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Gil-Salmerón, Alejandro, Konstantinos Katsas, Elena Riza, Pania Karnaki, and Athena Linos. "Access to Healthcare for Migrant Patients in Europe: Healthcare Discrimination and Translation Services." International Journal of Environmental Research and Public Health 18, no. 15 (2021): 7901. http://dx.doi.org/10.3390/ijerph18157901.
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Background: Discrimination based on ethnicity and the lack of translation services in healthcare have been identified as main barriers to healthcare access. However, the actual experiences of migrant patients in Europe are rarely present in the literature. Objectives: The aim of this study was to assess healthcare discrimination as perceived by migrants themselves and the availability of translation services in the healthcare systems of Europe. Methods: A total of 1407 migrants in 10 European Union countries (consortium members of the Mig-HealthCare project) were surveyed concerning healthcare discrimination, access to healthcare services, and need of translation services using an interviewer-administered questionnaire. Migrants in three countries were excluded from the analysis, due to small sample size, and the new sample consisted of N = 1294 migrants. Descriptive statistics and multivariable regression analyses were conducted to investigate the risk factors on perceived healthcare discrimination for migrants and refugees in the EU. Results: Mean age was 32 (±11) years and 816 (63.26%) participants were males. The majority came from Syria, Afghanistan, Iraq, Nigeria, and Iran. Older migrants reported better treatment experience. Migrants in Italy (0.191; 95% CI [0.029, 0.352]) and Austria (0.167; 95% CI [0.012, 0.323]) scored higher in the Discrimination Scale to Medical Settings (DMS) compared with Spain. Additionally, migrants with better mental health scored lower in the DMS scale (0.994; 95% CI [0.993, 0.996]), while those with no legal permission in Greece tended to perceive more healthcare discrimination compared with migrants with some kind of permission (1.384; 95% CI [1.189, 1.611]), as opposed to Austria (0.763; 95% CI [0.632, 0.922]). Female migrants had higher odds of needing healthcare assistance but not being able to access them compared with males (1.613; 95% CI [1.183, 2.199]). Finally, migrants with chronic problems had the highest odds of needing and not having access to healthcare services compared with migrants who had other health problems (3.292; 95% CI [1.585, 6.837]). Conclusions: Development of culturally sensitive and linguistically diverse healthcare services should be one of the main aims of relevant health policies and strategies at the European level in order to respond to the unmet needs of the migrant population.
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Et. al., Suleiman Mohammed Saeed. "Socio-Economic Effects of HIV/AIDS on Households with People Living With HIV/AIDS in Northern Nigeria." Turkish Journal of Computer and Mathematics Education (TURCOMAT) 12, no. 3 (2021): 5406–15. http://dx.doi.org/10.17762/turcomat.v12i3.2188.
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The purpose of this paper is to review the socio-economic effects of Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) on households with People Living with HIV/AIDS (PLWHA) in Northern Nigeria. The pandemic is devastating and constitutes a serious threat to the socio-economic development of infected, affected, and society at large. This study was qualitative in nature, thus it utilized in-depth interviews to pull together information from the 39 key informants as its method. It is observed that HIV/AIDS occurrence rate has led to poor health, loss of jobs, and a high rate of labour reduction in all sectors, and this has contributed to the tremendous decline of the economy. This study discovered that increased expenses of households with PLWHA on financing funerals, healthcare, and other medical expenditures with decreased investment. Children emerging as head of the households and tasks of caring for orphans are increasingly inconsistent with many other studies. The pandemic has been a serious threat to the social and economic interests and survival of the households with PLWHA and their members. Many lives are lost due to the pandemic. The worst affected group is young people in their productive ages and by implication affects the socio-economic development of PLWHA, their households, and society at large. Thus, households with PLWHA experience numerous forms of stigma and prejudice together with human rights abuse that is detrimental to the total well-being of PLWHA. The dimensions of the stigma can be classified as internalized, community, and social-based. The patterns of managing the challenges of HIV/AIDS-related stigma adopted from the experience of households with PLWHA adopted include isolation, non-disclosure, and loss of follow-up as well as migration. The paper suggested that the government should come up with policies that can take care and support the socio-economic activities of households with PLWHA and also need to introduce policies and procedures for the reduction of stigma and discrimination against households with PLWHA and its members living with the epidemic. Households with PLWHA need to be assisted with medication subsidies to reduce medical expenses and stress on the households’ capitals among other recommendations.
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Fouskas, Theodoros. "Repercussions of precarious employment on migrants’ perceptions of healthcare in Greece." International Journal of Human Rights in Healthcare 11, no. 4 (2018): 298–311. http://dx.doi.org/10.1108/ijhrh-01-2018-0010.
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Purpose The purpose of this paper is to investigate the cases of Bangladeshi, Filipina, Nigerian, Palestinian and Pakistani migrant workers and how the frame of their work and employment in precarious, low-status/low-wage jobs affects their perceptions and practices regarding health and access to healthcare services. Design/methodology/approach Using qualitative research methodology, the analysis via in-depth interviews focuses on male Bangladeshi, Nigerian, Pakistani and Palestinian unskilled manual and textile laborers as well as street vendors, and female Filipina live-in domestic workers. Findings Migrants are entrapped in a context of isolative and exploitative working conditions, i.e., in unskilled labor, textile work, street-vending, personal services, care and domestic work, which lead them to adopt a self-perception in which healthcare and social protection are not a priority. Social implications Throughout the paper it has become clear that these precarious low-status/low-wage jobs have an important underside effect on migrants’ lives, intensifying labor and health instability and exposing migrants to employment-generating activities that do not guarantee health safety. In Greek society, the impact of migration on public health is characterized by many as a “time bomb ready to explode,” especially in urban centers. Meanwhile, the economy and particularly the informal sector of the labor market is benefiting from migrant workers. More research is needed as this mode of exploitative labor and precarious employment needs to be adequately addressed to mitigate barriers in the access of labor and healthcare rights. Originality/value Via its contribution to the sociology of migration with particular emphasis on labor healthcare, the paper provides evidence that due to their concentration in precarious, low-status/low-wage jobs migrant workers have very limited access to healthcare services. The removal of inequalities and discrimination against migrant workers in accessing healthcare services and medical care is a challenge for South European Union countries and particularly for Greece. However, in spite of this, there is no uniform policy in the management of migrants with respect to their access to health services. The paper will aid debates between policy makers and academics working on migration and inequalities due to the division of labor and health disparities, will contribute to the understanding of the perils attached to precarious, low-status/low-wage jobs and in addressing health inequalities effectively.
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Penner, Louis A., John F. Dovidio, Donald Edmondson, et al. "The Experience of Discrimination and Black-White Health Disparities in Medical Care." Journal of Black Psychology 35, no. 2 (2009): 180–203. http://dx.doi.org/10.1177/0095798409333585.
