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This chapter explores the significance and implementation of family planning practices, emphasizing their vital role in enhancing reproductive health outcomes. This chapter conducts an in-depth examination of family planning practices within marginalized communities in Bangladesh, shedding light on the unique challenges and opportunities faced by these populations. By uncovering the nuances of family planning practices in marginalized contexts, this chapter underscores the need for tailored and culturally sensitive family planning programs. It advocates for program designs that facilitate the effective adoption of family planning practices among marginalized communities, ultimately promoting better reproductive health outcomes. Furthermore, this chapter highlights the importance of empowerment strategies in reaching and engaging marginalized communities. Through practice enhancement initiatives, it seeks to empower marginalized populations with the knowledge and resources necessary to make informed decisions about family planning, thereby contributing to improved reproductive health and overall well-being.

This preliminary study aims to examine the use of a co-designed immersive virtual reality intervention programme in improving access to health care for people with intellectual disability.

A co-production approach was used to design a virtual reality intervention in collaboration with people with intellectual disability, their families and carers. A mixed-method single sample pre-test-post-test design examined using a virtual reality intervention simulating health-care environments to improve access of attending health-care appointments. Qualitative feedback was used to understand participants’ experience and opinions of using the digital technology.

The study found that the intervention did help people access health-care appointment and reduced their fear. Improvements were also found in quality-of-life post intervention. Positive feedback was provided from participants on using digital technologies indicating the novelty of the approach and potential further applications.

To the best of the authors’ knowledge, this is the first study which has used virtual reality to support people with intellectual disability access health care.

This chapter discusses various aspects of family planning initiatives on a global scale, with a specific focus on their influence in Asian contexts, including Bangladesh. This chapter examines the diverse range of family planning programs and policies implemented worldwide, in Asia and Bangladesh considering cultural factors that significantly shape family planning decisions. By highlighting the unique approaches and challenges faced in different regions, it provides valuable insights into the evolving landscape of family planning efforts and their impact on population dynamics.

People who identify as transgender face stigma, isolation and harassment while often struggling to come to terms with their gender identity. They also disproportionately experience mental health difficulties. The purpose of this paper is to present the voices of transgender people in the Republic of Ireland (RoI) in regard to the issues they are facing, improvements they would like to see made to schools, workplaces, services and society in general and whether mental health supports fulfil their needs.

Ten open questions were embedded within a quantitative online survey (LGBTIreland study) on factors impacting social inclusion, mental health and care. These open questions were re-analysed with exclusive focus on the transgender participants (n = 279) using content/thematic analysis.

The participants in this study reported significant signs of mental distress. The following themes emerged: impact of stigma, deficiencies in mental health services, need for education on transgender identity, importance of peer support, achieving self-acceptance and societal inclusion questioned.

Efforts to recruit young participants have led to a possible over-representation in this study.

The findings suggest the need for improvement in mental health support services, including further education in how to meet the needs of transgender individuals.

Transgender people in Ireland experience social exclusion. The need for more inclusivity was emphasised most in secondary schools. Education on transgender identities in all contexts of society is recommended by the participants.

This study reports on the largest group of transgender participants to date in RoI. Their voices will affect perceptions on social inclusion and mental health care.

This paper examines the career progression of women auditors working in auditing firms in Tanzania and the strategies employed by women auditors to cope with the masculine nature of audit firms.

Data were collected through semi-structured, in-depth interviews with current and former female and male auditors in two auditing firms. A thematic approach to the analysis is adopted.

The study reveals that career progression of women auditors studied is constrained by gender-related barriers such as motherhood, pregnancy, maternity leave and limited coaching and networking, as well as household and caring responsibilities. These barriers are facilitated by the patriarchal system, which regards women as wives and mothers rather than professional workers. As a result, women auditors balanced work and family responsibilities by employing various coping strategies including establishing informal network organization, hiring nannies, living with family members, enrolling children to boarding schools and lobbying in the allocation of audit assignments. Despite employing these strategies, very few women reach top positions in audit firms in Tanzania.

The findings reveal a need for wider engagement on the role of women and men in society, particularly to address the gender-related barriers faced by women in the accountancy profession.

Most previous studies of gender in the accountancy profession have focused on Western contexts. This is one of few to examine the phenomenon in an African context.

This study aims to understand the utility of personas and illustrate, through a case study, how a persona-building exercise in a Community Based Prevention Marketing (CBPM) training of community leaders elicited important insights that complemented findings from ongoing formative research on vaccine hesitancy in the Hispanic/Latino population in the USA during COVID-19 pandemic.

An exploratory concurrent parallel qualitative study design compared three personas created by community-based organization members (n = 37) to transcripts from five formative research focus groups (n = 30) from the same project. All participants in this study were recruited by the National COVID-19 Resiliency Network as part of their capacity-building and formative research activities. Grounded theory guided the content analysis.

