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Open Access
Article
Publication date: 6 March 2017

Theresa Alfaro-Velcamp

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…

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Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Research limitations/implications

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.

Practical implications

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.

Social implications

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.

Originality/value

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.

Details

International Journal of Migration, Health and Social Care, vol. 13 no. 1
Type: Research Article
ISSN: 1747-9894

Keywords

Open Access
Article
Publication date: 17 April 2023

Noah Olasehinde, Uche Abamba Osakede and Abdulfatai Adekunle Adedeji

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…

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Abstract

Purpose

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.

Design/methodology/approach

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).

Findings

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.

Practical implications

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

Originality/value

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.

Details

International Journal of Health Governance, vol. 28 no. 2
Type: Research Article
ISSN: 2059-4631

Keywords

Open Access
Article
Publication date: 26 October 2021

Daniel Dramani Kipo-Sunyehzi

This paper aims to examine the factors that affect the quality of healthcare services in the implementation of the National Health Insurance Scheme (NHIS) at the local level in…

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Abstract

Purpose

This paper aims to examine the factors that affect the quality of healthcare services in the implementation of the National Health Insurance Scheme (NHIS) at the local level in Ghana from the perspectives of health policy implementers and beneficiaries in public-private organisations.

Design/methodology/approach

This paper has adopted a mixed research method with both qualitative and quantitative data, with in-depth interviews, document analysis and focus groups discussions. A total of 107 participants took part in the interviews and the questionnaire survey.

Findings

The study found that these factors greatly affect the quality of healthcare services from the implementers’ perspectives — referrals, effectiveness in monitoring, timeliness, efficiency, reimbursement, compliance with standard guidelines of Ghana Health Service (GHS) and accreditation process. For the beneficiaries, three healthcare services factors are important, including medical consultations, diagnostic services and the supply of drugs and medicines. Some other factors are found to be the least prioritized healthcare services, namely the issuance of prescription forms, verification of identification (ID) cards and staff attitude. However, the study found that implementers and beneficiaries exhibited a mixed reaction (perspectives) on accessing some healthcare services. In some healthcare services where the implementers perceived that beneficiaries have more access to such services, the beneficiaries think otherwise, an irony in the perspectives of the two actors.

Originality/value

This paper adds to the extant literature on the perspectives of policy implementers and beneficiaries on factors that affect the quality of healthcare services in general and specifically on the implementation of NHIS in Ghana with the public-private dimension.

Details

Public Administration and Policy, vol. 24 no. 3
Type: Research Article
ISSN: 1727-2645

Keywords

Content available
Article
Publication date: 1 December 2002

Ronald E. McGaughey

67

Abstract

Details

Benchmarking: An International Journal, vol. 9 no. 5
Type: Research Article
ISSN: 1463-5771

Open Access
Article
Publication date: 5 May 2021

Hamed Ahmadinia, Kristina Eriksson-Backa and Shahrokh Nikou

Immigrants, asylum seekers and refugees living in Europe face a number of challenges in accessing or using health information and healthcare services available in their host…

5573

Abstract

Purpose

Immigrants, asylum seekers and refugees living in Europe face a number of challenges in accessing or using health information and healthcare services available in their host countries. To resolve these issues and deliver the necessary services, providers must take a comprehensive approach to better understand the types of health information and healthcare services that these individuals need, seek and use. Therefore, the purpose of this paper is to develop that comprehensive approach.

Design/methodology/approach

In this paper, a systematic literature review of peer-reviewed publications was performed, with 3.013 articles collected from various databases. A total of 57 qualifying papers on studies conducted in Europe were included in the review after applying the predefined inclusion and exclusion requirements, screening processes and eliminating duplicates. The information seeking and communication model (ISCM) was used in the analysis.

