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1 – 10 of 56Manzoor Ahmad Malik and Wondimagegnehu Alemu
Research has found a strong correlation between maternal healthcare and health insurance coverage. But, despite having one of the best health coverage systems in the developing…
Abstract
Purpose
Research has found a strong correlation between maternal healthcare and health insurance coverage. But, despite having one of the best health coverage systems in the developing world, Rwanda still faces formidable challenges in provision certain key maternal health services, leading to higher levels of maternal morbidity and mortality. To understand this paradox, this study will examine the association between maternal health services and insurance coverage, utilizing the latest data from the Rwanda Demographic Health Survey.
Design/methodology/approach
Using a sample of 6,167 childbearing women aged 15–49 years, a bivariate and multivariate analysis was conducted to examine the paradoxical relationship between health insurance and maternal health services, such as antenatal care, in Rwanda.
Findings
The results reveal significant differences in ANC4+ and the timing of the first ANC, which remain low in Rwanda. Despite significant improvements in delivery factors and skilled ANC providers, ANC4+ rates in the country remain the lowest. However, this study found a positive and significant association between ANC4+ and insurance coverage (AOR = 1.64, p < 0.001).
Originality/value
Rwanda has implemented an effective health insurance policy, but there has been minimal progress in the utilization of maternal health services. Therefore, there is a strong need for policy interventions to reduce barriers to healthcare utilization. Additionally, supply-side factors such as transportation, socio-cultural factors and other logistic barriers should be examined in greater detail. These factors may overshadow the impact of health insurance on the utilization of healthcare services in Rwanda.
Peer review
The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-01-2023-0059
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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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This paper aims to analyse the factors influencing migration, the labour migration process and the status of migrant laborers in the informal sector, particularly those working in…
Abstract
Purpose
This paper aims to analyse the factors influencing migration, the labour migration process and the status of migrant laborers in the informal sector, particularly those working in brick kiln factories. It will shed light on the precarious nature of their work, often characterized by informal and verbal contracts. The paper examines occupational and environmental health hazards affecting the labourers and their impact on their well-being, the vulnerability of women in the precarious work environment and the associated health risks in brick kiln factories in India.
Design/methodology/approach
The study relies primarily on primary data collection, supplemented by secondary literature and documents. Balangir district was chosen as the research region due to its historical deprivation, underdevelopment and the historical prevalence of environmental distress, leading to distress-driven migration. To gather primary data, 40 respondents were selected from five selected blocks in Balangir district, resulting in a total of 200 respondents. In addition, in-depth interviews were conducted with 35 individuals across the selected blocks, with approximately seven participants from each block. In addition, interviews of 10 kids were taken and around 10 key informants including the trade union leaders, intellectuals and civil society activists.
Findings
Migrant labourers, including men, women and children, face significant health issues and are exposed to similar occupational health hazards. Internal migrant women workers are more vulnerable as they face critical health risks during pregnancy in host areas due to unfavourable working conditions and limited access to health-care services. Factors such as strenuous work, long working hours, poor nutrition and inadequate maternal care contribute to adverse outcomes such as spontaneous abortion, premature delivery and abnormal postnatal development.
Research limitations/implications
The brick kiln industry presents a distressing reality for men who are highly vulnerable to occupational accidents, and women workers are exposed to sexual abuse, exploitation and violence. The prevalence of physical harassment, ranging from leering to rape, is alarmingly high among women. These incidents not only inflict physical harm but also cause severe psychological trauma and increase the risk of sexually transmitted diseases. Despite the existence of laws aimed at protecting women’s rights and addressing sexual offences, the workers often remain unaware of their rights. This lack of awareness further compounds the vulnerability of women workers and perpetuates their exploitation in the workplace.
Practical implications
To address health issues comprehensively, interventions should encompass the entire migrant population, including men and children. Strategies should focus on improving access to health-care services, promoting occupational health and safety measures, ensuring proper immunization and nutrition for children and addressing the broader social determinants of health. Empowering women with knowledge about reproductive health and rights, raising awareness about available health-care services and strengthening health-care providers’ capacity to cater to migrant populations are crucial steps towards addressing health disparities.
Social implications
Urgent interventions and policies are needed to address the health vulnerabilities of internal migrant workers and women workers. It is required to ensure health-care accessibility, improving working conditions, ensuring access to maternal care and essential supplements and providing health-care services for both pregnant women and their children, regardless of migration status.
Originality/value
The study focused on precarious health and occupational hazards and accidents faced by migrant workers. It highlights women migrant labourer’s and children’s vulnerability in the Brick Klin sector, which is a value addition to the existing knowledge in social science.
Kumari Youkta and Rajendra Narayan Paramanik
This study aims to measure the level of satisfaction among women with childbirth services provided at public health facilities. Further, to analyse the impact of their…
Abstract
Purpose
This study aims to measure the level of satisfaction among women with childbirth services provided at public health facilities. Further, to analyse the impact of their socio-economic and obstetric characteristics on their level of satisfaction.
