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Asylum seekers, refugees and immigrants’ access to healthcare vary in South Africa and Cape Town due to unclear legal status. The purpose of this paper is to shed light on the source of this variation, the divergence between the 1996 South African Constitution, the immigration laws, and regulations and to describe its harmful consequences.

Based on legal and ethnographic research, this paper documents the disjuncture between South African statutes and regulations and the South African Constitution regarding refugees and migrants’ access to healthcare. Research involved examining South African jurisprudence, the African Charter, and United Nations’ materials regarding rights to health and health care access, and speaking with civil society organizations and healthcare providers. These sources inform the description of the immigrant access to healthcare in Cape Town, South Africa.

Asylum-seekers and refugees are entitled to health and emergency care; however, hospital administrators require documentation (up-to-date permits) before care can be administered. Many immigrants – especially the undocumented – are often unable to obtain care because of a lack of papers or because of “progressive realization,” the notion that the state cannot presently afford to provide treatment in accordance with constitutional rights. These explanations have put healthcare providers in an untenable position of not being able to treat patients, including some who face fatal conditions.

The research is limited by the fact that South African courts have not adjudicated a direct challenge to being refused care at healthcare facility on the basis of legal status. This limits the ability to know how rights afforded to “everyone” within the South African Constitution will be interpreted with respect to immigrants seeking healthcare. The research is also limited by the non-circulation of healthcare admissions policies among leading facilities in the Cape Town region where the case study is based.

Articulation of the disjuncture between the South African Constitution and the immigration laws and regulations allows stakeholders and decision-makers to reframe provincial and municipal policies about healthcare access in terms of constitutional rights and the practical limitations accommodated through progressive realization.

In South Africa, immigration statutes and regulations are inconsistent and deemed unconstitutional with respect to the treatment of undocumented migrants. Hospital administrators are narrowly interpreting the laws to instruct healthcare providers on how to treat patients and whom they can treat. These practices need to stop. Access to healthcare must be structured to comport with the constitutional right afforded to everyone, and with progressive realization pursued through a non – discriminatory policy regarding vulnerable immigrants.

This paper presents a unique case study that combines legal and social science methods to explore a common and acute question of health care access. The case is novel and instructive insofar as South Africa has not established refugee camps in response to rising numbers of refugees, asylum seekers and immigrants. South Africans thus confront a “first world” question of equitable access to healthcare within their African context and with limited resources in a climate of increasing xenophobia.

The purpose of this paper is to assess disabled persons' access to health care, and highlight barriers.

A total of 245 rural men and women with physical disabilities were interviewed, to determine their level of access to healthcare services. A simple composite mean of the weighted average indices of responses on the effectiveness of healthcare provision, equity, and users' satisfaction was calculated, to assess the overall level of access of the respondents to healthcare. The qualitative component highlighted an array of barriers that prevented the disabled individuals from accessing healthcare services.

The results indicated that access to the so‐called “inclusive” public healthcare for both males and females with physical disabilities was poor. The barriers identified were related to the built environments, healthcare delivery processes, and ceiling of health subsidies. The findings suggest that the absence of advocacy of disability rights and failure to adopt circumstantial equities at dispensing levels have resulted in the collapse of the promotion of disability rights at grassroots levels.

The study is location specific (rural), and it mainly focuses on individuals with physical disabilities in working‐age (15‐35 years) to assess their access to the rural healthcare.

Having an effective healthcare provision in an area and its equal access to both males and females is crucially important for their social and economic development. In this paper, the assessment of access to healthcare provides both an aggregated and a disaggregated picture by gender, which is poor for individuals with physical disabilities.

This paper aims to explore patients' satisfaction with access to treatment in both the public and private healthcare sectors in London.

Qualitative and quantitative methods were employed to determine patients' levels of satisfaction. A semi‐structured face ‐to‐face non‐probability quota sampling and a probability sample drawn from multistage cluster sampling methods were employed.

The results revealed varying access experiences among public and private care users. Public, as opposed to private, healthcare users experience unsatisfactory outcomes in relation to service climate factors (e.g. getting attention from doctors, time taken to get appointments, access to core treatment and opening hours). Overall, while women are more disadvantaged by spatial accessibility to treatment than men, both public and private healthcare users indicate major problems in accessing healthcare despite the myriad intervention strategies aimed at ameliorating the situation in both sectors. Therefore, access‐to‐care problems are significant and need to be addressed by managers and healthcare providers in order to improve the quality of service delivery and patient satisfaction. Private care users fare better than public users in obtaining medical care at short notice, having more agreeable opening hours for treatment and getting appointments for treatment with less difficulty.

Whereas the limitation of the study was due to its small sample size, it nevertheless will stimulate insight into further academic endeavours.

Academics and practitioners will find the results very useful when making decisions about healthcare provisions and how they can best meet user/patient satisfaction.