Findings

The findings revealed that while many health information and healthcare services are accessible in Europe for immigrants, asylum seekers and refugees, many of these individuals are unaware of their existence or how to access them. While our findings do not specify what health-related information these groups need, use or seek, they do suggest the importance and value of providing mental health, sexual health and HIV, as well as pregnancy and childbirth information and services. Furthermore, according to our results, health information services should be fact-based, easy to understand and raise awareness about healthcare structure and services available in Europe for this vulnerable population.

Practical implications

This study has a range of practical implications, including (1) highlighting the need for mental health and behavioural health services and (2) stressing the value of addressing cultural context and religious values while investigating (health) information seeking of people with foreign background.

Originality/value

This is one of the first studies to systematically review and examine the behaviour of immigrants, asylum seekers and refugees in relation to health information and healthcare services in the European context.

Details

Journal of Documentation, vol. 78 no. 7
Type: Research Article
ISSN: 0022-0418

Keywords

Open Access
Article
Publication date: 15 October 2021

Ignat Kulkov

Value creation based on artificial intelligence (AI) can significantly change global healthcare. Diagnostics, therapy and drug discovery start-ups are some key forces behind this…

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Abstract

Purpose

Value creation based on artificial intelligence (AI) can significantly change global healthcare. Diagnostics, therapy and drug discovery start-ups are some key forces behind this change. This article aims to study the process of start-ups' value creation within healthcare.

Design/methodology/approach

A multiple case study method and a business model design approach were used to study nine European start-ups developing AI healthcare solutions. Obtained information was performed using within and cross-case analysis.

Findings

Three unique design elements were established, with 16 unique frames and three unifying design themes based on business models for AI healthcare start-ups.

Originality/value

Our in-depth framework focuses on the features of AI start-up business models in the healthcare industry. We contribute to the business model and business model innovation by systematically analyzing value creation, how it is delivered to customers, and communication with market participants, as well as design themes that combine start-ups and categorize them by specialization.

Details

International Journal of Entrepreneurial Behavior & Research, vol. 29 no. 4
Type: Research Article
ISSN: 1355-2554

Keywords

Open Access
Article
Publication date: 3 October 2023

Salman Butt, Ahmed Raza, Rabia Siddiqui, Yasir Saleem, Bill Cook and Habib Khan

This literature review aims to assess the current research on healthcare job availability and skilled professionals. The objective of this research is to identify challenges…

Abstract

Purpose

This literature review aims to assess the current research on healthcare job availability and skilled professionals. The objective of this research is to identify challenges caused by the imbalance between healthcare service demand and qualified professionals and propose potential solutions and future research directions.

Design/methodology/approach

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was employed as the guiding framework for conducting this review. A qualitative research design analyzed 38 peer-reviewed, evidence-based research works from 50 journal publications. Inclusion criteria focused on empirical studies, observational research and comprehensive reviews published within the last ten years. Thematic and discourse analysis categorized themes and factors explored in selected publications.

Findings

The findings highlight significant challenges in the healthcare sector regarding job availability and skilled professionals. Developed countries face understaffed healthcare facilities, resulting in increased workloads and compromised care. Developing countries experience high rates of unemployment among healthcare graduates due to limited resources and mentorship.

Practical implications

Improving educational infrastructure, expanding training opportunities and increasing healthcare investments are crucial for nurturing a skilled workforce. Implementing effective retention policies, fostering international collaborations and addressing socioeconomic determinants can create a sustainable job market.

Originality/value

The healthcare sector faces critical challenges in balancing job availability and skilled professionals. Strategic solutions are proposed to create a sustainable and equitable healthcare workforce. By implementing recommendations and conducting further research, access to quality healthcare and global public health outcomes can be improved.

Details

Journal of Work-Applied Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2205-2062

Keywords

Open Access
Article
Publication date: 16 December 2022

Banna Banik, Chandan Kumar Roy and Rabiul Hossain

This study aims to investigate the consequence of the quality of governance (QoG) in moderating the effect of healthcare spending on human development.

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Abstract

Purpose

This study aims to investigate the consequence of the quality of governance (QoG) in moderating the effect of healthcare spending on human development.