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The current study of Black patients focuses on how discrimination contributes to racial disparities in health. The authors used a longitudinal methodology to study how perceived past discrimination affects reactions to medical interactions and adherence to physician recommendations. In addition, they explored whether these reactions and/or adherence mediate the relationship between discrimination and patients' health. The participants in this study were 156 Black patients of low socioeconomic status at a primary care clinic. Patients completed questionnaires on their current health, past adherence, and perceived past discrimination. Then, they saw a physician and rated their reactions to the visit. Four and 16 weeks later they reported on their adherence to physician recommendations and overall health. Perceived discrimination was significantly and negatively associated with patient health, reactions to the physician, and adherence. Path analyses indicated that adherence mediated the relationship between discrimination and patient health, but patient reactions to the interaction did not.
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Erinosho, Olayiwola A. "Health Care and Medical Technology in Nigeria: An Appraisal." International Journal of Technology Assessment in Health Care 7, no. 4 (1991): 545–52. http://dx.doi.org/10.1017/s0266462300007108.
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AbstractThe objective of the study was to ascertain the extent of utilization of medical technologies (defined as equipment) used in various health care institutions in Nigeria. The study also investigated the factors accounting for use of and under- and nonutilization of this equipment. Sixteen major and minor health care institutions were surveyed. The outcomes of the study indicate that not less than a third of the equipment was out of order at the time of the study. A number of factors are responsible for nonutilization of this equipment. They include lack of infrastructural facilities such as piped water, storage, and power supply; poor handling by badly trained staff; and the low priority that is accorded to maintenance. The study leads to the important conclusion that the local culture is unable to sustain the technologies that are procured.
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Oloko, Olakunle, Olayinka Oladunjoye Ogunbode, Olumuyiwa Roberts, and Ayodele Olatunji Arowojolu. "Antenatal care visits’ absenteeism at a secondary care medical facility in Southwest Nigeria." Journal of Obstetrics and Gynaecology 36, no. 8 (2016): 1026–30. http://dx.doi.org/10.1080/01443615.2016.1188270.
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Fawibe, A. E., L. O. Odeigah, T. M. Akande, A. G. Salaudeen, and I. Olanrewaju. "Self-reported medical care seeking behaviour of doctors in Nigeria." Alexandria Journal of Medicine 53, no. 2 (2017): 117–22. http://dx.doi.org/10.1016/j.ajme.2016.04.003.
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Berniker, Jessamyn S. "Legal Implications of Discrimination in Medical Practice." Journal of Law, Medicine & Ethics 28, no. 1 (2000): 85–88. http://dx.doi.org/10.1111/j.1748-720x.2000.tb00322.x.
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Recent medical studies have indicated that medical professionals discriminate in their treatment practices on the basis of race and gender. Among the many concerns stemming from this realization are questions about the possibility of legal actions and the availability of individual compensation for the denial of equal care. By meeting legal evidentiary standards, the recent statistical data pointing to discriminatory trends have created the potential for legal recourse through Title VI of the Civil Rights Act which prohibits recipients of federal funding from treating people differently on the basis of race or national origin.
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Eyongndi, David Tarh-Akong. "An appraisal of HIV and Aids (Anti-Discrimination) Act, 2014 and the tide of employment discrimination in Nigeria." Africa Nazarene University Law Journal 8, no. 1 (2020): 111–27. http://dx.doi.org/10.47348/anulj/v8/i1a5.
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Subjecting employees or applicants to a medical test to determine whether they are fit for employment and so pre-empt any liability that the employer may suffer owing to the unfitness of the employer has become a prevalent practice. However, a trend has developed in terms of which employers subject employees to medical tests to use the outcome as a reason to discriminate against them and terminate their employment. Testing positive for HIV/AIDS is one such outcome where the status of the employee, despite their right to be free from discrimination, has been used to terminate their employment. This is the plight that persons living with HIV/AIDS (PLW HIV/AIDS) must suffer at the hands of employers as they were being discriminated against based on their health status even though it did not affect their ability to discharge their duties. This situation led to discontentment which developed into serious pressure to protect PLW HIV/AIDS. To address the phenomenon, the legislature enacted the HIV and AIDS (Anti-Discrimination) Act 2014. This article adopts the desk-based methodology in appraising the provisions of the Anti-Discrimination Act to determine the extent to which the Act has dealt with the quagmire of employment discrimination against PLW HIV/AIDS in Nigeria. It also considers the challenges confronting the implementation of the Act. The Anti-Discrimination Act has criminalised termination of employment on account of the HIV/AIDS status of an employee and prohibits other forms of discrimination sequel to the status. The article concludes by making vital recommendations on how to implement the Act in a way that strikes a balance between curbing discrimination while promoting the employer’s business.
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Ayo Deji, Samson, Eyitope Oluseyi Amu, Paul Oladapo Ajayi, and Taiwo Samuel Ogunleye. "Preference for Traditional Medical Care to Orthodox Medical Care Among Secondary School Students in Rural Area of Nigeria." European Journal of Preventive Medicine 9, no. 1 (2021): 14. http://dx.doi.org/10.11648/j.ejpm.20210901.13.
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C.H.O., Chika, Edith N.C., Christiana N.O., and Adaobi M.I. "Preconception Care Utilization among Childbearing Women in South-East Nigeria." African Journal of Health, Nursing and Midwifery 4, no. 6 (2021): 1–13. http://dx.doi.org/10.52589/ajhnm-5mrkm80j.
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Adverse pregnancy outcomes remain a challenging health problem in Nigeria. Before conception, couples need to utilize preconception care which is meant to address most of the reproductive health risks. However, the use of this service and its determinants is not well investigated globally. This Cross-sectional study was aimed at assessing the utilization of preconception care and its determinants among mothers in South-East Nigeria. Pre-tested and validated structured Questionnaire on Preconception Care Utilization was used to collect data from 350 postnatal women who were systematically selected from 33 sampled health facilities. Data were collated and entered into SPSS version 20. Binary logistic regression was used to determine the association between the demographic characteristics of the mothers and the utilization of preconception care. Statistical significance was set at p<0.05. Results show that only 23.4% of the mothers utilized preconception care. Parity, employment status, and pregnancy intention were significantly associated with preconception care utilization. The odd of utilizing preconception care were 60.2% lower among multiparous women than primiparous women. Working-class mothers were more than 70% less likely to utilize preconception care than mothers who were not employed. Mothers whose pregnancy was intended were 3.4 times more likely to utilized preconception care than mothers whose pregnancy was unintended. Health facilities should establish functional clinics with the availability of evidence-based guidelines to improve uptake of preconception care. Health care professionals should intensify their efforts in encouraging women to receive preconception care.
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FAKOLADE, R., S. B. ADEBAYO, J. ANYANTI, and A. ANKOMAH. "THE IMPACT OF EXPOSURE TO MASS MEDIA CAMPAIGNS AND SOCIAL SUPPORT ON LEVELS AND TRENDS OF HIV-RELATED STIGMA AND DISCRIMINATION IN NIGERIA: TOOLS FOR ENHANCING EFFECTIVE HIV PREVENTION PROGRAMMES." Journal of Biosocial Science 42, no. 3 (2009): 395–407. http://dx.doi.org/10.1017/s0021932009990538.