Design/methodology/approach
To accomplish these objectives a cross-sectional survey was conducted in two districts of an Indian state, Bihar. Structured questionnaire was developed based on the scale proposed by Okumu and Oyugi (2018) both for vaginal and caesarean birth patients. For empirical analysis multiple linear regression model was employed.
Findings
Results suggest that majority of mothers are satisfied with the care they received during childbirth, regardless of whether they chose a caesarean (55%) or vaginal delivery (53%). Women report the lowest levels of satisfaction with postpartum care and the privacy that was preserved by healthcare personnel at health facility. Further the study also confirms the association between patient’s socio-economic characteristics and their satisfaction level.
Originality/value
This is the first study of its kind to highlight the situation of public healthcare system in Bihar, which is the third most populated state in India with poor social and health indicators.
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Sundeep Sahay and Esther N. Landen
The purpose of this paper is to understand how digital interventions are mediating the identity work of community health workers (CHWs) in the context of two African countries.
Abstract
Purpose
The purpose of this paper is to understand how digital interventions are mediating the identity work of community health workers (CHWs) in the context of two African countries.
Design/methodology/approach
This paper analyzes the everyday work of CHWs in two low- and middle-income country (LMIC) contexts (Uganda and Malawi) and seeks to understand changes in collective identity and the role of Information and Communication Technologies (ICTs) in mediating this “identity work”. As CHWs conduct their everyday tasks of care giving, data reporting and maintaining social interactions, they play two primary roles. One is the care giving role oriented towards the community, and two, is reporting and administrative work by virtue of them being affiliated with the Ministry of Health, either in formal or voluntary capacity. The ambivalence which they experience as they move back and forth between these two worlds of work is significantly now mediated through ICTs. The paper analyzes these dynamics and identifies three key sets of ambivalence in identity work: (1) role embracing-institutional distancing; (2) conformist-resistant and (3) dramaturgical-transformative. The paper makes unique contributions to information systems (IS) and ICT for development (ICT4D) studies in that it focuses on a nonprofessional group, which plays a fundamental role in providing care to underserved populations and also conducts data work which provides the foundation of the national health information system. This contrasts with dominant research in the field which focuses on professional groups, largely based in Western business organizations.
Findings
The paper identifies identity related tensions that emerge with the mediation of digital technologies in the work world of CHWs. These include tensions of conformist-resistant; and (3) dramaturgical-transformative. These findings are relevant and unique to the field of IS and ICT4D studies in that it focuses on a nonprofessional group, which plays a fundamental role in providing care to underserved populations and also conducts data work which provides the foundation of the national health information system.
Research limitations/implications
While acknowledging identity construction and negotiation is a function of both work and social lives, in this paper we could only focus on the work lives.
Practical implications
As digital interventions in the health sector of low and middle income countries is becoming increasingly widespread, often the focus is more on the supply side (the supply of the technology) rather than on the demand side (users experiences and aspirations). Identity becomes a lens to understand these demand side dynamics, which helps provides practical guidance on implementation approaches to ensure that the technology adds value to user work processes and there is a seamless and not a disruptive transition.
Social implications
CHWs are the most neglected cadre in the health system of low and middle income countries, even though they provide the cutting edge in care provision work to the most marginalized populations, living in rural and underserved areas. By focusing on how technologies can be more effectively implemented to support these care processes, the paper provides important social implications both for practice and research.
Originality/value
Analysis of identity construction and negotiation of informal groups in the unorganized sector of low and middle income countries has not received adequate attention in IS research. The paper seeks to fill this important gap.
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Rosemarie Santa González, Marilène Cherkesly, Teodor Gabriel Crainic and Marie-Eve Rancourt
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…
Abstract
Purpose
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.
Design/methodology/approach
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).
Findings
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.
Originality/value
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.
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Decentralization has profound implications for many health systems. This study investigates the effect of health system decentralization in Organization for Economic Co-operation…
Abstract
Purpose
Decentralization has profound implications for many health systems. This study investigates the effect of health system decentralization in Organization for Economic Co-operation and Development (OECD) countries on public health security capacity and health service satisfaction.
Design/methodology/approach
Multiple linear regression analyses were employed for variables related to the level of health security capacity and satisfaction with the healthcare system while controlling for all socio-demographic variables from the European Social Survey, including over 44,000 respondents from 25 OECD countries. The Health Systems in Transition series of countries were used for assessing the decentralization level.
Findings
The result of multiple linear regression analyses showed that the level of decentralization in health systems was significantly associated with higher health security capacity (ß-coefficient 3.722, 95% confidence interval (CI) [3.536 3.908]; p=<0.001) and health service satisfaction (ß-coefficient 1.463, 95% CI [1.389 1.536]; p=<0.001) in the study. Countries with a higher level of decentralization in health policy tasks and areas were significantly likely to have higher health services satisfaction, whereas this satisfaction had a significant negative relation with the lower level of decentralization status of secondary/tertiary care services in OECD countries (ß-coefficient −5.250, 95% CI [−5.757–4.743]; p = 0.001).
Originality/value
This study contributes to a better understanding of the extent to which decentralization of health services affects public health safety capacity and satisfaction with health services, whereas the level of decentralization in OECD countries varies considerably. Overall, the findings highlight the importance of public health security and satisfaction with health care delivery in assessing the effects of decentralization in health services.