Design/methodology/approach

The authors employ a two-step Windmeijer finite sample-corrected system-generalized method of moments (sys-GMM) estimation technique on a panel dataset of 161 countries from 2005 to 2019. The authors use healthcare expenditure as the main explanatory variable and the Human Development Index (HDI) as the dependent variable and also consider voice and accountability (VnA), political stability and absence of terrorism (PSnAT), governance effectiveness (GoE), regulatory quality (ReQ), rules of law (RLaw) and control of corruption (CoC) dimensions of governance indicators as proxies of good governance. The authors develop a new measure of good governance from these six dimensions of governance using principal component analysis (PCA).

Findings

The authors empirically revealed that allocating more healthcare support alone is insufficient to improve human development. Individually, PSnAT has the highest net positive effect on health expenditure that helps to increase human welfare. Further, the corresponding interaction effect between expenditure and the Good Governance Index (GGI) is negative but insignificant for low-income countries (LICs); negative and statistically significant for sub-Saharan African (SSA) economies and positive but insignificant for South Asian nations.

Originality/value

This study is an in-depth analysis of how governance impacts the effectiveness of healthcare expenditure to ensure higher human development, particularly in a large panel of 161 countries. The authors have developed a new index of good governance and later extended the analysis by separating countries based on the income level and geographical location, which are utterly absent in existing literature.

Open Access
Article
Publication date: 5 April 2022

Maria Vincenza Ciasullo, Weng Marc Lim, Mohammad Fakhar Manesh and Rocco Palumbo

Healthcare policies around the globe are aimed at achieving patient-centeredness. The patient is understood as a prosumer of healthcare, wherein healthcare service co-production…

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Abstract

Purpose

Healthcare policies around the globe are aimed at achieving patient-centeredness. The patient is understood as a prosumer of healthcare, wherein healthcare service co-production and value co-creation take center stage. The article endeavors to unpack the state of the literature on the innovations promoting the transition toward patient-centeredness, informing policy and management interventions fostering the reconceptualization of the patient as a prosumer of healthcare services.

Design/methodology/approach

A hybrid review methodology consisting of a bibliometric-interpretive review following the Scientific Procedures and Rationales for Systematic Literature Reviews (SPAR-4-SLR) protocol is used. The bibliometric component enabled us to objectively map the extant scientific knowledge into research streams, whereas the interpretive component facilitated the critical analysis of research streams.

Findings

Patient-centeredness relies on a bundle of innovations that are enacted through a cycle of patients' activation, empowerment, involvement and engagement, wherein the omission of any steps arrests the transition toward service co-production and value co-creation. Institutional, organizational and cognitive barriers should be overcome to boost the transition of patients from consumers to prosumers in a patient-centered model of healthcare.

Originality/value

The article delivers the state of the art of the scientific literature in the field of innovations aimed at sustaining the transition toward patient-centeredness and provides some food for thoughts to scholars and practitioners who wish to push forward service co-production and value co-creation in healthcare.

Details

Journal of Health Organization and Management, vol. 36 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Book part
Publication date: 22 March 2021

Sophie Guthmuller, Paolo Paruolo and Stefano Verzillo

This chapter summarises the role of EU actions in supporting healthcare policies in the EU Member States, both looking at implemented actions and describing current priorities for…

Abstract

This chapter summarises the role of EU actions in supporting healthcare policies in the EU Member States, both looking at implemented actions and describing current priorities for the future. It argues that these coordinated actions can be beneficial for EU Member States by helping them to avoid duplication of effort and to attain economies of scale. Moreover, data sharing with proper safeguards can unleash vast amount of ‘learning what works’ both for medical treatments and for healthcare sustainability measures. The need for this common learning appears ever more urgent while facing the health and economic consequences of the present pandemic.

Details

The Sustainability of Health Care Systems in Europe
Type: Book
ISBN: 978-1-83909-499-6

Keywords

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