Access To Health Care Services Research Articles

Promoting Equity: Child & Adolescent Health Service

Abstract The health and well-being of children and adolescents face significant challenges, particularly in times of social instability. In response to these challenges, the Norwegian government allocated funding in 2021 to establish a national center for Child and Adolescent Health Promotion Services. Situated within the Norwegian Institute of Public Health, this center focuses on enhancing expertise, professional development, and research within municipal maternity and child health clinics, school health services, and youth health clinics. This presentation delves into the crucial role of Universal Health Promoting Services (UHPS) in mitigating the adverse effects of social inequality on child and adolescent health. By leveraging evidence-based practices and identifying knowledge gaps in health promotion and disease prevention in primary care settings, UHPS serve as catalysts for reducing health disparities and enhancing outcomes among expecting parents, children, and adolescents. Moreover, UHPS plays a vital role in addressing the underlying determinants of health inequality, including social network, lifestyle factors, promotion of health literacy and ensuring accessible health care services for all. UHPS empowers individuals and communities to actively participate in health promotion efforts, fostering a culture of health equity and resilience. Through targeted health education programs, early intervention strategies, and community empowerment initiatives the UHPS work both at a systems and individual level to address social inequality in health. This presentation contextualizes UHPS within a broader picture aimed at promoting child and adolescent health while addressing social inequality in health. By highlighting effective approaches and areas requiring further research, it aims to contribute to the ongoing discourse on optimizing health outcomes for young populations.

8.D. Scientific session: Equitable Immunization: Leveraging Prisons for Vaccination Equity in Europe

Abstract Addressing low vaccine coverage is a pressing public health concern in Europe, where pockets of unvaccinated individuals persist despite ongoing efforts. The European region sees an estimated 1.4 million individuals detained on any given day, with a significantly higher number passing through prisons annually due to high turnover rates. Those experiencing incarceration often come from socially marginalized and disadvantaged groups, facing a multitude of health challenges including non-communicable diseases, infectious diseases, mental illness, cognitive disabilities, and substance dependence. Despite their elevated health needs, individuals in prison frequently encounter barriers to accessing healthcare services, including preventive measures such as vaccination. Available but limited data suggest that individuals entering the prison system are often under-immunized, particularly against Hepatitis B Virus (HBV), influenza, measles, mumps, rubella (MMR), and pneumococci. Unfortunately, vaccination services within prisons are often insufficient, typically being provided according to national schedules or in response to outbreaks of vaccine-preventable diseases (VPDs). It’s crucial to distinguish between the availability of vaccination services and actual coverage, as the modalities of vaccination offerings vary across the region. While individuals in prison are recognized as a target group for HBV vaccination, the methods of offering vaccines may differ based on factors such as age or risk group. Nevertheless, systematic implementation of HBV vaccination in prisons has shown clear benefits for both incarcerated individuals and the wider community. Given the significance of vaccinations in preventing diseases like HBV and human papillomavirus (HPV), which are linked to cancer, initiatives like the Europe Beating Cancer Plan and the European Council Recommendation on vaccine-preventable cancer emphasize their importance. Prisons can serve as a strategic point for delivering comprehensive healthcare and vaccination services to incarcerated individuals, yet routine data on vaccination coverage at entry and uptake during incarceration are often lacking, hindering effective health planning. To address this public health challenge, the ‘Reaching the hard-to-reach: Increasing access and vaccine uptake among prison population in Europe’ (RISE-Vac) project consortium has been formed. This collaborative effort brings together diverse expertise and established networks in the field of prison health, reflecting the varied epidemiological and structural landscapes across Europe. The objective of this workshop is to showcase recent research findings, evidence-based practices, and policy recommendations aimed at enhancing vaccination equity in the European region. By sharing insights and best practices, we aim to bolster efforts to improve vaccine access and uptake among incarcerated populations, ultimately contributing to broader public health goals. Key messages • Prison health is public health: vaccination services in prison are essential to achieve immunization targets in Europe. • Maximizing inter-sectoral collaboration is crucial for bridging the gap in vaccination access and uptake among people living in prison in Europe.

