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The purpose of this paper is to develop and evaluate the Standards of Healthcare Facility for Thai Female Inmates (SHF-TFI) through healthcare service improvement.

This research and quality improvement project was comprised of three phases. Surveying healthcare facilities and in-depth interviews with female inmates as well as prison nurses were employed in Phase I. Expert reviews and public hearing meetings were used for developing the SHF-TFI in Phase II. Satisfaction questionnaires, focus group interviews of the female inmates, and in-depth interviews with nurses and prison wardens were utilized to evaluate feasibility and effectiveness of SHF-TFI implementation in Phase III.

The SHF-TFI was elaborated in order to be more specific to the context of the correctional institutes and correspond with healthcare as to the needs of female inmates. It was divided into three main aspects: administrative standards, health service standards and outcome standards. After implementation, nurses reflected on the feasibility and benefits of the SHF-TFI on the organizations, inmates and nurses. The female inmates perceived remarkable improvement in the healthcare services including physical activity promotion and screening programs for non-communicable diseases, the physical environment and sufficiency of medical equipment. Moreover, the pregnant inmates and incarcerated mothers with children shared their views on better antenatal and child developmental care, as well as availability of baby supplies.

The findings support the feasibility and effectiveness of the SHF-TFI for quality care improvement and applicability of the Bangkok Rules in women’s correctional institutes.

This paper aims to examine links between women's access to micro‐finance and how they use maternal healthcare services in sub‐Saharan Africa (SSA).

The authors use theoretical and empirical literature to propose a framework to sustain and improve women's access to maternal healthcare services through micro‐financing.

It is found that improved access to micro‐finance by women, combined with education may enhance maternal health service uptake.

The paper does not consider empirical data in the analysis. The authors advocate empirically testing the framework proposed in other SSA countries.

It is important to empower women by facilitating their access to education and micro‐finance. This has implications for improving maternal healthcare utilization in SSA.

The paper moves beyond poor access to maternal health services in SSA and proposes a framework for providing sustainable solutions.

The purpose of this paper is to show the link between the comparative effectiveness research (CER) and the interest in developing drugs for rare disease by the pharmaceutical industry. Total healthcare spending is on the rise without having a corresponding better health outcome. As such, with the growing role of government in healthcare, measuring and demonstrating value is beginning to expand beyond the private sector to metrics applied in the public sector. A modern approach to comparative effective research began its rapid rise in the USA when the American Recovery and Reinvestment Act of 2009 allocated $1.1 billion for CER. This paper analyzes the implication and impact on the pharmaceutical industry.

The paper reviews the basic definitions of CER and its areas of strength and weakness. It used real examples of drugs to show the impact of the Reinvestment Act of 2009 on the rise of orphan drugs.

The study shows that the act encouraged the development of orphan drugs, mainly because of the low budget impact due to a smaller patient base. Provisions of the Affordable Care Act provide incentives for such rare disease indications, as no one can be denied coverage with pre-existing conditions.

The study is limited by the number of available rare drugs and the ongoing process of implementation of the Affordable Care Act.

The study shows the cost-effective method of treating medical conditions.

Development of orphan drugs opens up access to care for many patients at a cost-effective price.

This paper shows the link between the CER and the interest in developing drugs for rare disease by the pharmaceutical industry. It also brings out the possible implication of the Affordable Care Act on the pharmaceutical industry with respect to its strategies for drug development and drug portfolio.

Incarcerated transgender women often require healthcare to meet their physical-, mental-, and gender transition-related health needs; however, their healthcare experiences in prisons and jails and interactions with correctional healthcare providers are understudied. The paper aims to discuss these issues.

In 2015, 20 transgender women who had been incarcerated in the USA within the past five years participated in semi-structured interviews about their healthcare experiences while incarcerated.

Participants described an institutional culture in which their feminine identity was not recognized and the ways in which institutional policies acted as a form of structural stigma that created and reinforced the gender binary and restricted access to healthcare. While some participants attributed healthcare barriers to providers’ transgender bias, others attributed barriers to providers’ limited knowledge or inexperience caring for transgender patients. Whether due to institutional (e.g. sex-segregated prisons, biased culture) or interpersonal factors (e.g. biased or inexperienced providers), insufficient access to physical-, mental-, and gender transition-related healthcare negatively impacted participants’ health while incarcerated.

