Health Care Service Access and Utilization

The increased demand for health services and the inclusion of new aspects in what is culturally considered "health and health care" represent a significant challenge for the current health care system and health care practice model in Catalonia. Determining health care needs and providing the right responses to them should not only be the job of experts. Rather, it should involve the participation of all the agents who live with and in the health care system every day. The aim of this article is to point out the importance of the perceptions of the agents involved in health care for planning and decision-making in health policies. A summary of the integrated perspectives of the public, professionals, and managers from the Catalan health care system is presented. Such perspectives can reveal the agreements and disagreements concerning the dimensions of health care participants define as important: health resources, health care processes, and the relationship between profess...

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This study examined risk and protective factors associated with the criminal involvement of some members of the ethnocultural community. Results from ten focus groups comprised of diverse ethnocultural community members, law enforcement personnel, and service providers in four centres in Alberta revealed multiple, complex criminological risk factors related to home country experience, acculturation, strains in community interactions, socioeconomic disparity, negative media influence, and interaction with the criminal justice system. They also highlighted a number of protective factors that have prevented criminal involvement of ethnocultural community members, including family support, the strengths of ethnocultural communities, community engagement and civic participation, and access to social services. Insights from the focus groups served as the basis for a theoretical discussion and recommendations for crime prevention in a multicultural society.

Adolescence is a challenging developmental period for all young people. For immigrant youth, their experiences are compounded by complex linguistic, acculturative, psychological, and economic difficulties. Rooted in the central premise that immigrant youth are entitled to services that effectively address their settlement needs and promote their full participation in Canadian society, this article critically reviews the selected programs and services for immigrant youth in three Canadian metropolitan centers, namely Toronto, Calgary, and Vancouver. The findings reveal various shades of patchwork, sidelining and marginalization of immigrant youth in the social services and education arenas. This article calls for a paradigm shift in immigrant youth services from charity-based programming to an entitlement/rights-based model of practice.

Community based monitoring and planning of public health services, is one such intervention aimed at developing a perspective like this and improving the standard of health services, which was introduced in Maharashtra since 2007. SATHI functions as the state nodal organisation in this process. Inspired by the success of this project, it was felt that community based monitoring process could prove useful for improving anganwadi services, and a path breaking Nutrition Rights Project for community based monitoring on anganwadi services was launched in November 2012. It was implemented in Dhadgaon block of Nandurbar, Velhe block of Pune, Chikhaldhara and Dharani blocks of Amravati, Kurkheda block of Gadchiroli, Hanuman nagar and Reshimbaug of Nagpur city and Bainganwadi, Chembur of Mumbai city. Soon, the villagers developed a sense of ownership on the anganwadi. They began raising several problems, starting from very basic, like the anganwadi being closed, to a range of other issues. Due to the active support of the Chief Secretary (Women and Health), ICDS workers began to establish a dialogue with the people. Almost half of the problems were resolved at the local level. Some issues were raised at the higher level in the State Mentoring Committee, before the Chief Secretary and issues like vacant posts were resolved. Although half of the issues are still to be resolved, the success achieved is definitely encouraging. These stories, provide a glimpse of the things that can be done by ensuring people's participation, what community based monitoring can actually achieve in various settings, from remote tribal padas to a poor community in Mumbai. These are stories of change. They may be small, but they indicate a host of problems which are encountered in the actual functioning of anganwadis. This project is currently being implemented in 114 anganwadis, where within six months 2221 issues have been raised. Given this situation, the project raises concern about the condition of the more than one lakh other anganwadis across Maharashtra. However, these 17 stories are indicative of the fact that if people are given the charge of monitoring over public services, then these services actually reach the true beneficiaries. People start feeling a sense of ownership over these services. We hope that these stories would play a crucial role in convincing health experts, political leaders, policy makers and people at large, about the importance of community monitoring on public services.

