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1 – 10 of 913Pooja Kansra and Amiya Abdul Khadar
Population ageing is a demographic transition and burdens every country’s health sector. A lack of social security combined with low government health-sector spending has made…
Abstract
Purpose
Population ageing is a demographic transition and burdens every country’s health sector. A lack of social security combined with low government health-sector spending has made health-care utilisation difficult among elderly in many developing countries like India. This makes population ageing a global phenomenon for policymakers, researchers and stakeholders to discuss and debate in 21st century. The purpose of this paper is to examine the behavioural determinants of health-care utilisation among elderly population in Punjab.
Design/methodology/approach
This study examines health-care utilisation among the elderly population in Punjab. A structured questionnaire was used to collect the data in the state of Punjab, with a multi-stage stratified random sample of 385 respondents. Logit regression was used to analyse the association between several behavioural factors like age, gender, place of residence, source of livelihood, education and frequency of visits with health-care utilisation among elderly aged 60 and above.
Findings
This study revealed that gender, age, place of residence, source of livelihood, education and frequency of visits were significant determinants of health-care utilisation among elderly population.
Originality/value
This study directs the need to improve health-care utilisation in a country, reducing inequalities that exist among the elderly population with respect to socio-economic and demographic differences.
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Samuel Sekyi, Senia Nhamo and Edinah Mudimu
This paper aims to evaluate Ghana's National Health Insurance Scheme (NHIS) on healthcare utilisation by exploring its heterogeneous effects based on residential status and wealth.
Abstract
Purpose
This paper aims to evaluate Ghana's National Health Insurance Scheme (NHIS) on healthcare utilisation by exploring its heterogeneous effects based on residential status and wealth.
Design/methodology/approach
The study used the Ghana Socioeconomic Panel Survey (GSPS) datasets. An instrumental variable strategy, specifically the two-stage residual inclusion (2SRI), was employed to control endogenous NHIS membership.
Findings
Generally, the results show that NHIS improves healthcare utilisation (i.e. visits to a health facility and formal care). Concerning the heterogeneous effects of health insurance on healthcare utilisation, the results revealed that NHIS members are more likely to seek care, irrespective of their residence status. The results further indicate that the probability of visiting a health facility and utilising formal care increases for the poorest NHIS participants. Based on these, the authors conclude that NHIS provides equitable healthcare access and utilisation for its vulnerable populations, who are beneficiaries.
Originality/value
To the best of the authors' knowledge, this paper is the first to explore the heterogeneous effects of NHIS on healthcare utilisation across residential and income subpopulations. Splitting the dataset by residential status to examine healthcare utilisation inequality is worthwhile. In addition, analysing utilisation in terms of health care type would show whether Ghana's NHIS may be viewed as welfare-enhancing through increased formal health care utilisation.
Peer review
The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-05-2023-0330
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Camilla Michaëlis, Johanna Falby Falby Lindell, Cæcilie Hansen, Allan Krasnik, Susanne Reventlow, Marie Nørredam, Melissa Lutterodt and Annette Sofie Davidsen
Following the introduction of user fee for interpreting in Danish health care, a considerable decrease in interpreter services has been shown. This study aims to explore the…
Abstract
Purpose
Following the introduction of user fee for interpreting in Danish health care, a considerable decrease in interpreter services has been shown. This study aims to explore the experiences of language minority patients with health-care encounters when an interpreter was needed but not present.
Design/methodology/approach
Semistructured, in-depth interviews were conducted with 13 language minority patients with limited Danish proficiency. All interviews were conducted with interpreters in the participants’ native language. Data were analyzed using an inductive thematic approach.
Findings
Most participants experienced communication difficulties and difficulties participating actively in their own health care. The experience of unresolved language barriers led to a high degree of uncertainty and left the participants with unanswered health concerns. Participants expressed a reluctance to seek health care, which consequently limited the utilization of health care services.
