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Health in low-income countries has become associated with the provision of minimum guaranteed public health services though Essential Health Packages (EHPs). How far do EHPs deliver the human right to health for all? This study addresses this question through qualitative research into access to health care for vulnerable communities, using Malawi as a case study. This study shows that there are significant accountability gaps and perceptions of weak service provision in Malawi’s EHP in relation to some particularly marginalised (and stigmatised) groups that limit the right to health and the promise of “health for all”.

This study extends the body of qualitative work on EHPs in general and on Malawi in particular by exploring the perceptions of key stakeholders in relation to inclusivity and the delivery of health policies to particularly vulnerable groups. To do so, this study adopted an approach based on interpretive epistemologies (Scott, 2014). This study conducted largely unstructured interviews with a range of health stakeholders, speaking to stakeholders individually, rather than through focus groups due to the potentially sensitive nature of the topic.

The findings of this study are as follows: limited inclusion of civil society actors and local communities; local communities and local policymakers feel frustration with the gap between the promises of consultation in the EHP and the reality, and the difficulties of not having effective channels of communication; and exclusionary health practices for particularly vulnerable groups.

There are limitations based on the qualitative methodology, and in terms of the particularly vulnerable groups – the authors studied two such groups (people with disabilities and those who identify as LBTQ) but a wider survey of vulnerable groups is needed to extend and confirm the findings.

Greater attention to the health rights of vulnerable groups would improve access and services, even in the context of resource restrictions. This study suggests that a deeper engagement with human rights-based approaches would pay dividends in terms of increasing access to health in Malawi, even within the constraints of the EHP process. Furthermore, without this, there is the risk that discrimination and exclusion will become more embedded in health policies, rather than progressively minimised.

Without addressing these issues, there is the risk that discrimination and exclusion will become more embedded in health policies, rather than progressively minimised.

This paper makes an important contribution to the growing literatures on EHP in sub-Saharan Africa and Malawi in particular and to the importance of listening to stakeholder perceptions. It provides original data on stakeholder perspectives of the challenges associated with universalising health care in resource-constrained countries. To the best of the authors’ knowledge, it is one of the first papers to focus on the rights of disabled and LBTQ people in relation to EHPs.

Deaf people, who are British Sign Language (BSL) users, are, at times, carers for their parent or spouse when they have dementia. This can be a challenging role for the wider population, but if the common language in service provision is not one you share, then this care can be impacted by the lack of formal structures that support the Deaf caring role. This study aims to explore the experiences of Deaf carers supporting people with dementia, in an unpaid role, during the COVID-19 pandemic to understand more about their potential support preferences.

Online interviews with seven Deaf carers sharing their experiences of supporting their family member with dementia happened during the first year of the COVID-19 pandemic. Interpretive phenomenological analysis was used to qualitatively examine each Deaf carers’ stories.

Findings included Deaf carers’ lack of access to information, surrendering their autonomy to hearing family members to communicate with health-care professionals, with overarching isolation within local communities and online. Findings show a widespread infrastructural failure to meet the linguistic and specific support needs of this minority population.

Seven Deaf carers took part in this study. This means the findings may not be generalisable.

Health-care professionals and social care structures need to develop robust clear communication pathways for Deaf carers to receive the support needed to provide effective care.

If health-care professionals undertake training about Deaf people and BSL, that will mean Deaf carers will receive effective support to be able to care for a person living with dementia. This means that their Deaf identity will be recognised within the mainstream and the care provided will be much more effective for the person with dementia.

To the best of the authors’ knowledge, these are the first interviews undertaken with Deaf carers of people with dementia during the COVID-19 pandemic and its subsequent lockdowns. Understanding everyday barriers and social care limitations in terms of language access will enable Deaf carers to assert their rights and for care professionals to adapt their communication to match the individuals involved in the care package.

This study aims to co-develop a Frailty, Health and Care Needs Assessment (FHCNA) questionnaire for people experiencing homelessness and explore the feasibility of its use by non-clinical staff in homeless hostels.

The FHCNA, aimed at identifying frailty and other health and care priorities for people experiencing homelessness, was co-designed in workshops (online and in person) with homelessness and inclusion health staff. Its feasibility was tested by staff and their clients in two hostels, with pre- and post-study focus groups held with hostel staff to gain input and feedback.

The FHCNA was co-developed and then used to collect 74 pairs of resident and key worker inputted data (62% of eligible hostel residents). The mean age of clients was 48 years (range 22–82 years). High levels of unmet need were identified. Over half (53%) were identified as frail. Common concerns included difficulty walking (46%), frequent falls (43%), chronic pain (36%), mental health issues (57%) and dental concerns (50%). In total, 59% of clients reported difficulty in performing at least one basic activity of daily living, while only 14% had undergone a Care Act Assessment. Hostel staff found using the FHCNA to be feasible, acceptable and potentially useful in facilitating explorations of met and unmet health and social care needs of hostel clients. By identifying unmet needs, the FHCNA has the potential to support staff to advocate for access to health and social care support.