Perspectives of care providers on obstacles to healthcare access for people with disabilities in Ethiopia: a qualitative investigation

BackgroundDespite having similar healthcare needs to non-disabled individuals, people with disabilities in Ethiopia face significant challenges accessing healthcare services due to existing barriers. This study aimed to explore these barriers from the perspectives of care providers in primary healthcare facilities.MethodsQualitative research was conducted with care providers in Dire Dawa to identify barriers to healthcare access for people with disabilities. Thematic analysis was used to categorize data into themes.ResultsEight healthcare providers from four service departments participated in eight in-depth interviews and two focus groups. Six themes emerged: physical barriers, financial difficulties, non-accommodating diagnostic facilities, care providers’ attitudes and capacity, communication barriers, and lack of access to health information. Non-confidential and non-dignified care was also identified as a barrier.ConclusionThe study highlights important barriers that prevent people with disabilities from accessing primary healthcare services. Addressing these barriers is crucial for achieving disability-inclusive healthcare services. This research can serve as a starting point for further work in this area to promote equitable healthcare for people with disabilities.

Barriers and facilitators to healthcare services of people with mental ill-health in Europe

Abstract Background People with mental ill-health (PMIH) have higher cancer mortality rates than the general population. Barriers to healthcare service access may be a contributing factor. The EU-funded CO-CAPTAIN project aims to reduce health inequalities by improving overall health and reducing cancer burden by adapting and implementing the Patient Navigation (PN) Model targeted at PMIH. This qualitative study explored healthcare system experiences of PMIH in Austria, Greece, Poland, and Spain. Methods Eighty-one participants (22-76 years old), including 34 PMIH, 10 caregivers, 14 care team members, 12 mental health organization representatives, and 11 service manager representatives, were recruited. Semi-structured interviews focused on awareness of cancer risk factors, healthcare system experiences, and perspectives on PN as an intervention. Interviews were transcribed verbatim and analyzed using thematic analysis. Results Three major themes emerged: (1) somatic health relevance and preventive services utilization and (2) barriers / (3) facilitators to preventive services access. Knowledge of cancer prevention services varied greatly. Participants were aware of associations between risky health behaviors and health. Burden of mental health problems and discrimination, insufficient access to information, and lack of service flexibility were noted as barriers. Considerations of individual circumstances, social support, and empowerment were named as facilitators. Conclusions Tailored interventions involving healthcare professionals and PMIH in development of supportive environments and health literacy have the potential of overcoming identified barriers to the use of healthcare services. Key messages • People experiencing mental ill-health are faced with significant structural barriers when accessing somatic health services. • Understanding people’s needs in terms of access and utilization of health care allows us to define guidelines for future personalized healthcare solutions.

Utilizing laser therapy to manage oral potentially malignant disorders in older adults at the primary care level.

Oral lesions are a significant concern among older adults because they can progress to oral cancer if not diagnosed and treated promptly and effectively. Transportation to the hospital is a major barrier to oral healthcare for many older adults. The purpose of this editorial is to address the challenges of managing oral potentially malignant disorders in the older population, highlighting the barriers they face in accessing healthcare services, the potential use of laser therapy for management, and the direction of research in this area. Due to the limited access of the older to healthcare services, primary healthcare facilities within communities serve as their primary providers. Laser therapy is recommended for the management of oral potentially malignant disorders due to its favorable outcomes. This approach has been tested in several primary healthcare centers in Thailand. In our project, laser therapy was used to treat oral potentially malignant disorders in primary and secondary healthcare services. This includes photodynamic therapy for older patients with extensive lesions, as well as individuals with oral leukoplakia and erythroplakia who have declined curative surgery. It has also been used in cases of recalcitrant lichen planus to steroid or photobiomodulation therapy. This approach has been well accepted by both oral healthcare providers and patients. To expand access to these treatment options in such settings, it is critical to empower healthcare professionals, particularly dentists and dental nurses, to integrate laser techniques into geriatric care and oral cancer screening. Establishing a network foundation for orofacial laserology would also enhance the potential of such settings.