Research limitations/implications
Although the findings only represent a small sample of patients, the results still reveal major challenges that minority-language patients encounter when seeking health care. Future studies should explore, if the intention of the law is met through the user fees.
Practical implications
Despite having the same entitlements as native Danish-speaking patients, minority-language patients experienced difficulties accessing and using health care services due to the user fee and unresolved language barriers. The study elucidates patient perspectives and points to important ways of improving the quality of health care.
Originality/value
To the best of the authors’ knowledge, no investigation into the communicative consequences of the introduction of the user fee for interpreting services exists. Thus, this study seeks to address that gap.
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Anika Christin Bäumel, Alexandra Sauter, Andrea Weber, Michael Leitzmann and Carmen Jochem
Many refugees and asylum seekers in Germany experience a high disease burden and low health literacy. The current study aims to focus on assessing these issues among African…
Abstract
Purpose
Many refugees and asylum seekers in Germany experience a high disease burden and low health literacy. The current study aims to focus on assessing these issues among African refugees and asylum seekers in Bavaria, Germany. The authors evaluated their self-perceived health status and health literacy, and identified barriers and gaps in health care utilization, intending to improve health care services for this group.
Design/methodology/approach
The authors conducted a cross-sectional, questionnaire-based study involving 69 refugees and asylum seekers from Ethiopia, Eritrea and Nigeria. The authors performed descriptive and exploratory statistical analyses.
Findings
The authors found a substantial disease burden in the early stages of resettlement in Germany, particularly mental health symptoms (53.6%) and musculoskeletal problems (47.8%). Challenges in health literacy were observed, such as difficulties in understanding health information and managing emergency situations. Access to interpreters was limited, and understanding treatment certificates was more challenging than using electronic health cards, with 18.2% of participants reporting denial of medical treatment.
Practical implications
These findings highlight the need for early and tailored health support for refugees, with a particular focus on mental health. Efforts should be made to reduce language barriers and improve navigational skills within the health-care system, particularly in emergency situations. Addressing the restricted access to health care and bureaucratic obstacles is crucial for improved health outcomes among refugees.
Originality/value
To the best of the authors’ knowledge, this research is the first to specifically explore the self-reported health status and health literacy of African refugees and asylum seekers in Bavaria, Germany, providing valuable insights into the unique healthcare challenges of this often underrepresented and overlooked population.
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Samuel Sekyi, Philip Kofi Adom and Emmanuel Agyapong Wiafe
This study examined the influence of income and health insurance on the health-seeking behaviour of rural residents, addressing the concerns of endogeneity and heterogeneity bias.
Abstract
Purpose
This study examined the influence of income and health insurance on the health-seeking behaviour of rural residents, addressing the concerns of endogeneity and heterogeneity bias.
Design/methodology/approach
A two-stage residual inclusion was utilised to correct self-selection-based endogeneity problems arising from health insurance membership.
Findings
This study provides support for Andersen's behavioural model (ABM). Income and health insurance positively stimulate rural residents' use of modern healthcare services, but the effect of insurance risks a downward bias if treated as exogenous. Further, the effect of health insurance differs between males and females and between adults and the elderly.
Originality/value
This study advances the literature, arguing that, within the ABM framework, enabling (i.e. income and insurance) and predisposing factors (i.e. age and gender) complement each other in explaining rural residents' use of modern health services.
Peer review
The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-03-2023-0223
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Sanoobia Iqrar and Azra Musavi
This paper aims to understand the maternal health vulnerabilities of migrant women in slums and explore their challenges during and after childbirth.
Abstract
Purpose
This paper aims to understand the maternal health vulnerabilities of migrant women in slums and explore their challenges during and after childbirth.
Design/methodology/approach
The study used a qualitative approach, including in-depth interviews through purposive and snowball sampling techniques. Thematic analysis was used for analysing data. The consolidated criteria for reporting qualitative studies (COREQ)-32 items were followed for reporting this study.