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SummaryPeople living with HIV and AIDS (PLWHAs) often face stigma and discrimination, especially in developing countries. HIV-related stigma is expressed through social ostracism, personal rejection, direct and indirect discrimination, and denial from families and friends. Consequently, it is associated with reduced adoption of preventive and care behaviours, including condom use, seeking for HIV test and care-seeking behaviour subsequent to diagnosis. Ignorance about the epidemiology of the disease on modes of transmission and prevention aggravates HIV-related stigma in Nigeria. Behaviour change communication activities through mass media have been shown to be an effective approach in improving people's knowledge about the disease. This paper monitors trends in the level of accepting attitudes towards PLWHAs in Nigeria between 2003 and 2007. It also evaluates the impact of exposure to mass media and social support on the levels of accepting attitudes towards PLWHAs. A significant and positive trend was evident between 2003 and 2007 (p<0.0001). Furthermore, exposure to mass media communications on HIV and AIDS issues and social support were significantly related to the reduced stigma and discrimination against PLWHAs (p<0.0001).
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OSHI, DANIEL C., SARAH N. OSHI, ISAAC N. ALOBU, and KINGSLEY N. UKWAJA. "GENDER-RELATED FACTORS INFLUENCING WOMEN'S HEALTH SEEKING FOR TUBERCULOSIS CARE IN EBONYI STATE, NIGERIA." Journal of Biosocial Science 48, no. 1 (2014): 37–50. http://dx.doi.org/10.1017/s0021932014000534.
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SummaryThis is a qualitative, descriptive study to explore gender-related factors that influence health seeking for tuberculosis (TB) care by women in Ebonyi State, Nigeria. In-depth interviews based on interview guides were conducted with participants selected through purposive sampling in communities in the state. The results show that gender relations prohibit women from seeking care for symptoms of TB and other diseases outside their community without their husbands' approval. Gender norms on intra-household resource ownership and control divest women of the power to allocate money for health care seeking. Yet, the same norms place the burden of spending on health care for minor illnesses on women, and such repeated, out-of-pocket expenditures on health care at the village level make it difficult for women to save money for use for health care seeking for major illnesses such as TB, which, even if subsidized, still involves hidden costs such as transport fare. The opening hours of TB clinics do not favour their use by most women as they are open when women are usually engaged in income-generating activities. Attending the clinics may therefore entail opportunity costs for many women. People with chronic, infectious diseases such as TB and HIV are generally stigmatized and avoided. Women suffer more stigma and discrimination than men. Stigma and discrimination make women reluctant to seek care for TB until the disease is advanced. Policies and programmes aimed at increasing women's access to TB services should not only take these gender norms that disempower women into explicit consideration but also include interventions to address them. The programmes should integrate flexible opening hours for TB treatment units, including introduction of evening consultation for women. Interventions should also integrate anti-stigma strategies led by the community members themselves.
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Casagrande, Sarah Stark, Tiffany L. Gary, Thomas A. LaVeist, Darrell J. Gaskin, and Lisa A. Cooper. "Perceived Discrimination and Adherence to Medical Care in a Racially Integrated Community." Journal of General Internal Medicine 22, no. 3 (2007): 389–95. http://dx.doi.org/10.1007/s11606-006-0057-4.
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Edward, Ezedike, and Chrisantus Kanayochukwu Ariche. "Ethical issues in traditional herbal medical practice in Nigeria." International Journal of Humanities and Innovation (IJHI) 2, no. 4 (2019): 129–35. http://dx.doi.org/10.33750/ijhi.v2i4.55.
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There is increased use and popularity of herbal medicine in Nigeria in recent times. Scholars from different fields have attributed this recent upsurge to economic issues, high cost of modern medical care, loss of confidence in synthetic drugs, resistant of diseases to some modern drugs and easy accessibility of herbal medicines and its practitioners, amongst others. According to the World Health Organization (WHO), a large portion of the world’s population patronizes traditional herbal medicines. However, there is perceived neglect of the core principles of health care ethics by the practitioners and marketers of traditional herbal medicine in Nigeria. This is worrisome. In this connection, this paper argues that Nigerians will benefit immensely from traditional herbal medicine if its practitioners and marketers observe and respect these core principles of health care which includes the principles of beneficence, non-maleficence, autonomy, informed consent, justice, and truthfulness. This study is purely qualitative and adopts a textual critical analytic method.
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Orekoya, Ibrahim Oluwapelumi, and Omobola Oyebola Oduyoye. "Implications of Outbound Medical Tourism on Public Health Care Development in Nigeria." European Scientific Journal, ESJ 14, no. 30 (2018): 353. http://dx.doi.org/10.19044/esj.2018.v14n30p353.
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Medical tourism is the practice of patients travelling out of their country of origin or residence for the purpose of getting access to medical care services abroad. Outbound medical tourism is a phenomenon in Nigeria thereby contributing to the growth of the health care industry in destination countries. The paper examines the implications of outbound medical tourism on public health care development in Nigeria and reinforces the need for the Federal Government of Nigeria to restructure and reposition the health sector in the country towards effective and efficient health service delivery. The study employs secondary source of data. Public administrators and health care practitioners concerned about transforming Nigeria into a centre of medical tourist attraction may find it suitable to start by examining the issues raised in this study to initiate a good policy framework for the health sector. The study concludes that huge investment in the health sector can drastically reduce outbound medical tourism, make health care services affordable to all Nigerians and utilising foreign exchange to develop other relevant sectors of the Nigerian economy.
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Kareem, Muritala Kewuyemi, and Jamilah Adenike Adeogun. "Challenges Facing Female Muslim Medical Practitioners (FMMP) in the University College Hospital (UCH), Ibadan, Nigeria." ICR Journal 11, no. 1 (2020): 126–46. http://dx.doi.org/10.52282/icr.v11i1.27.
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In Nigeria, religious intolerance between Muslims and Christians continues to increase. Muslim women are among those who have felt the most impact from the resulting religious prejudice, intolerance, and discrimination, especially in their workplaces. While many studies have been conducted to investigate the myriads of challenges facing women in general and Muslim women in particular, little research has been done on the challenges they face in their workplaces. This study intends to fill this gap by studying Female Muslim Medical Practitioners (FMMP) at the University College Hospital (UCH), Ibadan, Nigeria. Purposive and snowball samplings were used to select seventy research participants. Face-to-face and in-depth individual interviews, which lasted between 30 minutes and three hours each, were used to collect data for the study, in which relevant statistical tests were used for data analysis. The study reveals that FMMPs in the hospital encounter several challenges, such as donning the hijab (the Muslim headscarf), performing daily prayers (salat), and employment opportunities. There is also evidence of high-level discrimination in the workplace. Finally, the study recommends that the management of UCH enhance its practice and policies regarding religious tolerance, equality, fairness, unity, and cooperation amongst its administrative staff and personnel.