Threadfin bream (Nemipterus sp.), is a key export commodity with rising demand in Lamongan waters. Research purpose assesses its stock status through growth, sustainability, and utilization analyses. A descriptivequantitative approach with random sampling (1,813 samples) was employed, using FiSAT II and Ms. Excel for data analysis. Results showed fish lengths of 160-310 mm TL and weights of 52-351 g. Growth was negatively allometric (Lc 50% = 222.5 mm > Lm 139.92 mm), indicating harvestable size. Growth parameters: L ∞ = 279.85 mm, K = 0.5/year, t0 =-0.75312. Mortality rates (Z, M, F) were 0.83, 0.62, and 0.21/year, respectively. Exploitation rate (E = 0.25) suggested moderate fishing pressure. Recruitment occurred year-round, peaking in July (16.6%). Maximum Sustainable Yield (MSY) was 52,479 kg with an optimal effort (f opt) of 1,595 trips. Utilization levels (2018-2023: 0.5-1) indicated fully exploited status

Este libro es fruto del trabajo realizado en el Grupo de Trabajo "El Istmo Centroamericano: Repensando los Centros" de CLACSO. Los textos proporcionan un panorama general de las estrategias sanitarias para gestionar la pandemia, pero se centran en análisis de las crisis sociopolíticas que se profundizaron al interior de los diversos Estados Centroamericanos a causa de la circulación del virus. Por medio de miradas interdisciplinarias, todos los textos nos muestran las consecuencias de la pandemia sobre los más vulnerables, el aumento de la precariedad social y rupturas del orden democrático, que bajo la excusa de "contener el virus" se promovieron en los diversos Estados

A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers ...

In Mexico, we have become accustomed to the idea that evaluation is a stage in the public policy process (Aguilar, 1992; Pérez and Maldonado, 2020), as well as an opportunity to redesign and improve the forms of intervention of the state when there is an impetus to solve social problems such as poverty, inequality and social backwardness (Castillo Fernández and Arzate Salgado, 2016). Since Mexico is a federal republic, we propose in this chapter to carry out an evaluation analysis from a fiscal federalism approach, understood as the arrangement in the distribution of powers between a central government and subnational governments for the provision of goods and services (Musgrave, 1969).

This paper examines Wole Soyinka’s representation of man’s duality and his perception and attitude towards the earth and his fellow man in society in Madmen and Specialists. It argues that an exploration of man’s dual nature would aid our understanding of his bizarre urge to destroy the natural environment and inflict pain on his kind at times and preserve both at other times. Through contrastive analysis, it scrutinizes Wole Soyinka’s portrayal of characters with negative and positive tendencies toward mother earth. Those with negative desires are constructed in the male-dominated destructive cult of ‘AS’ while those with positive ones are healers populated by women. This study also explores the tension between the sexes in a patriarchal society where men’s sole motivation is a depraved exploitation of human and natural resources of the earth, while women work hard at preserving and sustaining the earth and its assets. Reader-Response and Eco-Feminism are deployed as theoretical fr...

BackgroundSocial diversity can affect healthcare outcomes in situations when access to healthcare is limited for specific groups. Although the principle of equality is one of the central topics on the agenda of the European Union (EU), its scope in the field of healthcare, however, is relatively unexplored. The aim of this study is to identify and systematically analyze primary and secondary legislation of the EU Institutions that concern the issue of access to healthcare for various minority groups. In our research, we have concentrated on three features of diversity: a) gender identity and sexual orientation, b) race and ethnicity, and c) religion or belief.Method and materialsFor the purpose of this analysis, we conducted a search of database Eur-Lex, the official website of European Union law and other public documents of the European Union, based on specific keywords accompanied by review of secondary literature. Relevant documents were examined with regard to the research topi...

A mobilidade humana, particularmente a migração internacional, é tema
transversal e central da saúde global. A intensificação e superdiversidade dos fluxos migratórios agregam desafios à vigilância sanitária internacional e aos sistemas de saúde. Os migrantes são cerca de 3,6% da população mundial e, assim como os nacionais, integram as sociedades de acolhida e possuem necessidades inerentes à vida, incluindo à saúde. Contudo, migrantes, solicitantes de refúgio e refugiados encontram dificuldade para acessar os serviços de saúde em decorrência da inelegibilidade para o acesso, do custo, das especificidades linguísticas e culturais, da falta de informação e de ações de equidade direcionadas a esse público. Reconhecendo a Atenção Primária à Saúde (APS) como porta de entrada aos serviços de saúde e sua importância na promoção e manutenção da saúde da população, esta pesquisa objetivou analisar o acesso de migrantes à APS no Distrito Federal (DF), Brasil e em Limburgo, Países Baixos, por meio de estudo de caso comparado. Foram realizadas análises de registros administrativos, legislação e entrevistas semiestruturadas com profissionais de saúde de ambas as localidades e de migrantes e partes interessadas no DF. Os resultados demonstram que em ambos os locais de estudo os profissionais de saúde são receptivos ao atendimento de migrantes, empregam boas práticas, mas também enfrentam desafios organizacionais, informacionais, linguísticos e culturais que dificultam que a APS alcance seu objetivo de promoção, prevenção, educação e manutenção da saúde dos usuários migrantes.