Findings
The study found that migrant women were highly susceptible to adverse birthing outcomes due to risks involved in birthing, lack of care and hygiene, lack of skilled care in dealing with complicated pregnancies and exposure to domestic and obstetric violence.
Originality/value
The study intends to highlight the narratives of female migrants’ birthing and maternal health challenges. The entire process of childbirth in slums with consequences can result in maternal and infant morbidities and mortalities.
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Laura Curran and Jennifer Manuel
This study aims to examine the relationship between medication for opioid use disorder (MOUD) among pregnant individuals, referral source, mental health, political affiliation and…
Abstract
Purpose
This study aims to examine the relationship between medication for opioid use disorder (MOUD) among pregnant individuals, referral source, mental health, political affiliation and substance use policies in all 50 states in the USA.
Design/methodology/approach
This study describes MOUD receipt among pregnant people with an opioid use disorder (OUD) in 2018. The authors explored sociodemographic differences in MOUD receipt, referrals and co-occurring mental health disorders. The authors included a comparison of MOUD receipt among states that have varying substance use policies and examined the impact of these policies and the political affiliation on MOUD. The authors used multilevel binary logistic regression to examine effects of individual and state-level characteristics on MOUD.
Findings
Among 8,790 pregnant admissions with OUD, the majority who received MOUD occurred in the Northeast region (71.52%), and 14.99% were referred by the criminal justice system (n = 1,318). Of those who were self-referred, 66.39% received MOUD, while only 30.8% of referrals from the criminal justice system received MOUD. Those referred from the criminal justice system or who had a co-occurring mental health disorder were least likely to receive MOUD. The multilevel model showed that while policies were not a significant predictor, a state’s political affiliation was a significant predictor of MOUD.
Research limitations/implications
The study has some methodological limitations; a state-level analysis, even when considering the individual factors, may not provide sufficient description of community-level or other social factors that may influence MOUD receipt. This study adds to the growing literature on the ineffectiveness of prenatal substance use policies designed specifically to increase the use of MOUD. If such policies are consistently assessed as not contributing to substantial increase in MOUD among pregnant women over time, it is imperative to investigate potential mechanisms in these policies that may not facilitate MOUD access the way they are intended to.
Practical implications
Findings from this study aid in understanding the impact that a political affiliation may have on treatment access; states that leaned more Democratic were more likely to have higher rates of MOUD, and this finding can lead to research that focuses on how and why this contributes to greater treatment utilization. This study provides estimates of underutilization at a state level and the mechanisms that act as barriers, which is a stronger assessment of how state-specific policies and practices are performing in addressing prenatal substance use and a necessary step in implementing changes that can improve the links between pregnant women and MOUD.
Originality/value
To the best of the authors’ knowledge, this is the first study to explore individual-level factors that include mental health and referral sources to treatment that lead to MOUD use in the context of state-level policy and political environments. Most studies estimate national-level rates of treatment use only, which can be useful, but what is necessary is to understand what mechanisms are at work that vary by state. This study also found that while substance use policies were designed to increase MOUD for pregnant women, this was not as prominent a predictor as other factors, like mental health, being referred from the criminal justice system, and living in a state with more Democratic-leaning affiliations.
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Meagan O'Brien, Orla Kistmacher, Sabrina Marie Stephen and Gerard Thomas Flaherty
This paper aims to describe the unique health challenges facing female commercial sex workers (FSWs), including issues related to their marginalisation and difficulty accessing…
Abstract
Purpose
This paper aims to describe the unique health challenges facing female commercial sex workers (FSWs), including issues related to their marginalisation and difficulty accessing health care. It proposes solutions to some of these problems.
Design/methodology/approach
This paper addresses this sensitive subject through the methodology of a literature review, drawing on a variety of relevant published literature to inform a modern understanding of the current health challenges faced by this population.