To the best of the authors’ knowledge, this is the first study to co-develop and feasibility test a questionnaire for use by non-clinically trained staff to identify frailty and other health and care needs of people experiencing homelessness in a hostel setting.

The purpose of this paper is to compare home care workers' views of their employment conditions by provider type – private for-profit vs public and non-profit – using the case study of Ireland.

An online survey was distributed to care workers (n = 350) employed by private for-profit, public and non-profit home care providers in Ireland. Returned questionnaires were analysed statistically in R using chi-squared tests to systematically compare key aspects of employment conditions.

Analysis shows that conditions are perceived to be significantly worse for those employed by private for-profit providers (and to a lesser extent non-profit organisations) compared to the public provider. There are wide disparities between public and private sector conditions in terms of contracts, pensions, unsocial hours pay and travel time allowances. The main area of convergence is in relation to employer support, where although the public sector performed better, the difference between the three provider types is smaller.

Relatively little research compares working conditions in private for-profit providers vs public and non-profit providers in Ireland and other countries. The findings can be understood in the context of marketisation reforms and may partly be explained by a lack of regulation in Ireland's home care sector and low unionisation rates amongst care workers employed by private for-profit providers.

This study aims to explore how not-for-profit organisations (NFPs) adopt service innovation and improve their employee resilience capabilities as a response to environmental changes arising from marketisation of public services.

Using a multiple case-study research design, this study involved 32 interviews with frontline employees working in a not-for-profit care-providing organisation.

This study finds that the development of absorptive capacity can facilitate service innovation adoption in NFPs and improve employee resilience in times of transition.

This study offers theoretical insights on service innovation, absorptive capacity and employee resilience in NFPs. It makes practical recommendations that will enable NFPs to help frontline employees better adopt service innovation practices in business models endorsed by the private sector.

Research ethics and integrity stipulates that research must be conducted with responsibility towards the research community and should benefit the intended population. This chapter will share insights from an ongoing research programme to reduce family conflict in the context of dementia care while discussing the accompanying ethical considerations. Research into dementia care has primarily focused on improving outcomes for the care dyad, leaving the influence and input of the wider family unit under investigated. Family conflict can detrimentally impact the quality of care provided and leave caregivers vulnerable to psychosocial difficulties. Family conflict occurs in the context of dementia care but there is little research on how to reduce, or prevent, such conflict occurring. In this research programme, a systematic review investigated the effectiveness of interventions that include the wider family unit to reduce family conflict; only one study was included which evidenced the lack of interventions in this area. A qualitative scoping review was then conducted to explore the lived experiences of caregiving families with experience of family conflict and reported solutions. It was found that conflict occurred due to factors including care decisions and role transitions which impacted relationships and affected care provision. Solutions to conflict were less often reported, indicating an important gap in the literature. Interviews with Alzheimer's Society staff and volunteers revealed that stigma and denial surrounding dementia were prevalent, and families were often reluctant to seek external help. This research programme is currently establishing public patient involvement (PPI) to develop the research methodology and interview questions for people with dementia (PWD) and their family caregivers to explore their lived experiences and potential solutions to family conflict. To conclude, this research programme will propose a family-focused intervention aimed at systemic family conflict for those caring for someone with dementia.

Integrated health and social care initiatives are increasing and health and social care systems are aiming to improve health and social outcomes in disadvantaged groups. There is a global dialogue surrounding improving services by shifting to an integrated health and social care approach. There is consensus of what is “health care”; however, the “social care” definition remains less explored. The authors describe the state of “social care” within the current integrated care literature and identify the depth of integration in current health and social care initiatives.

A narrative literature review, searching Medline, PsychINFO, CINAHL, PubMed, Scopus and Cochrane databases and grey literature (from 2016 to 2021), employing a search strategy, was conducted.

In total. 276 studies were eligible for full-text review, and 33 studies were included and categorised in types: “social care as community outreach dialogues”, “social care as addressing an ageing population”, “social care as targeting multimorbidity and corresponding social risks factors” and “social care as initiatives addressing the fragmentation of services”. Most initiatives were implemented in the United Kingdom. In total, 21 studies reported expanding integrated governance and partnerships; 27 studies reported having health and social care staff with clear integrated governance; 17 had dedicated funding and 11 used data-sharing and the integration of systems’ records.

The authors' demonstrate that social care approaches are expanding beyond the elderly, and these models have been used to respond to multimorbidity [including coronavirus disease 2019 (COVID-19)], targeting priority groups and individuals with complex presentations.