Background The increasing trend of senior citizens and their complex healthcare needs demands the improvised provision of healthcare services and strategies to improve health service utilization to ensure health for all. Although health service provision has been prioritized, health service utilization is also a prime aspect that should be addressed to target the chronic needs of senior citizens. This study aims to assess the status of health service utilization and its influencing factors among senior citizens in rural municipalities of the Kaski district, Nepal. Methods A cross-sectional study was carried out in selected wards of all rural municipalities of Kaski District (Annapurna, Machhapuchre, Madi and Rupa). The study included a sample size of 392 senior citizens. Data were collected using a semi-structured interview schedule based on the Andersen-Newman behavioral model using the Study on Global Aging and Adult Health (SAGE) questionnaire to assess health service utilization. Data analysis included descriptive statistics to summarize participant characteristics and health service utilization patterns. Additionally, bivariate and multivariable logistic regression analyses were performed to identify key determinants of healthcare utilization, adjusting for potential confounders. All statistical analyses were conducted using Statistical Package for Social Sciences version 20, with a significance threshold set at p < 0.05. Results More than half (54.6%) of the senior citizens in the study visited healthcare facilities in the 12 months. Health service utilization was significantly associated with awareness of free healthcare services, membership in social health insurance, family support, self-perceived health status, independence in activities of daily living, and having a chronic disease with a p-value less than 0.05 and 95% confidence interval. After controlling for confounders, membership in social health insurance (aOR = 3.85, 95% CI: 2.31-6.40, p < 0.001), family support (aOR = 2.06, 95% CI: 1.01-4.15, p < 0.05), and the presence of chronic disease (aOR = 2.92, 95% CI: 1.70-4.98, p < 0.001) were statistically significant with health service utilization among the senior citizens.

National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate th...

Developing countries have been facing difficulties in reaching out to low-income and underserved communities for COVID-19 vaccination coverage. The rapidity of vaccine development caused a mistrust among certain subgroups of the population, and hence innovative approaches were taken to reach out to such populations. Using a sample of 1760 respondents in five low-income, informal localities of Islamabad and Rawalpindi, Pakistan, we evaluated a set of interventions involving community engagement by addressing demand and access barriers. We used multi-level mixed effects models to estimate average treatment effects across treatment areas. We found that our interventions increased COVID-19 vaccine willingness in two treatment areas that are furthest from city centers by 7.6% and 6.6% respectively, while vaccine uptake increased in one of the treatment areas by 17.1%, compared to the control area. Our results suggest that personalized information campaigns such as community mobilization ...

Brown algae, Padina sp., are found across tropical coastal areas as well as inter-tidal and sub-tidal regions. The aim of this research was to identify the morphological and molecular characteristics of the Padina species distributed across Port Lengeh in the Persian Gulf using morphological examinations and rbcL chloroplast gene sequencing. For this purpose, morphological features were undertaken using valid identification keys. For the molecular analysis, genomic DNA was extracted through slightly modified CTAB. The amplification of fragments was carried out using rbcL primers. The analysis of genome sequences was undertaken using Chromas, BioEdit and MEGA6 and the phylogenetic trees were constructed through Neighbor Joining (NJ) and Maximum Likelihood (ML). The results indicated that there was a 99% chance that the two identified Padina species (P. boergessenii and P. australis) belonged to the same cluster and that there were large genetic similarities among the compared Padina ...

The Medical-Legal Partnership (MLP) model promotes the provision of direct legal services, interdisciplinary training, and public policy advocacy by lawyers situated in sites of medical care. Although scholars have called on MLPs to be more proficient in driving policy change, MLPs do not have a consistent record of doing so. But where they have achieved success, MLPs have done so by working in local coalitions. Building on this history, this Essay introduces a methodology of coalition building for MLPs to advance public policy goals more successfully and proposes metrics that MLPs can use to gauge their success. Through storytelling and analysis of our own experiences with coalition work in Connecticut and in Hawai'i, we document how coalition work can achieve policy wins. The Essay concludes with some observations regarding obstacles to coalitional practice and suggests that legal education and training will be essential to promoting this vision of public policy advocacy.

