1747-9894

Keywords

Article
Publication date: 8 July 2014

Gordon Abekah-Nkrumah, Marta Guerriero and Purnima Purohit

Traditionally, the role of technology on health services has been argued from the supply side. The purpose of this paper is to use a demand side perspective to examine the effect…

Abstract

Purpose

Traditionally, the role of technology on health services has been argued from the supply side. The purpose of this paper is to use a demand side perspective to examine the effect of Information and Communication Technologies (ICTs) on the use of maternal health services in Ghana.

Design/methodology/approach

Study used data from the 2008 Ghana Demographic and Health Surveys and binary response regression models to examine the effect of women's access to ICTs on maternal healthcare utilization in Ghana. Three variables on maternal healthcare utilization were employed: use of contraception, antenatal care and place of delivery.

Findings

Results from the study show that the effect of the use of technology is both positive and significant. In particular, among the other ICTs (i.e. landline phone, listening to radio, watch television, color television in household, computer in household), the coefficients of mobile phone ownership tends to be consistently significant across all four reproductive health services. Therefore, ICTs have a good capacity to influence women's demand of health information. This needs to be taken into account when designing maternal health policies and interventions.

Originality/value

This is one of the few papers examining the effect of ICTs on utilization of maternal health services from the demand side compared to the popular supply side argument often found in the literature.

Details

International Journal of Social Economics, vol. 41 no. 7
Type: Research Article
ISSN: 0306-8293

Keywords

Article
Publication date: 10 June 2021

Ibraheem Khaled Abu Siam and María Rubio Gómez

Access to health-care services for refugees are always impacted by many factors and strongly associated with population profile, nature of crisis and capacities of hosing…

Abstract

Purpose

Access to health-care services for refugees are always impacted by many factors and strongly associated with population profile, nature of crisis and capacities of hosing countries. Throughout refugee’s crisis, the Jordanian Government has adopted several healthcare access policies to meet the health needs of Syrian refugees while maintaining the stability of the health-care system. The adopted health-care provision policies ranged from enabling to restricting and from affordable to unaffordable. The purpose of this paper is to identify the influence of restricted level of access to essential health services among Syrian refugees in Jordan.

Design/methodology/approach

This paper used findings of a cross-sectional surveys conducted over urban Syrian refugees in Jordan in 2017 and 2018 over two different health-care access policies. The first were inclusive and affordable, whereas the other considered very restricting policy owing to high inflation in health-care cost. Access indicators from four main thematic areas were selected including maternal health, family planning, child health and monthly access of household. A comparison between both years’ access indicators was conducted to understand access barriers and its impact.

Findings

The comparison between findings of both surveys shows a sudden shift in health-care access and utilization behaviors with increased barriers level thus increased health vulnerabilities. Additionally, the finding during implementation of restricted access policy proves the tendency among some refugees groups to adopt negative adaptation strategies to reduce health-care cost. The participants shifted to use a fragmented health-care, reduced or delayed care seeking and use drugs irrationally weather by self-medication or reduce drug intake.

Originality/value

Understanding access barriers to health services and its negative short-term and long-term impact on refugees’ health status as well as the extended risks to the host communities will help states that hosting refugees building rational access policy to protect whole community and save public health gains during and post crisis. Additionally, it will support donors to better mobilize resources according to the needs while the humanitarian actors and service providers will better contribute to the public health stability during refugee’s crisis.

Details

International Journal of Human Rights in Healthcare, vol. 16 no. 1
Type: Research Article
ISSN: 2056-4902

Keywords

Article
Publication date: 18 May 2015

Genevieve Elizabeth O'Connor

The purpose of this paper is to identify how need for service, enabling factors and pre-disposing characteristics influences access to service. In addition, the authors seek to

Abstract

Purpose

The purpose of this paper is to identify how need for service, enabling factors and pre-disposing characteristics influences access to service. In addition, the authors seek to examine the moderating influence of pre-disposing variables on the relationship between insurance and health services utilization.

Design/methodology/approach

The authors utilize data from a major metropolitan hospital in the USA to test and extend the behavioral model of health care.

Findings

Results indicate that insurance and pre-disposing variables have a direct impact on type of health service utilization. However, the insurance effect is found to vary by demographic factors.

Research limitations/implications

This paper is limited to secondary data. Future work can incorporate both attitudinal and behavioral measures to obtain a more comprehensive evaluation of services access.

Practical implications

The research offers a tactical framework for management to segment consumer markets more effectively.

Social implications

Through the framework, management will have the requisite knowledge to target segmented populations based on need, insurance, and pre-disposing variables which will help improve access to services and clinical outcome.

Originality/value

The findings of this paper will serve as a basis for future research exploring the influence of insurance on access to services.

Details

International Journal of Bank Marketing, vol. 33 no. 3
Type: Research Article
ISSN: 0265-2323

Keywords

1 – 10 of over 100000