The coronavirus (COVID-19) pandemic has led to a surge in demand for health-care facilities, medicines, vaccines and other health-care items. The purpose of this study is to investigate different facets of integrated Green Lean Six Sigma and Industry 4.0 approach in the context of COVID-19 for better healthcare management. Integrating Green Lean Six Sigma (GLSS) and Industry 4.0 (I4.0) has the potential to meet the modern demand of health-care units and also leads to improving the quality of inpatient care with better safety, hygiene and real-time diagnoses. A systematic review has been conducted to determine the tools/techniques, challenges, application areas and potential benefits for the adoption of an integrated GLSS-I4.0 approach within health-care facilities from the perspective of COVID management. Further, a conceptual framework of integrated GLSS-I4.0 has been proposed for better COVID management.

To conduct the literature review, the authors used the preferred reporting items for systematic reviews and meta-analysis and covers relevant papers from the arrival of COVID-19. Based on the systematic understanding of the different facets of the integrated GLSS-I4.0 approach and through insights of experts (academicians and health-care personnel), a conceptual framework is proposed to combat COVID-19 for better detection, prevention and cure.

The systematic review presented here provides different avenues to comprehend the different facets of the integrated GLSS-I4.0 approach in different areas of COVID health-care management. In this study, the proposed framework reveals that the Internet of Things, big data and artificial intelligence are the major constituents of I4.0 technologies that lead to better COVID management. Moreover, integration of I4.0 with GLSS aids during different stages of the COVID management, right from diagnosis, manufacture of items and inpatient and outpatient care of the affected person.

This study provides a significant knowledge database to the practitioners by understanding different tools and techniques of an integrated approach for better COVID management. Moreover, the proposed framework aids to grab day-to-day information from the affected people and ensures reduced hospital stay with better space utilization and the creation of a healthy environment around the patient. This inclusive implementation of the proposed framework will enhance knowledge base in medical areas and provides different novel prospects to combat other medical urgencies.

To the best of the authors’ knowledge, this study is the first of its kind to review different facets of the integrated GLSS-I4.0 approach with a view of the COVID health-care perspective and provides a conceptual framework.

The COVID-19 epidemic has brought attention to the variables that influence the mental health of health workers who are entrusted with nursing individuals. Despite the fact that many articles have examined the effects of social media usage on mental health, there is a lack of research synthesizing learning from this body of research. The purpose of this study is to use text mining and citation-based bibliometric analysis to conduct a detailed review of extant literature on health workers’ mental health and social networking habits.

This study conducts a full-text analysis of 36 articles selected on health workers' mental health and social media using text-mining techniques in R programming and a bibliometric citation analysis of 183 papers from the Scopus database in VOS viewer software. But the limitations of the methods used in this study are that the bibliometric analysis was limited to the Scopus database because the VOS viewer program did not support any other database and the text-mining approach caused the natural processing redundancy.

The bibliometric analysis reveals the thematic networks that exist in the literature of health workers’ mental health and social networking. The findings from text mining identified ten topic models, which helped to find the related papers classified in ten different groups and are provided alongside a summary of the published research and a list of the primary authors with posterior probability through Latent Dirichlet Allocation.

To the best of the authors’ knowledge, this is the first hybrid review, combining text mining and bibliometric review, on health workers’ mental health where social networking plays a moderating role. This paper critically provides an overview of the impact of social networking on health workers' mental health, presents the most important and frequent topics, introduces the scientific visualization of articles published in the Scopus database and suggests further research avenues. These findings are important for academics, health practitioners and medical specialists interested in learning how to better support the mental health of health workers using social media.

Infection and cross-contamination have been massive concerns in the medical field. This study aims to investigate consumers’ awareness and their choices of endoscopes, which may deter them from the cross-contamination problem.

A discrete choice experiment survey was administered to 166 respondents in Penang, Malaysia. Participants were asked to make hypothetical choices and estimate their preference for endoscopes. The multinomial logit model was used to estimate the assumptions based on the stated preference data collected.

Only two-fifths of respondents are aware of their rights regarding endoscope selection. The findings are consistent with utility theory, where choices are made to maximise personal satisfaction. If given the choice, consumers preferred the single-use endoscope over the reusable or the doctor’s preferred endoscope. Price, insurance coverage and personal income are significant determinants of the consumer’s choice of endoscopes.

This study only investigates subjects living in Penang. Other possible important attributes to endoscope choices, such as environmental and device availability may be considered in future study.

The findings may create awareness among consumers about their rights when choosing medical devices. It may also improve health-care institutions’ (users’) and device manufacturers’ (industry players’) understanding of consumer needs and demands from socioeconomic perspectives.

The research offers insights into consumer rights and awareness of health-care services. Ultimately leading to better policy to protect consumers’ rights and safety.

This study contributes to the rare literature on consumer rights toward medical devices, in particular, the consumer’s awareness of the choice of endoscopes.