A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers ...

National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate th...

Devolutionary trends in immigration and social welfare policy have enabled different levels of government to define membership and confer rights to people residing within the political boundary of a province or municipality in ways that may contradict federal legal status. Drawing upon theories of postnational and deterritorialized citizenship, we examined the legal construction of social rights within federal, provincial and municipal law in Toronto, Ontario. The study of these different policy arenas focuses on rights related to education, access to safety and police protection, and income assistance. Our analysis suggests that the interplay of intra-governmental laws produces an uneven terrain of social rights for people with precarious status. We argue that while provincial and municipal governments may rhetorically seek to advance the social rights of all people living within their territorial boundaries, program and funding guidelines ensure that national practices of market citizenship and the policing of non-citizen subjects are reproduced at local levels.

Objectives. We examined the extent of nonprescribed hormone use and self-performed surgeries among transgender or transsexual (trans) people in Ontario, Canada. Methods. We present original survey research from the Trans PULSE Project. A total of 433 participants were recruited from 2009 to 2010 through respondent-driven sampling. We used a case series design to characterize those currently taking nonprescribed hormones and participants who had ever self-performed sex-reassignment surgeries. Results. An estimated 43.0% (95% confidence interval = 34.9, 51.5) of trans Ontarians were currently using hormones; of these, a quarter had ever obtained hormones from nonmedical sources (e.g., friend or relative, street or strangers, Internet pharmacy, herbals or supplements). Fourteen participants (6.4%; 95% confidence interval = 0.8, 9.0) reported currently taking nonprescribed hormones. Five indicated having performed or attempted surgical procedures on themselves (orchiectomy or mastectomy...

This volume addresses the complexities of service delivery to migrants in irregular or marginalized situations, to persons with diverse linguistic, cultural or religious backgrounds, and to those who need navigational assistance to reach the services they need. Barriers in service access are generated in the interaction between organizations and their most disadvantaged groups of users. Healthcare services that are accessible to migrating populations reinforce their autonomy and are in the best interest of all.
The case study, which was conducted from 2017 to 2020, is based at the San Maurizio hospital of Bozen-Bolzano, the largest hospital in South Tyrol, a multilingual and autonomous province in Northern Italy bordering Austria and Switzerland. It explores the agency of healthcare practitioners in shaping accessible services when attentive to patient needs, connected to national advocacy networks, and supported by hospital administration. With this study the author hopes to provide a broad view of this transdisciplinary field of study and practice and to offer a roadmap for practitioners who may play a role as brokers of accessible services in healthcare organizations.

Background: Maternal health refers to the health of women during pregnancy, delivery, and the postpartum period,  and the services include promotive,  preventive,  therapeutic,  and rehabilitative health services for mothers and children provided by health facilities. Maternal and child health services are a priority program for community health. The main objective of this study was to assess the utilization of maternal health services among married women of reproductive age (MWARA).

Methods: A quantitative descriptive cross-sectional study design was adopted to assess the utilization of maternal health services. The  157 MWARA aged between 19 and 45 years were employed for this study from June to July 2024 at Tamankhola Rural Municipality, Baglung District, Gandaki Province, Nepal. The study employed a simple random sampling technique to select the wards, and a purposive sampling technique was used to get respondents. A  face-to-face interview with a semi-structured questionnaire among MWARS who had at least one child under two years was applied. The data were gathered, and univariate analysis was done by using IBM SPSS version 27 to disseminate the study's findings.

Results: Out of 157 respondents, nearly half (42.8%) belongedin nuclear families, while a little bit more than half  (58.59%) belongedin joint families.  Most respondents  (63.69%) married before the age of 20, and similarly (61.15%) had their first pregnancy at this young age. The majority of women (91.72%) had visited a health facility by walking on their feet. The utilization of antenatal care (ANC) services at least four or more times was found to be 97.45%, where a significant number (2.55%) of women didn’t utilize recommended ANC services as per protocol. Likewise, 66.88% were counseled on delivery preparation, 76.43% on breastfeeding, and 61.15% on recognizing pregnancy danger signs. Similarly, all the women (100%)  received the  Tetanus  Diphtheria  (TD)  vaccine,  and all mothers gave birth in a healthcare facility and found that all the mothers received recommended postnatal care (PNC), viz. most of them (96.2%) had three PNC visits, while few of them (3.8%) received only two PNC services.
Conclusion and Recommendation: The study found that most women utilized ANC, delivery and neonatal care, and PNC services, with fully institutional delivery, and there were no home deliveries,  which led to low pregnancy complications and mostly normal deliveries. All women received PNC services, and most of the newborns were bathed after an hour of birth.  Likewise,  a significant number of women received vitamin  A  and  IFA supplements after delivery. The investigators recommended that the policymaker reform the policy that incorporates the provision of maternal health services planning, implementation, and evaluation primarily by the local government with data-driven decision-making practice since maternal health is a concurrent responsibility of three tiers of government.
Keywords: ANC, Gynecology, MCH, MNH, PNC, Safe motherhood