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Mathew Nyashanu, Scovia Nalugo Mbalinda, Roda Madziva and Mandu Stephen Ekpenyong
The purpose of this paper is to explore the experiences of black Sub-Saharan African (BSSA) migrants from war-torn zones in accessing health services in the West Midlands region…
Abstract
Purpose
The purpose of this paper is to explore the experiences of black Sub-Saharan African (BSSA) migrants from war-torn zones in accessing health services in the West Midlands region of the UK. This may help to inform on factors influencing the uptake of health services for new migrant communities.
Design/methodology/approach
This study explored the experiences of BSSA migrants from war-torn zones in accessing health services in the West Midlands using an explorative qualitative approach. Ten focus groups made up of seven participants each were followed up with three in-depth one-to-one interviews from each focus group using a conversational approach where research participants were encouraged to direct and shape the discussion in accordance with their own experiences, views and particular concerns (Kvale, 1996) as opposed to responding to a pre-determined agenda.
Findings
Following transcription, coding and analysis of the focus group discussions and follow-up interviews, this study found that perceptions and attitudes of BSSA communities in accessing health services included difficulties in navigating the health system, intrusive and embarrassing questions from clinicians, stigmatisation through offering an HIV test, culturally unfriendly counselling support, unconfidently services and episodes of trauma flashbacks.
Originality/value
The experiences of BSSA migrants who sought health services in the West Midlands in the UK demonstrated important implications for future practice and informed service delivery. There is a need to consider cultural education for both BSSA migrants and health professionals to enhance understanding and trust between the groups. Basic professional training for health professionals should also encompass the needs of the growing ethnic populations in the UK.
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Suchismita Swain, Kamalakanta Muduli, Anil Kumar and Sunil Luthra
The goal of this research is to analyse the obstacles to the implementation of mobile health (mHealth) in India and to gain an understanding of the contextual inter-relationships…
Abstract
Purpose
The goal of this research is to analyse the obstacles to the implementation of mobile health (mHealth) in India and to gain an understanding of the contextual inter-relationships that exist amongst those obstacles.
Design/methodology/approach
Potential barriers and their interrelationships in their respective contexts have been uncovered. Using MICMAC analysis, the categorization of these barriers was done based on their degree of reliance and driving power (DP). Furthermore, an interpretive structural modeling (ISM) framework for the barriers to mHealth activities in India has been proposed.
Findings
The study explores a total of 15 factors that reduce the efficiency of mHealth adoption in India. The findings of the Matrix Cross-Reference Multiplication Applied to a Classification (MICMAC) investigation show that the economic situation of the government, concerns regarding the safety of intellectual technologies and privacy issues are the primary obstacles because of the significant driving power they have in mHealth applications.
Practical implications
Promoters of mHealth practices may be able to make better plans if they understand the social barriers and how they affect each other; this leads to easier adoption of these practices. The findings of this study might be helpful for governments of developing nations to produce standards relating to the deployment of mHealth; this will increase the efficiency with which it is adopted.
Originality/value
At this time, there is no comprehensive analysis of the factors that influence the adoption of mobile health care with social cognitive theory in developing nations like India. In addition, there is a lack of research in investigating how each of these elements affects the success of mHealth activities and how the others interact with them. Because developed nations learnt the value of mHealth practices during the recent pandemic, this study, by investigating the obstacles to the adoption of mHealth and their inter-relationships, makes an important addition to both theory and practice.
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Chinwe Regina Okoyeuzu, Angela Ifeanyi Ujunwa, Augustine Ujunwa, Nelson N. Nkwor, Ebere Ume Kalu and Mamdouh Abdulaziz Saleh Al-Faryan
Sub-Saharan Africa (SSA) is regarded as a region with one of the worst cases of armed conflict and climate risk. This paper examines the interactive effect of armed conflict and…
Abstract
Purpose
Sub-Saharan Africa (SSA) is regarded as a region with one of the worst cases of armed conflict and climate risk. This paper examines the interactive effect of armed conflict and climate risk on gender vulnerability in SSA.
Design/methodology/approach
The difference and system generalised method of movement (GMM) were used to examine the relationship between the variables using annualised data of 35 SSA countries from 1998 to 2019.
Findings
The paper found strong evidence that armed conflict and climate change are positive predictors of gender vulnerability. The impact of climate change on gender vulnerability is found to be more direct than indirect.
Practical implications
The direct and indirect positive effect of armed conflict and climate change on gender vulnerability implies that climate change drives gender vulnerability through multiple channels. This underscores the need for a multi-disciplinary policy approach to addressing gender vulnerability problem in SSA.
Originality/value
The study contributes to the climate action debate by highlighting the need for climate action to incorporate gender inclusive policies such as massive investment in infrastructure and safety nets that offer protection to the most vulnerable girls and women affected by armed conflict and climate change. Societies should as a matter of urgency strive to structural barriers that predispose girls and women to biodiversity loss.
Peer review
The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-09-2022-0595
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