This study is significant in drawing on the current literature on satisfaction which is usefully applied to evaluate patients' response to the quality management initiatives in the healthcare sector.

The purpose of this research study was to obtain healthcare executives’ perspectives on diversity in executive healthcare leadership. The study focused on identifying perspectives about diversity and its potential impact on the access of healthcare services by people of color. The study also identified perspectives about factors that influence the attainment of executive healthcare roles by people of color.

A convenience sample of healthcare executives was obtained. The executives identified themselves as belonging to one of two subgroups, White healthcare executives or executives of color. Participants were interviewed telephonically in a semi-structured format. The interviews were transcribed and entered into a qualitative software application. The data were codified and important themes were identified.

The majority of the study participants perceive that diversity of the executive healthcare leadership team is important. There were differences in perspective among the subgroups as it relates to solutions to improve access to healthcare by people of color. There were also differences in perspective among the subgroups, as it relates to explaining the underrepresentation of people of color in executive healthcare leadership roles.

This research effort benefited from the subject matter expertise of 24 healthcare executives from two states. Expansion of the number of survey participants and broadening the geographical spread of where participants were located may have yielded more convergence and/or more divergence in perspectives about key topics.

The findings from this research study serve to add to the existing body of literature on diversity in executive healthcare leadership. The findings expand on the importance of key elements in contemporary literature such as diversity, cultural competency and perspectives about the need for representation of people of color in leadership roles that guide healthcare policy and access. This study connects contemporary literature to perspectives of executives in the field and offers practical solutions to improving the representation of people of color in executive healthcare leadership roles.

The recommendations offered as a result of this research effort serve to create awareness of the challenges that people of color face in career attainment. Although the process of increasing the representation of people of color in executive healthcare leadership will be a complex task that will involve a number of players over the course of several years, this study serves to provide a practical roadmap with actionable tactics that can be deployed.

This paper is an extension of the work that was done by the author during the course of completing the program requirements for the author’s doctoral program. The findings were previously discussed in the author’s dissertation. The value of these findings is significant because they validate some of the topics in contemporary literature with the perspectives of practicing healthcare executives. This study is also unique from other studies in that it offers a long-term plan to increase the representation of people of color in executive roles by creating an early disposition toward executive level roles and identifies a number of practical steps toward that end.

This study investigates the effect of user fees on access and waiting time in Nigeria. For access, the effect of user fees on both preventive and curative care; and the effect of user fees on waiting time at public healthcare facilities were examined. User fees are vital for the fiscal sustainability of healthcare provision for most African economies. Its imposition could debar healthcare access by the poor while its removal can reduce quality of care and induce longer waiting time.

The wave 3 of the Nigerian General Household Survey (2015/16) data was used for users of public health facilities. Access to healthcare was modelled using utilization data in a logistic regression model while waiting time was through the Negative Binomial Regression Model (NBRM).

The analyses showed significant effects of user fees on access to both preventive and curative care and on time spent waiting to make use of healthcare services. Individuals were able to access healthcare services regardless of amounts paid. Also, there was a non-negative effect of user fee imposition on waiting time.

Nigeria should improve healthcare facilities to address the enormous demand for healthcare services when designing policy for health sector.

This paper shows that even with the imposition of user fees, healthcare facilities could still not cater for the rising healthcare needs of the populace but cautioned that its abolition may not be a preferred option.

The purpose of this paper is to examine women homeworkers' access to healthcare services in Thailand. Specifically, it focuses on how the state's universal healthcare service, introduced in the year 2002, has responded/not responded to the needs of poor women homeworkers in Bangkok.

Data collection was done through a structured questionnaire with 415 women homeworkers from 16 districts in Bangkok, Thailand, ten in‐depth interviews and 13 group discussions.

It was found that less than half of the women homeworker respondents accessed the universal healthcare scheme. The obstacles for access include both financial (transportation cost, loss of wage) and time. Also, homeworkers need support from the community/household to access these services. Universal health services itself is not enough to ensure access to healthcare service, especially among poor and minimally educated homeworkers with small children.

The research showed the need to have multiple approaches (state‐provided services and community organizing, as well as awareness among men about their role in care work), in order to ensure universal healthcare coverage.

Universal healthcare services are considered the best way to extend healthcare services to workers in the informal economy. This paper argues that total dependence on state‐provided services does not ensure universal healthcare coverage. There is a need for additional community‐based support mechanisms to ensure access to these services.

Incarcerated transgender women often require healthcare to meet their physical-, mental-, and gender transition-related health needs; however, their healthcare experiences in prisons and jails and interactions with correctional healthcare providers are understudied. The paper aims to discuss these issues.

In 2015, 20 transgender women who had been incarcerated in the USA within the past five years participated in semi-structured interviews about their healthcare experiences while incarcerated.