per cent of the island's 68,000 inhabitants live (Instituto Nacional de Estatística 2000a). 1 Santo Antão on the other hand, has a predominately rural population of 47,000. Due to the close links between the two islands, they can be thought of as a single region with a city (São Vicente) and a rural hinterland (Santo Antão). Together, they account for slightly more than a quarter of the country's population. 1 Although the city's official name is Mindelo, this is rarely used. Instead, São Vicente refers to the urban centre as well as the island itself. When I use 'São Vicente' in this thesis, it can be thought of as an urban environment. The next chapter addresses the misfit between the contemporary international migration order and existing migration theory. It first discusses the central tendencies behind what we might call 'the age of involuntary immobility'. This provides a wider context for the Cape Verdean experience with migration that I have just described. In the second part of the chapter, I discuss the weaknesses and potential of migration theory to explain contemporary migration and non-migration. Chapter three presents the aspiration/ability model in detail. This is my own theoretical contribution, which is inspired by the theories discussed in chapter two. The aspiration/ability model is reflected in the research questions as well as in the organization of the analytical chapters. (unskilled) Employed (unskilled) Remittance receiver No No No Yes No No No Yes Close family abroad 1 No No No Yes No No No Yes Other emigrant relatives No No No Yes No No No Yes Wish to emigrate Predicted probability 2 74 % 10 % 33 % 91 % 38 % 2 % 10 % 68 % Best guess about wish 3 Yes No No Yes No No No Yes Note: All the women are born in São Vicente. 1 Defined as parents, children, siblings or spouse. 2 The formula for this calculation is given in chapter four. 3 Reflecting a probability above or below 50 %.

National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate th...

The aim of the paper was to determine the frequency of gynecological examinations among the female university students in Serbia as well as a potential association with certain habits and lifestyles. The research was conducted at the three Serbian state universities in the period January-June in the academic year 2008/09 and included 1.164 female university students using a method of random sampling. In total, 18% of female university students said that they had never visited the gynecologist. The least concerned about their health when making the choice of food they eat and the least physically active were the females who had never visited the gynecologist. The females who had visited the gynecologist less than two times estimated themselves as healthier (p<0.05) as well as the girls who had the first gynecological examination before the age of 20. The girls who visited the gynecologist for the first time before they reached 20 years of age used condoms more consistently. Planning and organization of a broad spectrum of activities arranged at the faculties should focus the students' attention on the gynecological healthcare and adequately solve them.

The health of the self-employed is a key lever for economic and social development in Madagascar. This study explores disparities in access to healthcare between the self-employed and salaried workers, focusing on factors influencing healthcare-seeking behavior. The analysis is based on a survey of 418 participants, including 316 self-employed and 102 salaried workers in the Antananarivo-Renivohitra district. Statistical analyses reveal that distance from health services and lack of health coverage are major barriers to access to care for self-employed. Additionally, in situations where health coverage is unavailable, self-employed workers tend to rely more heavily on self-medication. The applied Multinomial Logit model confirms that factors such as age, distance, income and perception of illness play a significant role in access to care, with significant implications for health policy. These findings highlight the importance of implementing targeted policy measures to enhance healthcare access for self-employed, notably through the expansion of health coverage and the reduction of geographical barriers. Future research should continue to explore strategies for minimizing inequalities in access to healthcare, taking into account the socio-economic specificities of diverse populations.

A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers ...

As the global population ages, ensuring seniors' health and independence becomes a growing challenge. Advances in AI offer solutions and transformative possibilities for senior care, impacting health monitoring, medical diagnosis, social engagement, and daily living assistance. This article explores how AI can empower seniors, focusing on health benefits, independence, and the potential challenges and ethical concerns these technologies raise.