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Ogoh Alubo, S. "Power and privileges in medical care: An analysis of medical services in post-colonial Nigeria." Social Science & Medicine 24, no. 5 (1987): 453–62. http://dx.doi.org/10.1016/0277-9536(87)90220-6.
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Ahonkhai, Aima A., Ifeyinwa Onwuatuelo, Susan Regan, et al. "The patient-centered medical home: a reality for HIV care in Nigeria." International Journal for Quality in Health Care 29, no. 5 (2017): 654–61. http://dx.doi.org/10.1093/intqhc/mzx083.
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Ahonkhai, Aimalohi, Ifeyinwa Onwuatuelo, Elena Losina, et al. "1551The Patient-Centered Medical Home: A Reality for HIV Care in Nigeria." Open Forum Infectious Diseases 1, suppl_1 (2014): S412—S413. http://dx.doi.org/10.1093/ofid/ofu052.1097.
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Brusca, Rebeccah M., Catherine E. Simpson, Sarina K. Sahetya, et al. "Performance of Critical Care Outcome Prediction Models in an Intermediate Care Unit." Journal of Intensive Care Medicine 35, no. 12 (2019): 1529–35. http://dx.doi.org/10.1177/0885066619882675.
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Background: Intermediate care units (IMCUs) are heterogeneous in design and operation, which makes comparative effectiveness studies challenging. A generalizable outcome prediction model could improve such comparisons. However, little is known about the performance of critical care outcome prediction models in the intermediate care setting. The purpose of this study is to evaluate the performance of the Acute Physiology and Chronic Health Evaluation version II (APACHE II), Simplified Acute Physiology Score version II (SAPS II) and version 3 (SAPS 3), and Mortality Probability Model version III (MPM0III) in patients admitted to a well-characterized IMCU. Materials and Methods: In the IMCU of an academic medical center (July to December 2012), the discrimination and calibration of each outcome prediction model were evaluated using the area under the receiver–operating characteristic and Hosmer-Lemeshow goodness-of-fit test, respectively. Standardized mortality ratios (SMRs) were also calculated. Results: The cohort included data from 628 unique IMCU admissions with an inpatient mortality rate of 8.3%. All models exhibited good discrimination, but only the SAPS II and MPM0III were well calibrated. While the APACHE II and SAPS 3 both markedly overestimated mortality, the SMR for the SAPS II and MPM0III were 0.91 and 0.91, respectively. Conclusions: The SAPS II and MPM0III exhibited good discrimination and calibration, with slight overestimation of mortality. Each model should be further evaluated in multicenter studies of patients in the intermediate care setting.
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Mba, S., W. Ukponu, M. Saleh, et al. "Lassa fever infection among health care workers in Nigeria, 2019." International Journal of Infectious Diseases 101 (December 2020): 279. http://dx.doi.org/10.1016/j.ijid.2020.09.731.
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Tolani, MusliuAdetola, Muhammed Ahmed, RufusWale Ojewola, et al. "Assessment of health-care research and its challenges among medical doctors in Nigeria." Nigerian Medical Journal 61, no. 4 (2020): 218. http://dx.doi.org/10.4103/nmj.nmj_46_20.
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Iribhogbe, P. E. "(A276) Improving Emergency Medical Care in Nigeria - The Ubth Emt-Paramedic Training Programme." Prehospital and Disaster Medicine 26, S1 (2011): s93. http://dx.doi.org/10.1017/s1049023x11002937.
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BackgroundTrauma is the leading cause of death in the age group 15–44 years in Nigeria. The burden of trauma has continued to increase in the subregion. It is estimated that a significant proportion of trauma deaths occur prehospital. The role of the EMT-Paramedics in trauma and emergency care is well established. However the profession has been absent in the West African subregion. There was no training centre for EMT Paramedic professionals until the UBTH established one in 2008.ObjectiveTo review the UBTH EMT-Paramedic training programme and the implications for trauma and emergency care.MethodThe programme onset, implementation and challenges so far is reviewed in detail with illustrations.ConclusionThe injection of the EMT-Paramedic professionals into our health system will surely improve our emergency care. The support of the Government at all levels as well support for the training from all Medical professionals is urgently neede.
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Stephen Adeola, Oladele. "Medical Imaging System and the Health Care Delivery System in Nigeria: An Overview." International Journal of Medical Imaging 9, no. 1 (2021): 45. http://dx.doi.org/10.11648/j.ijmi.20210901.15.
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López-Cevallos, Daniel F., S. Marie Harvey, and Jocelyn T. Warren. "Medical Mistrust, Perceived Discrimination, and Satisfaction With Health Care Among Young-Adult Rural Latinos." Journal of Rural Health 30, no. 4 (2014): 344–51. http://dx.doi.org/10.1111/jrh.12063.
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Oburota, Chukwuedo Susan, and Olanrewaju Olaniyan. "Health care financing and income inequality in Nigeria." International Journal of Social Economics 47, no. 11 (2020): 1419–31. http://dx.doi.org/10.1108/ijse-05-2020-0286.
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PurposeThe purpose of this paper is to decompose the inequities induced by the Nigerian health care financing sources and their effect on the income distribution. Inequities in health care financing sources are of immense policy concern particularly in developing countries such as Nigeria, where high-level income inequality exists, and the cost of medical care is generally financed out-of-pocket (OOP) due to limited access to health insurance.Design/methodology/approachThe Duclos et al. decomposition model provided the theoretical framework for the study. Data were obtained from two waves of the Nigeria General Household Survey (GHS) panel, 2012–13 and 2015–16. The analysis covered 3,999 households in 2012–13 and 4,051 households in 2015–16. Two measures of health care financing: OOP payment and health insurance contribution (HIC) were used. The ability to pay measure was household consumption expenditure.FindingsThe major inequity issue induced by the OOP payments was vertical inequity. HICs created the problems of vertical inequity, horizontal inequity and reranking among households. Overall both health care financing options were associated with the worsening of income inequality both at the national and sectorial levels in the country. The operations of the NHIS need to be improved to ensuring improved health care coverage for the poor.Originality/valueThis paper fulfills an identified need to determine the income redistributive effects (REs) of the social health insurance (SHI) contribution at the national, urban and rural locations overtime.
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Airhihenbuwa, Collins O. "An Assessment of Health Needs in Selected Nigeria Villages." International Quarterly of Community Health Education 6, no. 2 (1985): 161–69. http://dx.doi.org/10.2190/lfuv-pvu7-hqmk-y1cx.
