Abstract
Background: Indigent selected for their health care is complex and poses enormous challenges. The actors involved have an influence on health actions and their perception is decisive for better care for the indigent. Little evidence exists on these perceptions and this paper has captured this. Methods: A case study involved 163 participants with a questionnaire and an interview guide. The quantitative responses were classified according to a measurement scale, proportions and overall indices of perception (Ip) and satisfaction (CSAT) were calculated. The relationship between variables was investigated using chi-square. Thematic analysis was used with qualitative data. The study met ethical requirements. Results: The participants had a positive perception of the selection: Ip = 0.77, but a minority (1/5) were dissatisfied with the selection. The perception of selection did not differ significantly depending on the experience of the actors. For the vast majority, the definition of indigent was satisfactory (CSAT = 91.4). The selection was done in a top down fashion and steps such as setting up committees, informing stakeholders, had shortcomings which negatively impacted the effectiveness of the selection. The needs of the participants included transparency in the indigent select process, matching the tools for selecting the indigent to the context, strengthening of local action, deconstruction of prejudices in terms of the indigent, power of actors to act, and importance for health services to reach out to the indigent. Conclusion: Considering the perception of the actors as well as their needs will improve the selection for effective care of the indigent.
Highlights
IntroductionSelection by community process is a complex intervention involving several factors such as health workers, social service staff and communities [2]
Indigent selection poses enormous challenges in the implementation of policies [1]
Level of stakeholder satisfaction with the indigent selecting process Among the health workers, 19% were completely satisfied with the selection process against 30% of the social services and community players, and 13% of the actor of the selection committees
Summary
Selection by community process is a complex intervention involving several factors such as health workers, social service staff and communities [2] The actors in their environment, decide stimuli to remember in order to distinguish, according to their values and beliefs, in their experiences what is central to what is incidental [3]. Their perception of the indigent selection is decisive for their performance in their care [5] These actors have a strong influence on community interventions as well as on health structures at the peripheral level [6]. They feel a motivation for action, when their needs are met [7] Indigent selected for their health care is complex and poses enormous challenges. Conclusion: Considering the perception of the actors as well as their needs will improve the selection for effective care of the indigent
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