Older people’s challenges accessing health services in central Nepal: a qualitative study using the domain of access framework

BackgroundLow- and middle-income countries face rapid population aging. However, the health system has remained largely unprepared to deliver health services to an aging population. As the population is rapidly aging in Nepal, their challenges and experience should be the focus for health care providers to address these issues. There is a paucity of evidence on barriers and facilitators to accessing health care services among older people in Nepal. The aim of this study was to investigate the challenges that older people experience while accessing health services in central Nepal.MethodsThis qualitative study was conducted between April and June 2023. In-depth interviews were conducted among older people of a municipality in central Nepal, which were analysed thematically using a deductive-inductive approach based on the theory of access.ResultsHypertension and diabetes were the most common health problems among the participants. The affordability of health services was a major issue, although there is a health insurance scheme and a major focus on universal health coverage from the Government of Nepal. Other issues included poor acceptability, poor communication between older people and health staff, and poor accommodation due to a lack of elderly-friendly services, including long wait times in the clinic. Living with family was a major facilitator of access to health care services and was interrelated with multiple domains of access.ConclusionsThis study identified barriers to accessing health care services for older adults in Nepal. We found that the affordability of health services, poor acceptability, poor communication between older people and doctors, and a lack of elderly-friendly services are the key challenges experienced by older people. Older people felt that these barriers were easier to overcome when they had family support. Therefore, for those living with their children, family support was reported as the major facilitator.

The nexus between maternal antenatal care attendance, newborn postnatal care and neonatal mortality in India: a matched case-control study

IntroductionOur study examines the relationship between newborn postnatal care and neonatal mortality stratified by maternal antenatal care attendance under a matched case-control framework.MethodsData from the fifth round of the National Family Health Survey was used. A total of 172,079 recent births to eligible women (15–49 years) in five years preceding the survey were included in the study. We used the conditional logistic regression model, a commonly used regression model to fit matched case-control data to examine the effects of newborn postnatal care on neonatal mortality. The mother’s age at birth of the newborn, previous birth intervals, birth order of the newborn, and birthsize of the newborn were included as the matching variables.ResultsNewborns receiving postnatal care within two days or more than two days of birth are less likely to die during the neonatal period. Preferences for newborn postnatal care were also observed to increase with more maternal antenatal care visits. Our study also found a lower risk of neonatal mortality among those newborns whose umbilical cord was examined within two days of birth, regardless of the number of maternal antenatal care visits. Similarly, the risk of newborn deaths was lower among babies whose body temperature was measured within two days of birth. The tendency to breastfeed their newborns within an hour after delivery was considerably higher among those births that occurred to mothers who had a higher number of maternal antenatal care visits. The risk of newborn deaths was also observed to be lower among those born in public or private healthcare facilities.ConclusionConsidering the cohesive nature of the relationship between neonatal mortality and maternal and child healthcare utilisation, strategic planning and management of the existing policies and programmes related to accessibility, availability, and affordability of maternal and child healthcare services is needed to achieve goal 3.2 of the Sustainable Development Goals. Promoting cost-effective measures such as continuous monitoring of the baby’s body temperature and umbilical cord care could also effectively help reduce neonatal mortality.

Elderly Care Provision under National Policy on Older Persons 2013: A Cross-Sectional Study in Dhaka City, Bangladesh

Bangladesh is undergoing a notable demographic transition, characterized by a substantial rise in the proportion of elderly individuals within its population. This demographic transition presents a range of economic, social and cultural issues that necessitate prompt attention and intervention. The aim of this study was to examine the current state of elderly care services and facilities available for older adults in urban landscape by taking into account the ‘National Policy on Older Persons 2013.’ This study was conducted in Dhaka city by employing a cross-sectional study design. The study population covers elderly people aged 60+ years, living in Dhaka City for more than five years continuously and are able to speak well with someone. The study was based on a sample of 240 and the respondents were chosen using convenient sampling technique. The data were collected through face-to-face interview using structured questionnaire and they were analyzed utilizing descriptive statistics. This study found that the existing elderly care services and available opportunities are below the satisfactory level for most of the older adults of the city, even though the ‘National Policy on Older Persons 2013’ was adopted a decade ago. The elderly people in Dhaka city encountered a number of difficulties considering their physical health, psychological and social well-being. In the case of availability of the affordable and quality healthcare services for older adults in their community, 30.4% of the respondents said that the availability, accessibility and affordability of quality healthcare services are very poor, followed by 24.6% below average and 26.3% at the average level. Nearly 75% of the study people said that they had ever experienced unfair treatment for being aged. Indeed, they receive care and support in an inconsistent, disorganized and incoherent manner. The study clearly revealed that there is a need to prioritize person-centered care as well as integrated care system for the effective management of the ageing population in Bangladesh. Jagannath University Journal of Science, Volume 11, Number 1, June 2024, pp. 118−134