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Two hundred and fifty five heads of households in Iyekuselu District, Bendel State Nigeria, were interviewed. Fifteen villages were randomly selected from the 107 villages that make up the district. There is high morbidity of infectious diseases identified in the study. Limited number of medical professionals and medical institutions present problems of availability of services. This is compounded by high cost of medical services and poor access to health care facilities. The self-perceived health care needs of the heads of households are disease prevention, availability of health services, improved accessibility to health care facilities and reduced cost of care. There is a strong need for health education programs in these villages. This should be attempted with the cooperation of community members, so as to attain the goal of promoting health and preventing diseases.
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Rosenbaum, Sara. "Insurance Discrimination on the Basis of Health Status: An Overview of Discrimination Practices, Federal Law, and Federal Reform Options." Journal of Law, Medicine & Ethics 37, S2 (2009): 101–20. http://dx.doi.org/10.1111/j.1748-720x.2009.00423.x.
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This is an important time to focus on the question of insurance discrimination based on health status. The nation once again is poised to embark on a major health care reform debate. Even as the number of uninsured stands at some 45 million persons, millions more may be poised to lose coverage during the worst economic downturn in generations. In addition, a large number of persons may be seriously under-insured, with coverage falling significantly below the cost of necessary health care. In recent years, the proportion of insured persons who are underinsured has grown by 60% since 2003, reaching an estimated 25 million persons in 2007. Health care costs experienced by insured persons now account for more than 75% of all personal bankruptcies related to medical care. Underlying these figures is a national approach to health care financing for the non-elderly that effectively increases the odds that those who are in poor health status will be uninsured or underinsured.
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Dienye, Paul O., and Precious K. Gbeneol. "Domestic Violence Against Men in Primary Care in Nigeria." American Journal of Men's Health 3, no. 4 (2008): 333–39. http://dx.doi.org/10.1177/1557988308325461.
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Domestic violence against men is rare in Nigeria. This study was aimed at assessing the prevalence of domestic violence against men, the sociodemographic characteristics of victims, and the pattern of injury sustained in a primary care setting. This was a retrospective study over a period of 5 years in which all the medical records of patients were retrieved and information on domestic violence extracted from them and transferred to a data sheet. Those whose records were grossly deficient were excluded from the study. A total of 220,000 patients were seen of which 48 (22 per 100,000) were victims of domestic violence. There were only five married male victims with a prevalence of 0.0023%. The injuries observed were scratches, bruises, welts, and scalds. The primary care physician needs a high index of suspicion to be able to detect it.
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Abugu, Uwakwe, and Dike C. Obalum. "An Agenda for Improving Legal Claims for Medical Malpractice in Nigeria." Asian Social Science 14, no. 5 (2018): 118. http://dx.doi.org/10.5539/ass.v14n5p118.
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The law and ethics of medical practice enjoy a relatively universal appeal, and speak the same language in different jurisdictions. This is due mainly to the fact that the practice of modern orthodox medicine is traceable to the Greek philosopher, Hippocrates (father of modern medicine) who brought scientific rationalization into medical practice, thus exploding the hitherto garb of metaphysics and Esoterism that beclouded the practice. The various works of the World medical Association in developing and disseminating ethical rules and standards of practice further strengthened the universal character of medical ethics. Accordingly, the right of patients and the duties of medical practitioners remain the same all over the world. But the extent to which these rights and duties are asserted, observed and enforced vary significantly among jurisdictions. Recent empirical investigation shows that in Nigeria only about 1.1% of all medical malpractice cases are enforced through legal action. This paper gives an analysis of the present state of medical practice in Nigeria in terms of the basic care exhibited by medical practitioners, the impression of patients about such care and other elementary requirements of doctor-patient relationship. It draws from a work which concludes that while the level of care is abysmally low leading to high level of malpractice, the level of legal claims is even lower. The paper proceeds to set out some legal and administrative remedial measures that could be taken to improve the almost non-existent claims against practitioners involved in medical malpractice in Nigeria.
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Leng, Jim, Abiola Falilat Ibraheem, Atara Isaiah Ntekim, et al. "Survey of medical student knowledge in oncology and survivorship care in Nigeria: A pilot study." Journal of Clinical Oncology 37, no. 15_suppl (2019): e18106-e18106. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e18106.
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e18106 Background: In low middle-income countries (LMICs), cancer patients present in later stages of disease for many reasons, including missed diagnoses. Due to high patient: physician ratios, generalists are taught broadly and prepared to treat diseases outside the scope of their interest in training. The delivery of high-quality cancer care requires an interdisciplinary team of physicians with excellent medical school training in oncology. To date, there has been no formal assessment of medical education for oncology in Nigeria. This study aims to assess the ability of the curriculum in Nigeria to prepare future doctors tasked with treating a growing number of patients with cancer. Methods: An anonymous survey was administered to final year medical students at Lagos State University and University of Ibadan, Nigeria. The survey assessed demographics, reports of experience during medical school with oncology, comfort ratings with different aspects of oncologic care (Likert scale, 1 = not at all, 5 = extremely), and included five clinical vignettes. Results: 146 graduating students in two medical schools responded (response rate = 36.6%). Twelve percent of students indicated that they planned to pursue a career in oncology. The majority of students reported exposure through lectures to medical oncology (85%), radiation oncology (82%), and surgical oncology (85%), but fewer reported exposure to lectures in hospice care (75%) and cancer survivorship care (52%). Most students (87%) have not attended a tumor board during medical school. In clinical vignettes, students performed worst on long-term chemotherapy toxicities, and best on surgical oncology risk. Overall, students indicated being “moderately comfortable” with topics in medical, radiation, surgical, and palliative care on a Likert scale, and “somewhat comfortable” with survivorship care. Conclusions: Although students in Nigeria report learning about disciplines in oncology care, they report varying comfort levels with specific oncology topics by the end of medical school. The results of this pilot study support the need to develop an interdisciplinary oncology curriculum in Nigeria.
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Egwuchim, K., and A. Nzelu. "Establishment of Structured Preventive Mobile Cancer Care in Nigeria: A Success Story." Journal of Global Oncology 4, Supplement 2 (2018): 188s. http://dx.doi.org/10.1200/jgo.18.32600.
