Qualitative investigation of barriers to accessing care by people who inject drugs in Saskatoon, Canada: perspectives of service providers

Katherine Lang,Judith Wright,Shawna Berenbaum,Anas El-Aneed,Colleen Anne Dell,Jaycie Neil

doi:10.1186/1747-597x-8-35

Abstract

BackgroundPeople who inject drugs (PWID) often encounter barriers when attempting to access health care and social services. In our previous study conducted to identify barriers to accessing care from the perspective of PWIDs in Saskatoon, Canada: poverty, lack of personal support, discrimination, and poor knowledge and coordination of service providers among other key barriers were identified. The purpose of the present investigation was to explore what service providers perceive to be the greatest barriers for PWIDs to receive optimal care. This study is an exploratory investigation with a purpose to enrich the literature and to guide community action.MethodsData were collected through focus groups with service providers in Saskatoon. Four focus groups were held with a total of 27 service providers. Data were transcribed and qualitative analysis was performed. As a result, concepts were identified and combined into major themes.ResultsFour barriers to care were identified by service providers: inefficient use of resources, stigma and discrimination, inadequate education and the unique and demanding nature of PWIDs. Participants also identified many successful services.ConclusionThe results from this investigation suggest poor utilization of resources, lack of continuing education of health care providers on addictions and coping skills with such demanding population, and social stigma and disparity. We recommend improvements in resource utilization through, for example, case management. In addition, sensitivity training and more comprehensive service centers designed to meet PWID’s complex needs may improve care. However, community-wide commitment to addressing injection drug issues will also be required for lasting solutions.

Highlights

People who inject drugs (PWID) often encounter barriers when attempting to access health care and social services
Discriminatory attitudes are prevalent among service providers and can be due to difficult behaviours exhibited by PWIDs
In this study we examined the opinions of service providers regarding barriers for PWIDs to access care

Summary

Introduction

People who inject drugs (PWID) often encounter barriers when attempting to access health care and social services. In our previous study conducted to identify barriers to accessing care from the perspective of PWIDs in Saskatoon, Canada: poverty, lack of personal support, discrimination, and poor knowledge and coordination of service providers among other key barriers were identified. People who inject drugs (PWIDs) experience excess mortality when compared to the general population, [1,2] and are at risk of developing serious health conditions such as blood-borne disease, psychiatric illness, bacterial infections, and overdose [3,4]. PWIDs do not seek care as often as people who do not inject drugs [5,6,7]. These include limited programs and services, poor access to services and extensive paperwork [10,24,27]

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Conclusion