Uptake of cash benefits among children with a disability in Norway: The role of parental socioeconomic characteristics and immigrant background

AbstractCaring for a disabled child involves both indirect and direct economic costs, which in turn may create a financial burden for the family. Using Norway as a case, we examine if public compensatory measures reach those most in need, by assessing whether socioeconomic disadvantages and immigrant background impact adversely on the uptake of a nationally available cash benefits eligible for parents caring for a child with a disability. We take advantage of national administrative register data on children with a selection of well‐defined diagnoses born between 2009 and 2017 (N = 14,469). Our results show nonnegligible, but relatively minor, social inequalities in the uptake of cash benefits related to socioeconomic and immigrant background. Our findings indicate that this state's financial support seems to reach those most in need. However, it is essential to deepen our understanding of how socioeconomic and immigrant backgrounds influence access to and utilization of municipal healthcare services. Notably, the application process for these services often involves a greater degree of discretion on the part of welfare professionals. Further research is needed to illuminate the nuanced dynamics of these factors in the context of accessing healthcare services at the local level.

Experiences of Sexual and Gender Minorities with Health Care in the Philippines: A Qualitative Study.

There is limited availability and accessibility of health care facilities and services tailored to the specific health care needs of sexual and gender minorities (SGMs) in the Philippines. The purpose of this study was to describe SGMs' experiences with health care services in the Philippines. Using a phenomenological design, interviews were conducted with participants recruited online through SGM networks and organizations. Individual, online-recorded interviews were conducted with 14 participants who were at least 18 years old, were Filipino nationals residing in the Philippines, self-identified as SGM, could comprehend and write in Filipino, and received any health care service within the past year. Data were entered and analyzed using the NVivo software. Three major themes emerged: patient-centered communication and relationship, holistic care, and caring environment. Participants identified the significance of genuine, affirming, and respectful communication in building positive relationships and continuing engagement with health care. Holistic care is embedded in clinical competence, gender sensitivity, continuity of care, and collaborative practice with other disciplines. A caring environment minimizes gender-related stigma and discrimination and promotes acceptance of diverse sexual identities. Filipino SGMs face several multifaceted health care concerns and challenges stemming at the individual, institutional, and societal levels. Sexual and gender biases, stigma, and discrimination are major barriers to health care among SGMs. Promotion of culturally and gender-sensitive care among Filipino SGMs should involve training of health care providers and creation of programs and policies to understand and respect SGMs while considering social, cultural, and political influences on their health and well-being.

Disease Prediction and Drug Recommendation Using ML

In today's dynamic healthcare landscape, the integration of technology has become indispensable. The project sets out to create a cutting-edge healthcare solution that will transform the very foundations of healthcare decision-making by utilizing the powerful powers of machine learning. The main objective of this project is to develop a dual-dashboard system that will serve both patients and medical staff. The main objective is to reduce the gap between patients and healthcare professionals, which has existed for a long time. It makes it possible for people to receive highly personalized health assessments, enables efficient appointment scheduling, and provides doctors with recommendations for data-driven treatments. Ultimately, this project aims to profoundly impact the accessibility and quality of healthcare services. It seeks to enhance the patient experience, augment the precision of medical decision-making, and foster seamless collaboration between individuals and their healthcare providers.