Findings
This paper discusses issues around criminalisation of commercial sex workers, complexities of family planning, sexually transmitted infection prevention, mental health and substance abuse and how increasing health-care worker awareness of the health needs of this vulnerable population can be a positive step in building trust within this relationship. Although adoption of the proposed recommendations put forth in this paper may help to eliminate some of the barriers encountered by female sex workers, further research is recommended.
Originality/value
The subject of commercial sex worker health care is neglected in the academic literature. This review explores the topic in an open and balanced manner and presents a broad and updated overview of the current health-care challenges faced by FSWs as well as opportunities for optimising access and quality of sex worker health care.
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Saira Hanif Soroya, Adeel Ur Rehman and Anthony Faiola
Quality of life is dependent on a healthy lifestyle and the self-care behavior of individuals. The study's purpose is to find out the determinants of individuals' self-care…
Abstract
Purpose
Quality of life is dependent on a healthy lifestyle and the self-care behavior of individuals. The study's purpose is to find out the determinants of individuals' self-care behavior. As such, self-care behavior is influenced by several factors that include individual knowledge, available information sources and their use, information-seeking related skills and cognitive state.
Design/methodology/approach
A quantitative research design followed using a questionnaire-based survey method. A total of 384 responses from the Pakistani public were collected using the convenience sampling technique. Structural equation modeling (SEM) was performed for examining the possible link between the variables.
Findings
Health literacy, Internet and social media use, and health information-seeking behavior had a direct/indirect positive impact on self-care behavior, but health anxiety had a negative impact. Health literacy and health information-seeking behavior positively mediated the relationship among Internet and social media use health anxiety and self-care.
Research limitations/implications
Improving health literacy appears to be key to supporting better self-care, but it is an exploratory study, more research is required to confirm these findings. Policymakers, health professionals and information professionals should work together to improve health literacy and support informed self-care among the population.
Originality/value
Thus far, no previous study has examined the collective role of social media exposure, health anxiety, health literacy and health information-seeking behavior as predictors of self-care behavior. Although self-care behavior among the general population might be different compared to chronic patients, only few studies have examined the former as a unit of analysis.
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This research paper aimed to study the legal structure of top-performing health governance systems and compare them with the Indonesian health social security system to identify…
Abstract
Purpose
This research paper aimed to study the legal structure of top-performing health governance systems and compare them with the Indonesian health social security system to identify the main differences and provide recommendations for Indonesian and other developing countries’ health policymakers and administrators.
Design/methodology/approach
Using formative research with a conceptual approach and statute approach as method in this study. Data was gathered using the document study technique, which studies various documents, especially legal documents related to health law, linked to legal purpose theories. Moreover, the World Health Organization ranking was considered to choose the two countries (France and Singapore) with a high social health security system for comparative analysis. All data collected has been analyzed using a qualitative and theoretical basis. Content analysis was performed by analyzing the legal documents, and the regulatory framework of all three countries was deeply analyzed to draw conclusions and recommendations.
Findings
Indonesia has specific laws to implement a social security system in the health sector. However, the lack of the best medical facilities and infrastructure and weak implementation of existing laws were identified as major reasons behind the poor health security system compared to comparative countries. Also, as a developing nation Indonesian Government face budgetary pressures and huge population challenges to meet required standards. Thus, the financing approaches used by Singapore and France may help developing countries meet these challenges effectively. Therefore, there is a dire need to strengthen the social health security system all over the country with amendments to laws and ensure the implementation of prevailing laws and regulations.
Practical implications
Providing understanding related to the social security health system in Indonesia along with a detailed description of the sound social health security system in France and Singapore will further provide an avenue for the researchers to critically analyze this line of study to devise some valuable suggestions further and to draw loopholes in the system.
Originality/value
A comparative approach for legal studies in the health sector is rare. So, this research advanced the social security health system-related literature and legal studies on the health sector by using this comparative approach to develop policy insights and future research directions, which will further help the field to grow.
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