Objective Epidemics impact individuals unevenly across race, gender, and sexuality. In addition to being more vulnerable to COVID-19 infection, evidence suggests racialized gender and sexual minorities experienced disproportionate levels of discrimination and stigma during the COVID-19 epidemic. Drawing on Critical Race Theory (CRT), we examined the experiences of gay, bisexual, queer, and other men who have sex with men (GBQM) of colour facing discrimination during COVID-19. Design Engage-COVID-19 is a mixed methods study examining the impact of COVID-19 on GBQM living in Vancouver, Toronto, and Montréal, Canada. We conducted two rounds of qualitative interviews (November 2020 to February 2021, and June to October 2021) with 93 GBQM to explore the evolving impact of COVID-19 on their lives. Transcripts were coded using inductive thematic analysis. Data analysis was conducted using Nvivo software. Results Fifty-nine participants identified as Black, Indigenous, and/or a Person of Co...

Purpose-The purpose of this study was to understand the unique mental health concerns and access barriers experienced by South Asian Muslim youth populations living in the Peel Region of Toronto, Canada. Design/methodology/approach-For this qualitative exploratory study, interviews (n ¼ 15) were conducted with mental health professionals, educators and spiritual leaders (n ¼ 11) who work with South Asian Muslim youth living in Peel Region, as well as with South Asian Muslim youth themselves (n ¼ 4, aged 20-23). Interview transcripts were analyzed using reflexive thematic analysis. Findings-Four primary themes emerged from the data: challenges and stressors, barriers, facilitators and hope and recovery. South Asian Muslim youth navigate a number of unique stressors related to the domains of culture, religion and family dynamics, as well as the impact of migration. Practical implications-The findings stress the necessity of creating culturally safe, multilevel strategies to meet the nuanced challenges and diverse needs of South Asian Muslim youth communities. Originality/value-This is one of the few papers to the knowledge that addresses the mental health needs and service access barriers of youth populations at the intersections of South Asian diasporic community belonging and Muslim faith in Canada.

A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers ...

National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate th...

The paper reviews current knowledge on the health of Canadian immigrants, examines evidence, and identifies research gaps. The information presented is derived from two recent literature reviews. Most literature suggests that Canadian immigrants, particularly recent arrivals, enjoy health advantages over long-term immigrants and the Canadian-born population in terms of overall health status and the prevalence of certain chronic diseases. Immigrants with infectious diseases may experience improvements in health over time. Patterns of immigrant mental health are less clear. More research is needed on specific health problems, how to address determinants of health, and the types of programs and services necessary to maintain immigrants in good health over time. Steps must be taken to strengthen existing databases and develop new ones.

have suggested that the dominant group shows more comfort interacting with European immigrants than with immigrants of color from other origins (Angus Reid Group, 1991; Driedger & Palmer, 2012; Kalin & Berry, 1994) and that they recognize educational and work backgrounds from Western countries with more readiness than those from other countries (e.g., Esses, Dietz, Bhardwaj, 2006). There is surprising little study on how the host population may have changed as a result of their encounters with immigrants. This study addresses this void in the literature. Specifically, it examines what mentors learn from their involvement in a mentoring program for professional immigrants in Vancouver. It asks the following questions: 1) How and why did mentors get involved in the mentoring program? 2) What did they learn from as a result of mentoring new professional immigrants? and 3) How has their learning impacted their practices at work and beyond? Immigrant settlement services and the workplace connections program To facilitate immigrants' integration into the host labour market, Canada has, in the last few decades, offered settlement services, such as language training programs, employment preparation programs, and bridging and mentoring programs. Whereas previously, settlement services were provided through provincially-run public agencies, since the mid-1990s, through contractual arrangements with the state, non-governmental settlement agencies have started delivering settlement services (Sadiq, 2004). In the case of British Columbia, the federal government off-loaded its responsibility for funding settlement services onto the province in 1998 (Biles, 2008). In 2001, the province then adopted a policy of competitive tendering for grant contracts. Settlement services nationally are also periodically reviewed to determine their relevance (e.g., is there a continued need for the program?), design and delivery (e.g., does the service have the infrastructure to facilitate services?) and performance (e.g., do immigrants gain the skills needed for