Spatiotemporal evolution and development path of healthcare services supply in China

ObjectPromoting the accessibility and equity of healthcare services, as well as enhancing service capacity, are crucial for building a sound healthcare system. Particularly in the past two years of the normalized COVID-19 situation, this issue has garnered widespread attention in the academic community. This study aims to investigate and analyze the characteristics and trends of the spatial-temporal evolution of healthcare service supply levels in China. It also seeks to explore the influencing factors and pathways for development, with the goal of optimizing the allocation of healthcare resources.MethodsThis article uses the entropy weight TOPSIS method combined with Dagum Gini coefficient and Kernel density to evaluate the supply level of healthcare services in 31 provinces and cities in China from 2012 to 2020, and explores its development and spatial pattern characteristics. Then, through Moran index, panel regression model and spatial econometric testing, the spatial correlation problem and its influencing factors are further analyzed, and targeted policy recommendations are proposed based on it, laying the foundation for further promoting the balanced development of healthcare service supply capacity.Results(1) Healthcare services supply levels in various provinces and cities in China have significantly increased, with a shift in spatial distribution from ‘higher in the east and lower in the west’ to ‘convergence between east and west, with lower levels in the central regions.’ (2) Relative differences among regions are narrowing annually, primarily due to interactions between the four regions rather than within each region, with expanding impact of overlapping regions. (3) Absolute differences among regions are also decreasing, moving towards uniformity with a contraction of extension and a restraint on the trend towards multipolarization. (4) Spatial correlation between adjacent regions is weakening, eventually becoming non-significant, with fading spatial effects. (5) The correlation between local economic development, population factors, institutional arrangements, and the current state of supply is significant, and the research design and conclusions remain robust even after thorough consideration of spatial effects. The study explores the development pathways based on the objective existence of regional development and the controllable government actions.ConclusionThe overall level of healthcare service supply in China has improved, but regional differences still exist. The objective level of regional development and the subjective behavior of local governments have a significant impact on the supply of healthcare services. Therefore, it is recommended that each region adapt to local conditions, identify its own strengths and weaknesses, coordinate resource supply and demand, consider the impact of key factors, and optimize the allocation of healthcare development resources.

Using the theoretical domains framework to identify the sociocultural barriers and enablers to access and use of primary and maternal healthcare services by rural Bangladeshi women: a qualitative study

In Bangladesh, increasing the use of primary healthcare (PHC) and maternal healthcare (MHC) services is the main focus of achieving the United Nations Sustainable Development Goal-3, ensuring healthy lives and wellbeing for all. However, little is known about the sociocultural barriers and enablers to accessing and using PHC and MHC services among rural Bangladeshi women. This qualitative study aimed to identify sociocultural barriers and enablers to accessing and using PHC and MHC services among Bangladeshi rural women by using the Theoretical Domains Framework (TDF). This exploratory qualitative study used focus groups and interviews to collect data from women (28), their husbands (8) and healthcare providers (18). Data were analysed using Framework approach underpinned by the TDF. Four main themes emerged from data analysis, of which key barriers were summarised in three themes: (i) family barriers including lack of family reinforcement, (ii) social barriers including gender of healthcare providers, and (iii) cultural barriers including superstition to access and use of healthcare services. The remaining theme, sociocultural support, included information about key enablers, such as family support, neighbourhood connection and media influence. Several key behavioural constructs that aligned with the TDF need to be targeted when developing an intervention to promote access and use of PHC and MHC services.

Telemedicine dan Kesehatan: Memahami Dampak Teknologi Kedokteran di Era Digital dalam Konteks Ajaran Islam

In the digital era, telemedicine has revolutionized healthcare by providing faster and more accessible remote medical services. This article explores the transformative impact of this technology on the quality and accessibility of healthcare services, while also examining its compatibility with Islamic values. From an Islamic perspective, telemedicine is reviewed in relation to ethical principles such as the preservation of life, the ease of access to treatment, and respect for patient privacy. The article aims to highlight how telemedicine can serve as an innovative solution that not only supports modern healthcare advancements but also aligns with ethical guidelines within Islamic teachings. This study offers fresh insights into the opportunities and challenges of telemedicine in healthcare, particularly within Muslim communities, and its implications for ethical medical decision-making.