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Background and context: Mass medical mission is a nonprofit, public health charity aimed at complementing the effort of government in improving the health indices of Nigerians. Its core initiative is the National Cancer Prevention Program (NCPP), a foremost effort toward national cancer control in Nigeria. In 2007, NCPP spearheaded community-based mass cervical cancer screening in Nigeria, initially known as National Cervical Cancer Prevention Program (NCCPP). This effort has contributed to a 15% reduction of cervical cancer mortality in Nigeria, from 9659 deaths to 8240 deaths, between 2008 and 2012 (GLOBOCAN data). The improvement in cervical cancer survivorship in Nigeria was proof positive that winning the fight against cancer was possible if the effort could be scaled up. Consequently, mass medical mission escalated its advocacy drive, which was tagged the Big War Against Cancer in Nigeria. Aim: The short-term goal was to raise funds toward the provision one Mobile Cancer Centres (MCC) for each state and a Comprehensive Cancer Centre for each of the six geopolitical zones in the long-term. Strategy/Tactics: Mass medical mission initiated the establishment of a fundraising platform known as the Committee Encouraging Corporate Philanthropy (CECP-Nigeria). A private sector led initiative to promote concerted and synergistic philanthropy for the common good through public-social-private partnership. The President of Nigeria is the grand patron while the Vice President, the National Patron. Returns: Through this effort, four of the pilot set of MCC (known as PinkCruise) are now in Nigeria, one of which was donated by the Lagos State Governor. The fixed centers from which the PinkCruise operate have also been set up in four selected cities representing the four old regions of Nigeria. These mobile units are unique as they are multifunctional with state-of-the-art facilities for screening, follow-up and treatment (including mammography, endoscopy, colonoscopy, colposcopy, cryotherapy, laboratory, vaccination and surgeries for precancer and early cancer). The PinkCruise have been deployed to carry out systematic mobile health outreaches, known as Mission PinkCruise, which also have an eye-care aspect known as Mission PinkVISSION. PinkVISSION is also an initiative of mass medical mission (mmm), aimed at achieving the goals of “Vision 2020: The Right to Sight”, by incorporating preventive eye care into cancer prevention and general health promotion. The acronym, VISSION, stands for Voluntary Integrated Sight Saving Initiative Of Nigeria. Both Mission PinkCruise and Mission PinkVISSION are free of charge to the hosts and the beneficiaries. What was learned: The synergy between PinkVISSION and PinkCruise results in improved uptake, impact and cost effectiveness of both the cancer campaign and the eye campaign.
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Gonzales, Kelly L., William E. Lambert, Rongwei Fu, Michelle Jacob, and Anna K. Harding. "Perceived Racial Discrimination in Health Care, Completion of Standard Diabetes Services, and Diabetes Control Among a Sample of American Indian Women." Diabetes Educator 40, no. 6 (2014): 747–55. http://dx.doi.org/10.1177/0145721714551422.
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Purpose The purpose of this study is to examine perceived experiences of racial discrimination (perceived discrimination) in health care and its associations with completing standards of care for diabetes management and diabetes control. Methods This cross-sectional study included 200 adult American Indian (AI) women with type 2 diabetes from 4 health care facilities located on tribal reservations in the Pacific Northwest. Participants completed a survey, and medical records were abstracted. Logistic regression was completed to assess associations. Results Sixty-seven percent of AI women reported discrimination during their lifetime of health care. After adjusting for patient characteristics, perceived discrimination was significantly associated with lower rates of dental exam; checks for blood pressure, creatinine, and total cholesterol; and pneumococcal vaccination. The association between perceived discrimination and total number of diabetes services completed was not statistically significant. Perceived discrimination was associated with having A1C values above target levels for diabetes control in unadjusted and adjusted models, but no association was observed for blood pressure or total cholesterol. Conclusions In our sample of AI women with diabetes, two-thirds reported experiencing racial discrimination in their health care experience. Those reporting perceived discrimination completed fewer diabetes services and therefore may be at increased risk for comorbidities of diabetes. This finding supports the continued need for culturally responsive health care and programs of diabetes education to recognize perceived discrimination and its potential to impact success in self-management and services utilization.
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Famuyiwa, Oluwole O., and Olatunji F. Aina. "Mothers' Knowledge of Sickle-Cell Anaemia in Nigeria." International Quarterly of Community Health Education 30, no. 1 (2010): 69–80. http://dx.doi.org/10.2190/iq.30.1.f.
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The study ascertains knowledge of mothers of sufferers of sickle-cell anaemia specifically regarding aetiology of the disorder and acceptable medical care. One hundred fifty-seven mothers of children suffering from sickle-cell anaemia (HbSS) attending a haematology clinic of a general hospital in Lagos were randomly sampled and asked about the aetiology and their understanding of the rules of care using a short open-ended questionnaire. The mean age of the mothers was 37.4 and a significant majority belong to the lower socio-economic strata. Thirty-four percent reported having been informed of the hereditary basis of anaemia but 48.4% received no explanation. Doctors, nurses, and lay literature were the main sources of information on the condition, as well as its medical care. The considerable gaps in appropriate knowledge on sickle-cell anaemia in Nigeria observed indicates that adequate and properly-presented information to parents or guardians of patients should be an essential part of a comprehensive care plan.
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Nwafor, C., C. Alikor, and N. Unamba. "Medical Practitioners and their Health: Doctors’ Personal Health Care Choices in Port Harcourt, Nigeria." Journal of Advances in Medicine and Medical Research 23, no. 1 (2017): 1–6. http://dx.doi.org/10.9734/jammr/2017/33954.
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David, O. Olukanni, E. Azuh Dominic, O. Toogun Tunde, and E. Okorie Uchechukwu. "Medical waste management practices among selected health-care facilities in Nigeria: A case study." Scientific Research and Essays 9, no. 10 (2014): 431–39. http://dx.doi.org/10.5897/sre2014.5863.
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Gupta, Raju, Sonia Makhija, Shruti Sood, and Veena Devgan. "Discrimination in Seeking Medical Care for Female Child from Birth to Adolescence – A Retrospective Study." Indian Journal of Pediatrics 83, no. 5 (2015): 410–13. http://dx.doi.org/10.1007/s12098-015-1959-0.
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Thorburn, Sheryl, Jennifer Kue, Karen Levy Keon, and Patela Lo. "Medical Mistrust and Discrimination in Health Care: A Qualitative Study of Hmong Women and Men." Journal of Community Health 37, no. 4 (2011): 822–29. http://dx.doi.org/10.1007/s10900-011-9516-x.
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Soomro, Munawar Hussain. "BARRIERS TO TRANSGENDER HEALTH CARE IN PAKISTAN." Gomal Journal of Medical Sciences 16, no. 2 (2018): 33–34. http://dx.doi.org/10.46903/gjms/16.02.1869.