Findings highlight the need for interventions that target multi-level barriers to care in order to improve incarcerated transgender women’s access to quality, gender-affirmative healthcare.

This study provides first-hand accounts of how multi-level forces serve to reinforce the gender binary and negatively impact the health of incarcerated transgender women. Findings also describe incarcerated transgender women’s acts of resistance against institutional and interpersonal efforts to maintain the gender binary and present participant-derived recommendations to improve access to gender affirmative healthcare for incarcerated transgender women.

In this article visible minority immigrant women's encounters and perceptions in accessing healthcare in Canada are explored. The aim is to understand the role play of the vulnerability statuses, gender, visibility, immigration and their intersectionality as factors contributing to (in)equitiesin healthcare accessibility.

Qualitative data were collected from a sample of 32 adult immigrant women, living in Halifax, Nova Scotia, Canada, using five focus group meetings. The participants have migrated from five regions of the world; South‐Eastern Asia, Middle‐Eastern Asia, the African continent, Latin/South America and non‐English speaking countries in Eastern Europe. Data were analysed using an inductive coding using the cultural health capital framework.

The findings reveal that audio and visual personal attributes such as skin colour, accent and excess body weight that are beyond Canadian norms lead to unfavourable interpersonal dynamics. Fundamental causes of diseases and clinical discourses are embedded in ethno‐cultural realties of gender, ethno‐racial identity, English communication styles and immigration related economic downturns.

Individual level recommendations include self efficacy and empowerment. Policies and program level recommendations include enhancement of multicultural realms of healthcare to promote equity in healthcare accessibility.

Utilization of cultural health capital framework to illustrate inequities in healthcare accessibility, for visible and audible minority immigrant women, living in a country with universal healthcare coverage, brings a novel conceptual approach. New policy implications stemmed from the original research findings. Canadian cultural health capital framework that was developed in this article can be applied to illustrate other minorities' healthcare accessibility.

The purpose of this paper is to explore the relationship between the ratification of the United Nations’ (UN’s) Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) and women’s and girls’ health outcomes using a unique longitudinal data set of 192 UN-member countries that encompasses the years from 1980 to 2011.

The authors focus on the impact of CEDAW ratification, number of reports submitted after ratification, years passed since ratification, and the dynamic impact of CEDAW ratification by utilizing ordinary least squares (OLS) and panel fixed effects methods. The study investigates the following women’s and girls’ health outcomes: total fertility rate, adolescent fertility rate, infant mortality rate, maternal mortality ratio, neonatal mortality rate, female life expectancy at birth (FLEB), and female to male life expectancy at birth.

The OLS and panel country and year fixed effects models provide evidence that the impact of CEDAW ratification on women’s and girls’ health outcomes varies by global regions. While the authors find no significant gains in health outcomes in European and North-American countries, the countries in the Northern Africa, sub-Saharan Africa, Southern Africa, Caribbean and Central America, South America, Middle-East, Eastern Asia, and Oceania regions experienced the biggest gains from CEDAW ratification, exhibiting reductions in total fertility, adolescent fertility, infant mortality, maternal mortality, and neonatal mortality while also showing improvements in FLEB. The results provide evidence that both early commitment to CEDAW as measured by the total number of years of engagement after the UN’s 1980 ratification and the timely submission of mandatory CEDAW reports have positive impacts on women’ and girls’ health outcomes. Several sensitivity tests confirm the robustness of main findings.

This study is the first comprehensive attempt to explore the multifaceted relationships between CEDAW ratification and female health outcomes. The study significantly expands on the methods of earlier research and presents novel methods and findings on the relationship between CEDAW ratification and women’s health outcomes. The findings suggest that the impact of CEDAW ratification significantly depends on the country’s region. Furthermore, stronger engagement with CEDAW (as indicated by the total number of years following country ratification) and the submission of the required CEDAW reports (as outlined in the Convention’s guidelines) have positive impacts on women’s and girls’ health outcomes.