This study found personas and focus groups to be complementary. A high degree of co-occurrence was observed when investigating the uptake of the COVID-19 vaccine under the categories of barriers, culture and communication. Between the two methods, the authors found strong associations between fear, disruption to the value system, work-related barriers, inaccessibility to health care and information sources and misinformation. Areas of divergence were negligible.

While personas provided background information about the population and sharing “how” to reach the priority population, focus groups provided the “why” behind the behavior, followed by “how”.

A community-driven persona-building process built on cultural community knowledge and existing data can build community capacity, provide rich information to assist in the creation of tailored messages, strategies and overall interventions during a public health crisis and provide user-centered, evidence-based information about a priority population while researchers and practitioners wait on the results from formative research.

This case study provided a unique opportunity to analyze the complementary effectiveness of two methods acting in tandem to understand the priority population: stakeholder-informed persona-building and participant-informed focus group interviews. Understanding their complementary nature addresses a time gap that often exists between researchers and practitioners during times of crises and builds on recommendations associated with bringing rigor into practice, promoting academic contribution to real-world issues and building collaborative partnerships. Finally, it supports the utility of a nimble tool that improves social marketers’ ability to know more about their audience for intervention design when time is of the essence and formative research is ongoing.

Institutional abuse is a worldwide phenomenon with the UK also subject to several high-profile abuse scandals perpetuated on people with learning disabilities and/or mental health conditions living within institutional settings. This study aims to provide a broad perspective of safeguarding practices within institutional care to inform practice and service development in this area.

A narrative overview was undertaken of a range of empirical evidence, discussion papers, enquiry reports, reports from regulatory bodies and professional guidance to explore safeguarding practices within institutional care for individuals with learning disabilities and/or mental health conditions.

A range of literature was identified that exposed and explored abuse in this context. Three key themes were identified: failings within institutional care; safeguarding issues and concerns; and good practice within institutional care. Whilst guidance is available, standards are explicit and protocols facilitate improvement potential in this area, a consistent message was that statutory recommendations for reform have not been effective.

This paper provides an important resource for practitioners and service providers involved in institutional care. An accessible overview of both the empirical evidence and grey literature on adult safeguarding within institutional settings is provided, along with a range of standards and resources that specify practice in these settings.

This paper – the final paper of a series of three – aims to discuss the implications of the findings from a service user needs assessment of people experiencing homelessness in the Northwest of England. It will expand on the previous paper by offering a more detailed analysis and discussion of the identified key themes and issues. The service user needs assessment was completed as part of a review of local service provision in the Northwest of England against the backdrop of the COVID-19 pandemic.

Semi-structured questionnaires were administered and used by health-care professionals to collect data from individuals accessing the Homeless and Vulnerable Adults Service (HVAS) in Bolton. The questionnaires included a section exploring Adverse Childhood Experiences. Data from 100 completed questionnaires were analysed to better understand the needs of those accessing the HVAS.

Multiple deprivations including extensive health and social care needs were identified within the cohort. Meeting these complex needs was challenging for both service users and service providers. This paper will explore key themes identified by the needs assessment and draw upon further comments from those who participated in the data-gathering process. The paper discusses the practicalities of responding to the complex needs of those with lived experience of homelessness. It highlights how a coordinated partnership approach, using an integrated service delivery model can be both cost-effective and responsive to the needs of those often on the margins of our society.

Data collection during the COVID-19 pandemic presented a number of challenges. The collection period had to be extended whilst patient care was prioritised. Quantitative methods were used, however, this limited the opportunity for service user involvement and feedback. Future research could use qualitative methods to address this balance and use a more inclusive approach.

This study illustrates that the needs of the homeless population are broad and varied. Although the population themselves have developed different responses to their situations, their needs can only be fully met by a co-ordinated, multi-agency, partnership response. An integrated service model can help identify, understand, and meet the needs of the whole population and individuals within it to improve healthcare for a vulnerable population.

This study highlighted new and important findings around the resilience of the homeless population and the significance of building protective factors to help combat the multiplicity of social isolation with both physical and mental health problems.

The discussion provides an opportunity to reflect on established views in relation to the nature and scope of homelessness. The paper describes a contemporary approach to tackling current issues faced by those experiencing homelessness in the current context of the COVID-19 pandemic. Recommendations for service improvements will include highlighting established good practices including embedding a more inclusive/participatory approach.

The purpose of this chapter is to highlight how universities got into the predicament in which they currently find themselves in, or somewhat planned to be in, in the 2020s. The historical account outlines the purpose of higher education and who it was for throughout the last few centuries, before a more in-depth analysis of the last few decades will highlight how, and why, neoliberal and subsequently managerial aspects of leadership and performance metrics crept into universities before an analysis of the last 5–10 years, including the onset and consequences of COVID, will demonstrate that many ‘COVID recovery plans’ around staff cuts and course reforms were already in place before COVID, but it was COVID that allowed these plans in most cases to be escalated.