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he term “transgender” refers to a spectrum of individuals who express gender in ways that deviate from the gender binary. It includes transsexuals, crossdressers and others.1,2 In Pakistan, the state of being a transgender presents a serious challenge to the traditionally established binary systems of nature/culture, man/woman, masculinity/ femininity and sex/gender. Even transgender community were given their identity as citizens of Pakistan in year 2009.3 Whereas the transgender persons suffer significant health disparities.4,5 Real or perceived stigma and discrimination within biomedicine and the health care provision in general may impact transgender people’s desire and ability to access appropriate care. The situation of the community is worse because they are left ignored and isolated without the survival facilities, education, employment opportunities, identity crisis or even the conformity from the dominant social class.3 National health services of Pakistan should include rigorous determination in the health care system to provide adequate care for transgender in the country. There is need to know the mechanism through the knowledge and biases of medical work force across the spectrum of medical training with regard to transgender health care. With these studies we can validate and propose potential solutions to address the identified gaps. Whereas the situation in other developing countries including those belonging to African and Asian regions is not good. In developed countries the situation is found to be much better. However, reported data shows that transgender people even in developed world face various kinds of discrimination especially in health care situations. The federal government of USA does not have laws specifically for protecting transgender people from discrimination in employment, housing, healthcare, and adoption. U.S. President Barack Obama had issued an executive order prohibiting discrimination against transgender people in employment by the federal government and its contractors. While in Pakistan there was no specific law for the transgender, however, a Senate committee had approved a bill in December 2017 for full legal protection to transgender people. It will provide a relief to transgender people for their health care and other facilities. Further, National Assembly of Pakistan approved the final Bill as Act called the Transgender Person (Protection of Rights) Act, 2018 on 18 May 2018.6 There is need to assess the perceptions and knowledge of the heath care provider workforce to provide medical care to transgender. Barriers may include fear of stigma associated with providing transgender medical care. Barriers may also include bias in the structure of clinics, forms, and electronic medical record systems in addition to gaps in knowledge and bias among support staff. Identification of solutions to the gaps is needed, which are not solely a lack of knowledge. The degree to which third party payer policy impedes access needs to be determined. Determination of change needed to overcome the financial barrier to care is also required. It is necessary to evaluate other barriers including societal stigma, mental health issue among patients, and socioeconomic issues. Finally evaluation of strategies to overcome these barriers is a must to address the matter.
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Umegbolu, Chinwe Stella. "Access to Justice for People with Disability in Nigeria: Therapeutic Day Care Centre (TDCC) as a Case Study." ATHENS JOURNAL OF LAW 7, no. 2 (2021): 265–78. http://dx.doi.org/10.30958/ajl.7-2-8.
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Access to justice through the court system for non-disabled persons is trampled upon every day in Nigeria. One can then imagine the plight of the disabled persons most of whom live in abject poverty and constant discrimination from their respective families, religious congregation, educational sectors, Judicial practices and the ineffectiveness of the government policies, which clearly plummeted people’s confidence in the social justice system as well as the entire political structure. Against this backdrop, this study presents the findings of the analyses of these discriminations and Injustices; stemming from basic amenities to prevailing cultural vices, religious practices and lack of commitment on the part of the government. To attend and implement the needs of the disabled persons, which are hindrances to access to justice for the disabled persons in Nigeria. Thus this writer used Therapeutic Day Care Centre (TDCC) as a case study by interviewing the people that work with them as well as primary and secondary data. The conclusion points to the needs of these ‘special’ groups or disabled persons that were explicitly listed herein to be strictly adhered and for the Nigeria Bar Association (NBA) to take a proactive stand to redress the lawful inadequacies so as to enhance their access to justice. Keywords: Alternative Dispute Resolution; Multi-door courthouse; Litigation; Access to Justice; Disabled Person; Therapeutic; Human rights.
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Chikamoto, Yosuke, and Dara Vazin. "College Students’ Perceptions Regarding Medical Waivers for Wellness Incentives Under the Affordable Care Act." Californian Journal of Health Promotion 14, no. 3 (2016): 58–63. http://dx.doi.org/10.32398/cjhp.v14i3.2068.
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Background and Purpose: The use of health-contingent financial incentives in promoting employee wellness is controversial because of potential discrimination against those who could not reach certain health goals due to health factors. To protect consumers from such discrimination, the Affordable Care Act (ACA) requests protective mechanisms; however clear and detailed guidelines for the medical waivers have yet to be developed. This study aimed to identify college students’ opinions about employee wellness programs where monetary incentives are given for those whose Body Mass Index falls into the normal range with particular attention to medical waivers. Methods: A cross-sectional survey study was conducted with participants consisting of a convenience sample of 58 college students in California. Results: Some scenarios were considered more legitimate for waivers than others (pregnancy, 67.3%; chronic back pain; 43.1%; broken leg, 38%; and steroid use; 34.5%). The non-medical reason of "trying to lose weight" was also considered legitimate by 21% of respondents. Responses varied by participants’ gender and their own weight status. Conclusion: College students did not view all scenarios as legitimate reasons for medical waivers. These findings call for physicians to develop a list of legitimate reasons for medical waivers, and for physician preparedness in discussing these issues with patients.
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Ekechi, Felix K. "The Medical Factor in Christian Conversion in Africa: Observations from Southeastern Nigeria." Missiology: An International Review 21, no. 3 (1993): 289–309. http://dx.doi.org/10.1177/009182969302100302.
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This article discusses missionary recruitment strategies from the perspective of missionary medical work in southeastern Nigeria. In other words, it examines missionary use of medical services as the bait to catch converts. Furthermore, the essay discusses the link between disease, missionary medicine, and Christian conversion. Attention is given to the role of culture in the conversion process, as well as to the impact of missionary and colonial medical services on African health care systems. The study is based largely on archival mission sources, including Catholic and Protestant archival materials collected from missionary societies in England, France, Rome, and Nigeria. Finally, it looks at the Catholic and Protestant struggle for dominance via the provision of medical services, and the persistence of traditional African health care systems despite missionary and colonial iconoclastic tendencies.
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Mathew, Satheesh. "The Invisible Culture of Discrimination." Timeless Mahatma 12, no. 1 (2019): 23–24. http://dx.doi.org/10.38192/12.1.13.
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A recent ITV news item featured Radhakrishna Shanbag, a senior surgeon with over 20 years of service in the NHS, being asked, ‘Please can I have a white doctor for my operation?’, by one his patient’s 1 . Any form of racism is both painful and upsetting, however to a dedicated professional it throws a much greater challenge. To remain professional, composed and objective in the face of adversity, is ingrained in medical training. One is also expected to provide the very best of care ‘free from all bias’ at all times to all comers. As in this case, professionals have no choice but to swallow the insults and provide alternatives to get the best possible outcome, suppressing the impact on self-worth and devastating emotional trauma.
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Bolanle, Folami Ahmadu, and Musolihu Majeed Olayori. "Discrimination against Religious Minorities in Nigeria: An Analysis with Reference to Human Development in the 21st Century." Al-Milal: Journal of Religion and Thought 2, no. 2 (2020): 110–28. http://dx.doi.org/10.46600/almilal.v2i2.89.
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This study examines religious discrimination against religious minorities like Muslims living in Christian populated areas in the south east, Christians are as well living in Muslim dominated areas. Minority Traditional worshippers in either Muslim or Christian majority areas, private institution, companies owned by Christians or Muslims etc. The discrimination against religious minorities has mitigated the peaceful co-existence among religious identities and other major life events which has culminated national development in all spheres of human engagement such as economic, social, political, security, etc. The researchers have tried to provide an analytical study of the empirical data as well as of the existing literature. The result of our findings shows that many religious identities have been denied of securing job opportunities, professing religion of their choice, finding it difficult to receive health care services, managing religious institutions, denied of equal rights of citizens, get political appointments, among others. The study recommends that people of different religions should embrace and tolerate one another, avoid the use of fanaticism, allow religious minorities to practice religion of their choice in order to dislodge prejudices from the society.