Comparative analysis of international and Malaysia approaches to the treatment of patients with chronic gastritis from the point of view of evidence-based medicine

Background: Chronic gastritis, often resulting from *Helicobacter pylori* infection, is a widespread gastrointestinal disorder. The condition requires evidence-based treatment approaches to ensure effective management and improved patient outcomes. This study conducts a comparative analysis of the treatment approaches for chronic gastritis in Malaysia and internationally, focusing on adherence to evidence-based medicine (EBM) practices. Understanding the similarities and differences in these approaches is critical for enhancing Malaysia's healthcare strategies. Methods and Materials: The study employed a systematic review of relevant literature sourced from global medical databases, including PubMed, Embase, and Cochrane Library. The review focused on therapeutic options, diagnostic standards, and evidence-based protocols for managing chronic gastritis, with emphasis on both international and Malaysian healthcare systems. Studies included in the review primarily focused on adult patients diagnosed with chronic gastritis and treated using evidence-based methodologies. Results: The analysis revealed significant parallels in the treatment protocols between Malaysia and international guidelines, particularly in the use of proton pump inhibitors (PPIs) and antibiotic regimens for *H. pylori* eradication. However, differences emerged in the implementation of advanced diagnostic tools, accessibility of healthcare services, and the influence of local antibiotic resistance patterns. While Malaysia follows global best practices, rural-urban healthcare disparities impact the consistency of treatment delivery and patient outcomes. Conclusion: Both international and Malaysian approaches to chronic gastritis prioritize evidence-based medicine. The findings suggest that Malaysia effectively adapts international guidelines to its local healthcare context, though improvements are needed in addressing healthcare accessibility and antibiotic resistance. Enhanced implementation of EBM practices, particularly in rural areas, and personalization of treatment based on resistance patterns, could further optimize patient outcomes in Malaysia.

Urbanization factors and the vagaries of the rural health care industry in Nigeria: an analysis of the accessibility of healthcare services by older adults in the Nsukka Local Government Area

This study sought to determine the effects of urbanization on access to healthcare services by older adults in Nsukka Local Government Area. The Nigerian healthcare industry is organized under the three tiers of government: Federal, State and Local governments. As such, most of the healthcare facilities are located in urban areas while majority of older adults reside in different local governments in rural communities where there are a few of the facilities. This has led to poor utilization of medical services by older adults in rural areas. This study adopted a mixed method approach. While questionnaire was used to collect quantitative data, interviews were used to collect qualitative data for the study. Questionnaire survey was used to collect data from 1180 older adults between the ages of 60 years and above from six communities in the study area. Descriptive statistics and Chi square were used to analyze the data while frequency distribution tables and percentages were used to present the results. The research showed that there are inadequate health facilities for the older adults in rural communities in Nsukka LGA. It also found that the older adults suffered challenges arising from lack of medical doctors, nurses, equipments, and drugs for effective healthcare delivery. It is recommended that more efforts should be geared towards providing adequate health facilities and health workers by government at public hospitals in rural communities to increase accessibility and adequate utilization by the older adults.

Air pollution, healthcare use, and inequality: Evidence from China

This study provides the first investigation into the causal distributional effects of air pollution on healthcare utilization in China. Studies have addressed the average impact of air pollution in developed countries while overlooking its distributional effects in developing nations where inequality is evident. We obtained data from the China Health and Retirement Longitudinal Study and employed wind direction as an instrumental variable. The findings indicate that air pollution significantly increased inpatient care use among individuals aged 60 and above. Moreover, the study documents significant disparities between and within urban and rural populations. The mechanism analysis indicates that accessibility of healthcare services contributes to inequality. Contributing factors include China's Hukou system, health insurance system, and the distance to hospitals in rural areas. The findings indicate that air pollution intensifies health inequality in the developing world while suggesting that policies to increase healthcare equity could generate significant welfare benefits.

Influence of Household Socio-Economic, Demographic, And Cultural Factors on Women's Access to Maternal Healthcare in Malindi Sub County, Kilifi County, Kenya