This paper proposes periphery of practice as a conceptual lens to examine the learning experiences engaged by Chinese immigrant women navigating the Canadian labour market. Part One: Periphery of Practice: A Learning Perspective Canada is a country depending on immigrants for its economic and demographic growth (Jakubowski, 1997). Since 1967, without enough people coming from its traditional immigrant source countries, Canada has officially opened its door to non-Caucasians from other countries but with a point system to ensure the entry of immigrants as desirable as possible. Despite Canada's preferences for skilled and highly educated immigrants, research has shown that these immigrants experience systematic employment degradation and deprofessionalization (e.g. Basran & Li, 1998). The economic fortunes of the recent immigrants have declined compared with their counterparts before the 70's and it is known that there is a correlation between the magnitude of this decline and the changing composition of recent immigrants (Baker & Benjamin, 1994). A plethora of studies have tried to explain immigrants' unfortunate economic outcome, and to communicate the integration barriers that immigrants are faced with. However, how immigrants cope with these barriers and the learning entailed have only become a focus of study in recent years. However, there is a lack of learning perspective that helps to illustrate the learning of immigrants on the periphery in order to have a bearing the host society. In this paper, I am proposing "periphery of practice" as a learning perspective, which is informed by the learning theory of community of practice (Wenger, 1998) and the sociological approach of institutional ethnography (Smith, 1987). Periphery of practices treats learning as enterprises engaged by individuals whose identities are constantly in the making, and as social phenomena constituted through familial and social processes penetrating and encompassing the local. It has benefited from Wenger's (1998) notion of participation and reification as two integral aspects of learning. Participation is the embodied experiences of people that combine doing, talking, thinking, feeling and belonging. Reification refers to the process that gives forms to our perception of experience, which is essentially a meaning negotiation practice. Central to the meaning making process is identity formation and/or transformation, which includes the enactment of identification, and the exercises of negotiability or "the ability, facility and legitimacy (of individuals) to contribute to, take responsibility for and shape the meanings that matter within a social configuration" (Wenger, 1998, pp. 197). My attention to the subjectivity and identity of learners is to help the understanding of learning as socially situated and embodied practices. As Bahktin (as cited in Smith and Lave, 2001), points out: "in the making of meaning… we "author" the world and ourselves in that world. But, the "I" is by no means a freewheeling agent, authoring worlds from springs of meaning and insight within. … the "I" builds and so is built, opportunistically with preexisting materials" (p. 10). Instead of seeing identity as "undifferentiated, equal, equally ephemeral,

Indigenous governance of health care has increasingly been advocated among Indigenous peoples in many countries. However, there is limited research that has empirically examined its benefits. In 2020/21, we conducted a survey of 2113 Indigenous Wayuu individuals in Colombia who received services from the Indigenous Wayuu led health care insurance organization Anas Wayuu and its network of service providers, and Wayuu individuals who received services from non-Indigenous health insurance organizations. We compared their health care utilization and perception of quality of care. A main finding of the study was that Anas Wayuu enrollees were more than twice as likely to access health care than enrollees from non-Indigenous health insurance organizations, even when controlling for the demographic and health characteristics. The study provided compelling evidence suggesting that Anas Wayuu, being an Indigenous led health organization improves access to, and quality of care, among Indigenous health service recipients.

Over the last fifteen years, Canada has received an increasing number of women from Mexico and Central America who are submitting refugee claims based on domestic, social, and political violence, and on the failure of political and judicial institutions in their home countries to protect them. This group of female humanitarian arrivals, however, has been largely denied refugee status. While gender-based claims are statistically more likely to be successful relative to other types of claims in

Electronic health record (EHR) is an efficient ICT tool for processing health data in real-time. Nigeria lacks an
active e-health profile owing to financial, organizational and human factors such as poor computer literacy, resistance to change etc. This was a cross-sectional descriptive study which sought to determine healthcare providers’ knowledge and perceptions of electronic health records and their perceived effect on health service delivery in tertiary health facilities in Uyo, Nigeria. A semi-structured questionnaire was distributed to 400 healthcare providers recruited via proportionate sampling technique from two tertiary health facilities in the study location. Data was analyzed using SPSS 25, hypotheses were tested using chi-square statistics. Findings showed that majority, 335 (83.6%) of the respondents had fair to good (16% and 65% respectively) knowledge of the EHR. Of the 121 respondents who had used the EHR, 94 (77.6%) had positive perceptions of the technology, 82 (67.8%) reported improvement in patients’ outcomes. Eased access to patient data, 91 (81.0%); reduced waiting time, 74 (61.2%); secured means of data storage, 88 (72.7%); lessened workload, 75 (61.9%); improved patients’ satisfaction of services rendered, 79 (65.3%) and reduced health cost, 41 (34.7%). A relationship was established between healthcare providers’
perceptions of EHRs and perceived effect on health service delivery (p = 0.007 < 0.05). There was no relationship between
healthcare providers’ knowledge of the EHR and perceived effect on health service delivery whereas, their positive perceptions of the system had an equal positive perceived effect on health service delivery in the study location.