This paper presents an analysis of how health intersects with the experience of housing insecurity and homelessness, specifically for migrant women. The authors argue that it is important to understand the specificities of the interplay of these different factors to continue the advancement of our understanding and practice as advocates for health and housing security.

An exploratory, qualitative, methodological approach was adopted, using a broad definition of housing insecurity: from absolute homelessness (e.g. residing rough) to invisible homelessness (e.g. couch surfing) to those at risk of homelessness. In total, 26 newcomer (foreign-born women who came to live in Canada during the previous ten years, regardless of their immigration status) women were recruited in Montreal, Canada. Participants were recruited directly through advertisements in public places and in collaboration with community organizations (women’s centers, homeless shelters, crisis centers, domestic violence shelters, immigrant settlement agencies and ethnic associations) and they self-identified as having experienced housing insecurity. Efforts were made to include a diversity of immigrant statuses as well as diversity in ethnicity, race, country of origin, family composition, sexual orientation, age and range of physical and mental ability. Women were engaged in semi-structured, open-ended interviews lasting approximately 1 h. Interviews were conducted in English or French in a location and time of participants’ choosing.

The findings are presented around three themes: how health problems instigate and maintain migrant women’s housing insecurity and homelessness; ways in which women’s immigration trajectories and legal status may influence their health experiences; and particular coping strategies that migrant women employ in efforts to maintain or manage their health. The authors conclude with implications of these findings for both policy and practice in relation to migrant women who experience or are at risk of housing insecurity and homelessness.

Intersections of women experiencing migration and housing insecurity in Canadian contexts have rarely been examined. This paper addresses a gap in the literature in terms of topic and context, but also in terms of sharing the voices of migrant women with direct experience with housing insecurity.

To compare chronic health status, utilization of healthcare services and life satisfaction among immigrant women and their Canadian counterparts.

A secondary analysis of national data from the Canadian Community Health Survey (CCHS), 2015–2016 was conducted. The survey data included 109,659 cases. Given the research question, only female cases were selected, which resulted in a final sample of 52,560 cases. Data analysis was conducted using multiple methods, including logistic regression and linear regression.

Recent and established immigrant women were healthier than native-born Canadian women. While the Healthy Immigrant Effect (HIE) was evident among immigrant women, some characteristics related to ethnic origin and/or unhealthy dietary habits may deteriorate immigrant women's health in the long term. Immigrant women and non-immigrant women with chronic illnesses were both more likely to increase their use of the healthcare system. Notably, the present study did not find evidence that immigrant women under-utilized Canada's healthcare system. However, the findings showed that chronic health issues were more likely to decrease women's life satisfaction.

This analysis contributes to the understanding of immigrant women's acculturation by comparing types of chronic illnesses, healthcare visits, and life satisfaction between immigrant women and their Canadian counterparts.

The purpose of this paper is to illustrate a microcosm of the complexities that women face in a masculine environment.

Ten women administrators were selected from one Southeastern University in the USA, using criterion sampling. The interviews of five women from male‐dominated colleges (greater than 50 percent male faculty‐MD) and five from female‐dominated fields (FD) were analyzed. For further study, the texts of the four women from healthcare colleges were compared with the six from non‐healthcare fields. Interviewees were asked questions about their background, leadership and power. Confidentiality was adhered to according to the university's IRB guidelines and policies.

The social world of the healthcare Deans was evident and was shaped around a “rigid hierarchy of authority and power” that goes beyond gender and is stratified among health‐related professions.

This examination of the hierarchical discourse of power within the social world of healthcare gives valuable instruction for women's negotiation through adaptation.

The paper aims to find out how far the size of household landholding directs patriarchal traits and thus influence women's autonomy.

The study used a two-part methodology. The first part provides theoretical background based on existing literature on women's autonomy and related information in formulating the “landholding-patriarchy hypotheses”. The second part of this study evaluates the empirical evidences of the association between the size of household landholding and women's autonomy.

Results indicate considerable variation in women's autonomy with the size of their household landholding: women's autonomy decreases with increasing size of household landholding. Evidence suggests that landholding directs patriarchal traits, as manifested in a reasonable influence on women's autonomy in rural India.

The paper innovates a means to understand the contributing factors to lowering women's autonomy, thus explore the relevance of “landholding-patriarchy hypothesis”.