Participants described an institutional culture in which their feminine identity was not recognized and the ways in which institutional policies acted as a form of structural stigma that created and reinforced the gender binary and restricted access to healthcare. While some participants attributed healthcare barriers to providers’ transgender bias, others attributed barriers to providers’ limited knowledge or inexperience caring for transgender patients. Whether due to institutional (e.g. sex-segregated prisons, biased culture) or interpersonal factors (e.g. biased or inexperienced providers), insufficient access to physical-, mental-, and gender transition-related healthcare negatively impacted participants’ health while incarcerated.

Findings highlight the need for interventions that target multi-level barriers to care in order to improve incarcerated transgender women’s access to quality, gender-affirmative healthcare.

This study provides first-hand accounts of how multi-level forces serve to reinforce the gender binary and negatively impact the health of incarcerated transgender women. Findings also describe incarcerated transgender women’s acts of resistance against institutional and interpersonal efforts to maintain the gender binary and present participant-derived recommendations to improve access to gender affirmative healthcare for incarcerated transgender women.

Accessing adequate healthcare to all people is one of the main goals of the health sector. The purpose of this paper is to investigate healthcare services access development of the provinces in Iran during 2007 and 2013.

This is a descriptive cross-sectional study. The study population included all the provinces in Iran. The data for 13 variables, including physical and human health resources, was collected from the Ministry of Health and Medical Education and the Statistics Center of Iran. Taxonomy technique was used to determine the degree of healthcare services access development in the provinces.

The findings show that Semnan was the province with the most developed healthcare services access with development score of 0.342 while Sistan Balocehstan province was the least developed with development score of one in 2007. In the year 2013, Chahar-Mahal Bakhtiari and Sistan Baluchestan were the least and most developed provinces with scores of 0.551 and 0.989, respectively. The mean and standard deviation of the development scores in access to healthcare services in 2007 and 2013 were 0.7463±0.1268 and 0.7766±0.1058, respectively.

Most previous studies that examined disparities in access to healthcare resources in Iran only considered one resource. This study applied a taxonomy technique to investigate the disparity and changes in access using 13 main healthcare resources. This approach helped the authors to investigate whether the decisions of the policy makers were intended to eliminate the disparities.

In India, people with disabilities (PWDs) have emerged as one of the most vulnerable populations during COVID-19, particularly those living in informal settlements. Although the government has made efforts to ensure healthcare access for all, these efforts seem inadequate considering that PWDs' needs vary greatly depending on type and degree of disability. The purpose of the study is to identify barriers in healthcare access for PWDs in Mumbai's informal settlements during COVID-19.

A qualitative approach employed multiple case study methods. Eight PWDs were selected as cases from the informal settlements of M-East Ward, Mumbai. The data was gathered using observation and interaction with the PWDs. Data were analyzed for emergent themes to explore the presence, meaning, and relationships of barriers faced by PWDs accentuated by pandemic.

Findings indicate a complex and compounded interplay of structural, administrative, psycho-social, and technological factors which created numerous challenges for PWDs to access healthcare provisions during pandemic. These factors include socioeconomic challenges, the built environment inaccessibility, limited transportation facilities, and lack of trained healthcare personnel to support PWDs.

This research adds to an understanding of the barriers faced by PWDs and provides insights for formulating contextualized policies to ensure accessible health services for PWDs when needed. Findings point out ways in which understanding the barriers would help to identify the gaps in the resource system, and to mobilize required resources in the relevant healthcare departments.

Purpose: Fear of deportation and its relationship to healthcare access has been less studied among immigrant Latinx men who have sex with men (MSM), a population at risk for HIV and characterized by their multiple minority statuses. The first step is to accurately measure their fear of deportation.

Approach: We used an exploratory sequential mixed methods design. Eligibility criteria were that research participants be ages 18–34 years; Latinx; cisgender male; having had sex with another male; residing in the District of Columbia metro area; and not a US citizen or legal permanent resident. In Study 1, we used in-depth interviews and thematic analysis. Using participants' interview responses, we inductively generated 15 items for a fear of deportation scale. In Study 2, we used survey data to assess the scale's psychometric properties. We conducted independent samples t-test on the associations between scale scores and barriers to healthcare access.

Findings: For the 20 participants in Study 1, fear of deportation resulted in chronic anxiety. Participants managed their fear through vigilance, and behaviors restricting their movement and social network engagement. In Study 2, we used data from 86 mostly undocumented participants. The scale was internally consistent (α = 0.89) and had a single factor. Those with higher fear of deportation scores were significantly more likely to report avoiding healthcare because they were worried about their immigration status (p = 0.007).

Originality: We described how fear of deportation limits healthcare access for immigrant Latinx MSM.

Research implications: Future research should examine fear of deportation and HIV risk among immigrant Latinx MSM.