This report of an NHS England funded study (collaborative team led by Greenfields as Principal academic Investigator) explored  how best to break down barriers to inclusion in health research experienced by Refugees and Asylum Seekers. The study was co-produced with community partners with lived experience of the UK asylum system and agencies providing support for  refugees and asylum seekers in relation to health care access

This paper explores the role of the Mental Health System (MHS) on the Health System of the Province of Buenos Aires, trying to throw light on its financing structure. The extent of this research is limited to the Province of Buenos Aires, one of the three major provinces of the Republic of Argentine. It could be easily inferred from this that conclusions obtained in this paper cannot be extended to other provinces, neither to the whole country. The Gross Regional Product of the province of Buenos Aires represents around 36% of the GDP of Argentine, which sums up to 280.000 millions of Pesos. As the nominal exchange rate with the Dollar is 1:1, values can be expressed either in Pesos or in Dollars interchangeably. The population of Buenos Aires is 38.4% of the total population of the country, namely 14.214.701 people, the density being 42.2 people per km2.

Ce mémoire de maîtrise vise à comprendre comment la question de l'accessibilité aux soins de santé mentale se pose dans l'univers des jeunes adultes en difficulté. Plus précisément, le but de l'étude est de documenter les barrières à l'accès aux soins de santé mentale, d'analyser les logiques sous-jacentes à ces barrières et finalement d'évaluer l'impact de l'expérience d'être jeune adulte en difficulté sur celles-ci. L'approche de l'anthropologie médicale et le concept de souffrance sociale, sensibles aux facteurs culturels, socio-économiques et politiques, servent de contexte d'analyse aux 12 entretiens semi-dirigés réalisés auprès de jeunes adultes fréquentant des Auberges du cœur à Montréal. L'identification de barrières à l'accès a, dans un premier temps, permis d'observer que les obstacles dans l'expérience de recours aux soins de santé mentale peuvent provenir autant des institutions que des jeunes adultes eux-mêmes. Dans un deuxième temps, l'analyse qualitative a servi à dégager trois principales logiques qui sous-tendent ces barrières : le parti pris positiviste, la logique marchande, et la tendance à la psychologisation. Les données récoltées tendent à montrer que des influences politiques et économiques sont déterminantes dans le maintien de différents types de barrières à l'accès et qu'une pleine reconnaissance de ces enjeux profonds est essentielle pour agir positivement sur l'accessibilité aux soins de santé mentale de la population en général, et plus particulièrement des jeunes adultes en difficulté dont les besoins se font criants.

A small steering committee of individuals (see Appendix 1) in Calgary is interested in exploring the feasibility of a community-service organization that would target South Asian communities. Coupled with interest from the Minister of Human Services, the Honorable Manmeet Bhullar, this group is interested in understanding the best practices of the Punjabi Community Health Services (PCHS) organization based in Toronto, Ontario, which delivers a comprehensive service delivery model. This model, developed by PCHS-Toronto, implements culturally appropriate interventions in the South Asian communities in the areas of addictions, mental health, aging, health promotion, domestic violence, and parenting (Punjabi Community Health Services, 2010). PCHS started in 1990 by delivering one service – a support service for men with addiction problems – and continued to build its service model by including research and community-level assessments.Today, the organization delivers 24 programs, to various South Asian communities, including public events, educational workshops, and cultural competency training. Shift is interested in supporting community organizations in their pursuit to prevent domestic violence in their communities. This report will support the Calgary committee to understand the essential components of PCHS-Toronto that are required to build a similar organization in Calgary. The model proposed in this report draws on PCHS-Toronto, but does not attempt to replicate it in its entirety because any organization in Calgary needs to be sensitive to, and borne of, the Calgary context.

A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers ...