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This study aims to explore the challenges of providing primary health care (PHC) to Afghan immigrants in Tehran as an important global human right issue.

In this exploratory study, a total of 25 purposively selected PHC providers, including physicians, psychologists and midwives, were approached for face-to-face, semi-structured interviews, lasting 30 min on average. Thematic analysis was used to analyze the data.

The most common challenges of providing PHC to Afghan immigrants were categorized at individual, organizational and societal levels. Communication barriers and socioeconomic features emerged at the individual level. The organizational challenges included mainly the lack of insurance coverage for all immigrants and the lack of a screening system upon the immigrants’ arrival from the borders. At the societal level, the negative attitudes toward Afghan immigrants were causing a problematic challenge.

The main limitation was the possibility that only health-care professionals with particular positive or negative perspectives about immigrants enter into the study, because of the voluntary nature of participation.

Findings can help policymakers adopt evidence-informed strategies for facilitating PHC provision and improving the access to health care in immigrants as a global human right concern.

This study alerts about undesirable consequences of certain attitudes and behaviors of the society toward immigrant health.

To the best of the authors’ knowledge, this is one of the first studies conducted in PHC centers in Tehran Province that explores the challenges of providing PHC to Afghan immigrants.

This chapter analyses and discusses local government health promotion in Norway.

Institutional theory indicates that political and administrative jurisdictions are path dependent in their policy formation and implementation. By using data from different sources this assumption is analysed and discussed according to health promotion in Norwegian municipalities. The main methodology is cross tabulations, bivariate correlations and regression is carried out to supplement analyses.

Municipalities are path dependent in their health promotion policies. They acknowledge and prioritize health behaviour independent of experienced socio-economic challenges, municipal capacity as size and income, and local government political profile. Competence devoted to health promotion can create changes in policies.

The rhetoric on determinants and social determinants in particular is new in Norway. Rhetoric on, and interventions, that highlight the social determinants of health need to be coordinated.

The chapter presents new knowledge on Norwegian local government health promotion and how this is implemented in relation to the challenges experienced.

Disclosure seems to be a useful strategy for adults to deal with both the public and self-stigma of mental illness. However, youth may face a different set of risks when coming out with their experiences. The purpose of this paper is to examine youth, parent, and teacher perspectives on the costs and benefits of disclosure by middle- and high school-aged youth to better understand these risks.

Focus groups were conducted with questions framed to elicit the different ways mental health challenges are discussed in schools and families.

Surprisingly, the benefits of disclosure seemed to far outweigh the costs across groups. Benefits included ways to deal with stigma, reducing isolation, and “differentness,” as well as the pursuit of mental health services if needed. Costs included harsh responses to disclosure by peers and family members. Participants shared strategies used to minimize risk, including where and with whom youth might share their stories.

The results suggest many youth have disclosed their experiences with mental health challenges and have received mixed responses; these reactions often serve as the barometer for future disclosure decisions. Other youth are considering disclosure in a variety of settings, but are unsure how to go about it safely. Implications for addressing stigma are discussed.

To our knowledge, this is the first qualitative research study conducted with youth about disclosure of mental illness experiences. These results will help guide modification of programming that could be beneficial in aiding disclosure decisions and reducing disclosure-related risks for youth who come out.

This paper aims to discover and analyze the challenges hampering blockchain technology’s (BT’s) implementation in the Indian health-care sector. A total of 18 challenges have been prioritized and modeled based on an extensive literature search and professional views.

An integrated multi-criteria decision-making approach has been used in two phases. Best worst method (BWM) is used in the first phase to prioritize the challenges with sensitivity analysis to validate the findings and eliminate a few challenges. In the second phase, interpretive structural modeling is applied to the remaining 15 challenges to obtain relative relationships among them with cross-impact matrix multiplication applied to classification analysis for their categorization.

The study’s results reveal that limited knowledge and expertise, cost and risk involved, technical issues, lack of clear regulations, resistance to change and lack of top management support are the top-ranked or high-intensity challenges according to the BWM. Interpretive structural modelling findings suggest that the lack of government initiatives has been driving other challenges with the highest driving power.

This work has been conducted in the Indian context, so careful generalization of the results is needed.

This work will give health-care stakeholders a better perspective regarding blockchain’s adoption. It will help health-care stakeholders, service providers, researchers and policymakers get a glimpse of the strategies for eradicating mentioned challenges. The analysis will help reduce the challenges’ impact on blockchain’s adoption in the Indian health-care sector.

The adoption of BT is a novel concept, especially in developing countries such as India. This is one of the few works addressing the challenges to BT adoption in the Indian health-care sector.

Based on a case study in Hamilton, Ontario, Canada, the purpose of this paper is to explore the difficulties faced by local health care providers in the face of constantly evolving refugee policies, programs, and arrivals. In doing so, it illustrates the complications faced by service providers in providing care to refugee arrivals and how the diversity of arrivals challenges health care provision and ultimately the health and well-being of refugees.

A series of semi-structured, in-depth interviews with key service professionals in both the social service and health fields in Hamilton, Ontario, Canada, examined both health and health care issues.

Beyond challenges for service providers that have been previously flagged in the literature, including language barriers and the limited time that they have with their clients, analysis revealed that health care providers faced other challenges in providing care, with one challenge reflecting the difficulty of providing care and services to a diverse refugee population. A second challenge reflected the lack of knowledge associated with constantly evolving policies and programs. Both challenges potentially limit the abilities of care providers.

On-going changes to refugee and health care policy, along with the diversity of refugee arrivals, will continue to challenge providers. The challenge, therefore, for health care providers and policy makers alike is how to ensure adequate service provision for new arrivals.

The Federal government should do a better job in disseminating the impact of policy changes and should streamline programs. This is particularly relevant given limited budgets and resources, tri-partite government funding, short time-frames to prepare for new arrivals, inadequate background information, barriers/challenges or inequitable criteria for access to health and social services, while addressing an increasingly diverse and complex population.

The research reinforces the complexity of the needs and challenges faced by refugees when health is considered, and the difficulty in providing care to this group.

While there is a large refugee health literature, there is relatively little attention to the challenges and difficulties faced by service providers in addressing the health needs of the diverse refugee population, a topic that is particularly important given limited funding envelopes, shifting policies and programs, and a focus on clients (refugees). It is this latter piece – the challenges faced by providers in providing care to refugees – which this paper explores.

The purpose of this paper is to report the findings of a scoping review on the health challenges of families experiencing homelessness. There is a bi-directional relationship between health and homelessness in that poor health can increase the risk of housing loss, and experiencing homelessness is bad for one’s health. The experience of homelessness differs between populations and this review focuses on families as one of the fastest growing segments of the homeless population. While research has been integrated on the causes of homelessness for families, this same integration has not been conducted looking at health challenges of families experiencing homelessness.

A scoping review methodology is utilized in the paper. As the goal of this work is to ultimately develop interventions for a Canadian context, primacy is given to Canadian sources, but other relevant literature is also included.

A clear distinction is seen in the literature between health challenges of children of homeless families and health challenges of parents. These themes are explored separately, and preliminary recommendations are made for potential points of intervention as personal, program and policy levels.

This review of current evidence is an important first step in building a foundation for interventions to improve health outcomes for those experiencing housing loss.

The purpose of this paper is to explore opinions of health workers on priorities and challenges of the HIV/AIDS commodities management system in Abuja, Nigeria. The results from this research are to inform future guideline revisions on the management of these commodities, in order to produce the most efficient and cost‐effective approach.

A qualitative research was conducted from a social constructionist perspective. Purposive sampling was used to recruit 12 health workers, comprising pharmacists, laboratory scientists and logisticians involved in HIV/AIDS commodity management in Abuja, Nigeria. Views and experiences of these workers were explored on HIV/AIDS commodity management through in‐depth interviews, to ascertain challenges of the current system and needed interventions. The data were subjected to thematic content analysis.

Results of the study include the need for coordinated and integrated health commodity management system, sustainable human resource and infrastructure development and an effective data management system to address current challenges.

The data collection approach did not provide an opportunity for idea exchange and review in a focused group and the number of respondents was limited to 12 due to time constraints. However, the respondents were experts in the field.

Government needs to commit financial resources to support of the health supply chain to ensure sustainability beyond donor support. Donors should change their strategy of “quick fix” approach to health supply chain challenges, as these often result in Government laxity in addressing public health needs.

The paper provides insight into areas on which the Government of Nigeria should focus attention in health supply chain strategy, which is currently perceived as not coordinated.

Health-care knowledge is dispersed among different departments in a health care organization, which makes it difficult at times to provide quality care services to patients. Therefore, this study aims to identify the main challenges in adopting health information technology (HIT).

This study surveyed 148 stakeholders in 4 key categories [patients, health-care providers, United Arab Emirates (UAE) citizens and foresight experts] to identify the challenges they face in adopting health care technologies. Responses were analyzed using exploratory (EFA) and confirmatory factor analysis (CFA).

EFA revealed four key latent factors predicting resistance to HIT adoption, namely, organizational strategy (ORGS); technical barriers; readiness for big data and the internet of things (IoT); and orientation (ORI). ORGS accounted for the greatest amount of variance. CFA indicated that readiness for big data and the IoT was only moderately correlated with HIT adoption, but the other three factors were strongly correlated. Specific items relating to cost, the effectiveness and usability of the technology and the organization were strongly correlated with HIT adoption. These results indicate that, in addition to financial considerations, effective HIT adoption requires ensuring that technologies will be easy to implement to ensure their long-term use.

The results indicate that readiness for big data and the IoT-related infrastructure poses a challenge to HIT adoption in the UAE context. Respondents believed that the infrastructure of big data can be helpful in more efficiently storing and sharing health-care information. On the technological side, respondents felt that they may experience a steep learning curve. Regarding ORI, stakeholders expected many more such initiatives from health-care providers to make it more knowledge-specific and proactive.

This study has implications for knowledge management in the health -care sector for information technologies. The HIT can help firms in creating a knowledge eco-system, which is not possible in a dispersed knowledge environment. The utilization of the knowledge base that emerged from the practices and data can help the health care sector to set new standards of information flow and other clinical services such as monitoring the self-health condition. The HIT can further influence the actions of the pharmaceutical and medical device industry.

This paper highlights the challenges in HIT adoption and the most prominent factors. The conceptual model was empirically tested after the collection of primary data from the UAE using stakeholder theory.

Research shows peer health education programs on university campuses can support students in pursuing sustainable health-related behavior changes. However, few programs deliver peer health education through a nondiet, weight-inclusive framework. Research shows that health educators who challenge the status quo of diet culture and weight-focused health interventions may face unique challenges when sharing this perspective with others. Thus, the purpose of this study was to examine the experiences of peer educators who provided critical health education by introducing a nondiet, weight-inclusive approach to health.

Five health coaches from a university health coaching program at a mid-sized southwestern university participated in a semi-structured interview. The data were analyzed through interpretative phenomenological analysis.

Peer educators faced numerous challenges when introducing nondiet, weight-inclusive approaches such as lacking credibility as a peer to challenge weight-centric messages, feeling conflicted about honoring clients’ autonomy when clients are resistant to a weight-inclusive approach and feeling uncomfortable when discussing client vulnerabilities. Peer educators also identified several strategies that helped them navigate these challenges such as being intentional with social media, using motivational interviewing to unpack clients’ concerns about weight, and seeking group supervision.

Given the reality that health coaches will face challenges sharing weight-inclusive health approaches, educators and supervisors should explicitly incorporate strategies and training methods to help peer health coaches prepare for and cope with such challenges. More research is also needed to examine effective ways to introduce weight-inclusive approaches to college students.

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.

This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).

Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.

This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.