Globally, maternal healthcare access remains a critical concern due to significant disparities, particularly in developing countries where access rates are notably lower. The Sustainable Development Goals underscore the importance of prioritizing maternal health, urging nations to improve access to maternal healthcare services. However, various factors hinder full access to such services. This study investigated the influence of social and economic factors on household access to maternal healthcare in Malindi Sub County, Kilifi County. Specifically, it examined the impact of income levels, literacy rates, parental age, and religious beliefs. The study, grounded in the Behavioral Model of Healthcare Service Utilization, Maternal Morbidity Measurement (MMM), and the Three Delay Theory, employed a descriptive survey design approach. A sample size of 382 respondents was determined using the Krejcie and Morgan’s (1970) formula from a population of 73,547 households. Stratified sampling was employed to divide the sub-county into five strata based on wards, selecting households with mothers accessing maternal health services using purposive sampling. Additionally, twenty respondents were purposively chosen for key informant interviews. Because the dependent variable in the questionnaire was binary (access to maternal healthcare was either yes or no), the study used binomial logistic regression modeling to ascertain the influence of income levels, literacy levels, parental age and religious beliefs on the access to maternal healthcare. Income levels, with a coefficient of 2.236 (p-value = 0.007), literacy levels, with a coefficient of 1.981 (p-value = 0.002), and religious beliefs, with a coefficient of 1.004 (p-value = 0.037), were identified as significant factors positively influencing access to maternal healthcare. Conversely, parental age demonstrated a significant negative impact on access, with a coefficient of -1.262 (p-value = 0.004). The study concludes that socioeconomic status, education, and religious beliefs significantly influence maternal healthcare access, with a particular concern regarding diminished access as parental age increases. Consequently, this research emphasizes the critical need for targeted interventions to alleviate these disparities, recommending economic empowerment for women with lower income levels, health literacy education initiatives for vulnerable populations, and a multimodal approach to address cultural barriers and support both younger and older mothers in accessing healthcare services.

Understanding health needs of professional truck drivers to inform health services: a pre-implementation qualitative study in a Canadian Province

ObjectivesLong-haul truck drivers experience multiple challenges, including increased health risks. A large percentage of professional truck drivers (PTDs) suffer from numerous chronic physical health conditions such as obesity, hypertension, diabetes, heart disease, sleep disorders, etc.) as well as poor mental health and social challenges. Furthermore, this population experiences numerous barriers related to accessing health care services including primary care and resources to improve their health. PTDs living in rural and remote areas are at higher risk. The objective of this study is to understand the views of PTDs and the trucking industry on health and personalized healthcare interventions and services.MethodsIn-depth semi-structured interviews were conducted with twenty-six individuals with contextual knowledge and experience in the trucking ecosystem, to better understand the needs, expectations, and preferences of PTDs based in New Brunswick (Canada), related to their health (physical, mental, and social). Analysis of the audiotape recording was conducted using thematic content analysis.ResultsThree major themes emerged from the qualitative analysis describing PTDs’ health needs, existing health and preventive services, as well as recommendations for personalized healthcare interventions and services to be implemented: (1) “My life as a trucker!” Understanding needs and challenges, (2) “Taking care of myself, do you think it is easy while you’re on the road?” Describing drivers and motivators for better health, and (3) “Can you hear what we need?” Translating needs into recommendations for tailored health services and preventative services.ConclusionA highly demanding work environment and lack of timely access to integrated primary care negatively affect PTDs’ health. Results of this study shed light on how to tailor primary care to improve its responsiveness and adequacy to PTDs’ needs and realities. PTDs-sensitive integrated services, including multicomponent interventions (health education, coaching for lifestyle changes, and social support), are still lacking within the New Brunswick health system.

Facilitators and barriers of adherence to rectal interventions by parents of young children with functional constipation: a qualitative study.

Functional constipation in children is a worldwide problem that impacts both children's gastrointestinal function and the quality of family life. The treatment of this condition often depends on parental involvement to administer rectal interventions to their children to stimulate defecation. However, adherence to rectal interventions is currently suboptimal. We sought to explore the factors that facilitate and hinder parents from adherence to rectal interventions. A descriptive qualitative study was conducted involving semi-structured interviews with parents of infants and young children with functional constipation requiring rectal interventions from March to May 2023. The data were analyzed using content analysis. Fourteen parents participated in the study. Parents reported the main facilitators of adherence to prescribed rectal interventions as recognition of illness severity, support from family and friends, and medical resource support and e-health literacy. Parents reported the primary barriers as information barriers, family conflict, cognitive misalignment, and difficulties in accessing healthcare services. Rectal interventions are often essential in managing constipation in young children, with parental compliance being crucial for effective treatment. Healthcare providers must consider the psychosocial aspects of parents' perceptions, adhere to guidelines to standardize communication, and ensure comprehensive education to improve medication literacy.