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Okpala, Pat U., Rebecca Uwak, Ada C. Nwaneri, et al. "Nurses’ knowledge and attitude to the care of HIV/AIDS patients in South East, Nigeria." International Journal Of Community Medicine And Public Health 4, no. 2 (2017): 547. http://dx.doi.org/10.18203/2394-6040.ijcmph20170289.
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Background: HIV/AIDS pandemic has brought huge demands on the healthcare workforce worldwide. Nurses play a critical role in caring for persons living with HIV/AIDS (PLWHA). Inadequate care and discrimination due to negative attitudes of nurses caring for persons living with HIV/AIDS will not only affect the patients, but will adversely affect the fight to halt the pandemic. The objective of this study was to determine nurses’ knowledge and attitude to the care of HIV/AIDS patients in South East, Nigeria.Methods:Descriptive survey design, with the aid of five-point Likert questionnaire administered on 240 nurses caring for PLWHA in University of Nigeria Teaching Hospital Enugu, Nigeria was used.Results: Majority of the respondents had good knowledge of HIV/AIDS. There were significant relationships between the age (P<0.05), marital status (P<0.05), professional cadre of the respondents (P<0.05) and their level of knowledge. 227 (94.6%) of the respondents had positive attitude towards the care of PLWHA. Factors that negatively influenced nurses’ attitude in caring for PLWHA include fear of contagion 56 (82.4%), social stigma 10 (14.7%), culture/religion 6 (8.8%). There were significant relationships between the professional cadre of nurses (P<0.05), knowledge about HIV/AIDS (P<0.05) and their attitude towards the care of HIV/AIDS patients.However, there were no significant relationships between the nurses' marital status (P>0.05), religion, (P>0.05) and their attitude towards the care of HIV/AIDS patients.Conclusions:The study suggested the need for more in-service trainings on HIV/AIDS for nurses to improve nurses’ knowledge and positive attitude towards the care of PLWHA.
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Jinabhai, Champak C., Hoosen M. Coovadia, and Salim S. Abdool-Karim. "Socio-Medical Indicators of Health in South Africa." International Journal of Health Services 16, no. 1 (1986): 163–78. http://dx.doi.org/10.2190/jtnm-2d1h-8tk8-63dv.
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Socio-medical indicators developed by WHO for monitoring progress towards Health-for-All have been adapted to reveal, clearly and objectively, the devastating impact of state planning based on an outmoded immoral and unscientific philosophy of race superiority in South Africa on the health of the disenfranchised majority within the context of social and economic discrimination; Health policy indicators confirm that the government is committed to three options (Bantustans, A New Constitution, and A Health Services Facilities Plan) all of which are inconsistent with the attainment of Health-for-All; Social and economic indicators reveal gross disparities between African, Coloured, Indian, and White living and working conditions; Provision of health care indicators show the overwhelming dominance of high technology curative medical care consuming about 97 percent of the health budget with only minor shifts towards community-based comprehensive care; and Health status indicators illustrate the close nexus between privilege, dispossession and disease with Whites falling prey to health problems related to affluence and lifestyle, while Africans, Coloureds, and Indians suffer from disease due to poverty. All four categories of the indicator system reveal discrepancies which exist between Black and White, rich and poor, urban and rural. To achieve the social goal of Health-for-All requires a greater measure of political commitment from the state. We conclude that it is debatable whether a system which maintains race discrimination and exploitation can in fact be adapted to provide Health-for-All.
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Tsang, Eileen Yuk-ha. "Gay Sex Workers in China’s Medical Care System: The Queer Body with Necropolitics and Stigma." International Journal of Environmental Research and Public Health 17, no. 21 (2020): 8188. http://dx.doi.org/10.3390/ijerph17218188.
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The struggles of China’s gay sex workers—men who sell sex to other men—illustrate how the multi-layered stigma that they experience acts as a form of necropolitical power and an instrument of the state’s discrimination against gay sex workers who are living with HIV. One unintended side effect of this state power is the subsequent reluctance by medical professionals to care for gay sex workers who are living with HIV, and discrimination from Chinese government officers. Data obtained from 28 gay sex workers who are living with HIV provide evidence that the necropower of stigma is routinely exercised upon the bodies of gay sex workers. This article examines how the necropolitics of social death and state-sanctioned stigma are manifested throughout China’s health system, discouraging gay sex workers from receiving health care. This process uses biopolitical surveillance measures as most of gay sex workers come from rural China and do not enjoy urban hukou, thus are excluded from the medical health care system in urban China. Public health priorities demand that the cultured scripts of gendered Chinese citizenship must reevaluate the marking of the body of gay sex workers as a non-entity, a non-human and socially “dead body.”
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Wervers, Kim, Jolanda J. Luime, Ilja Tchetverikov, et al. "Comparison of disease activity measures in early psoriatic arthritis in usual care." Rheumatology 58, no. 12 (2019): 2251–59. http://dx.doi.org/10.1093/rheumatology/kez215.
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Abstract Objectives To compare responsiveness and longitudinal validity of Disease Activity Score 28 (DAS28), Disease Activity index for PSoriatic Arthritis (DAPSA), Composite Psoriatic Disease Activity Index (CPDAI), Psoriatic ArthritiS Disease Activity Score (PASDAS), GRAppa Composite scorE (GRACE) and Minimal Disease Activity (MDA) in usual care PsA patients, within 1 year after diagnosis. Methods Data collected in the Dutch southwest early PsA cohort (DEPAR) were used. Responsiveness was assessed using effect size (ES), standardized response mean (SRM), and discrimination between different general health states. Longitudinal validity was tested using mixed models with outcomes health-related quality of life (HRQOL), productivity and disability. Results Responsiveness was highest for PASDAS, with ES 1.00 and SRM 0.95, lowest for DAPSA, with ES 0.73 and SRM 0.71, and in between for DAS28, CPDAI and GRACE. Differences in general health were best discriminated with PASDAS and GRACE. Patients reporting stable or worsening general health could not be distinguished by DAS28 or CPDAI. Discrimination was better using DAPSA, but worse than when using PASDAS and GRACE. Longitudinal evolvement of HRQOL and productivity had the highest association with low disease activity according to GRACE, followed by PASDAS, MDA, DAPSA, DAS28, with the lowest association for CPDAI. Conclusion PASDAS and GRACE were superior with respect to responsiveness, and together with MDA best related to longitudinal evolvement of HRQOL, productivity and disability. Responsiveness and longitudinal validity of most outcomes were inferior for DAS28, DAPSA and CPDAI. As alternatives to the continuous measure DAPSA, use of PASDAS or GRACE should be considered.
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Nnadi, DanielChukwunyere, and Swati Singh. "Knowledge of palliative care among medical interns in a tertiary health institution in Northwestern Nigeria." Indian Journal of Palliative Care 22, no. 3 (2016): 343. http://dx.doi.org/10.4103/0973-1075.185080.
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