Access To Quality Health Care Research Articles

A Study To Assess The Satisfaction Level Among The Beneficiaries Of Janani Shishu Suraksha Karyakram In Rural Areas Of Jabalpur District, India.

Introduction- The satisfaction derived from utilizing JSSK services underscores its pivotal role in transforming the healthcare landscape for millions of women and children in India. At its core, the program embodies the fundamental principle that every individual has the right to access quality healthcare without facing financial hardship. Objective: To find out the Satisfaction level among the beneficiaries of JSSK in Jabalpur district. Methods- It was a descriptive Cross-sectional study done in the rural areas of Jabalpur district. A sample of 385 was acquired using the formula z2pq/l2. Multistage random sampling was used for selection of study participants. House to house visit was conducted to collect data using predesigned, pretested semi-structured questionnaire regarding satisfaction on using services of JSSK and Behaviour among the support staff. Results- The present study observed that out of total more than half of the study participants were satisfied with utilization of various JSSK entitlements whereas about one third of them expressed dissatisfaction with the services. About half of the study participants were satisfied regarding supporting services and behaviour of hospital staff. Conclusion- A robust monitoring and feedback mechanisms should be enabled in order to track the continuous improvement and responsiveness to the evolving needs and preferences of beneficiaries, which will further enhance the satisfaction levels.

Challenges in accessing health care services for women and girls with disabilities using a humanitarian physical rehabilitation program in Lebanon: a mixed method study

BackgroundAchieving equitable healthcare access for persons with disabilities is vital, as they often face various barriers that impact their health and well-being. Recognizing the importance of gender equity, this study aims to explore the specific barriers faced by women and girls with disabilities in accessing quality healthcare services in Lebanon.MethodsA mixed-method sequential explanatory approach was employed. Initially, a retrospective descriptive study analyzed data from the International Committee of the Red Cross (ICRC)-supported physical rehabilitation programme (PRP) database. Subsequently, in-depth interviews were conducted to delve into factors influencing gender-disproportionate service users and to uncover barriers to accessing healthcare. Levesque et al.‘s ‘Conceptual framework on healthcare access’ was used to organize and map the results.ResultsThe quantitative analysis of service utilization at ICRC PRP centers from 2015 to 2022 revealed significant gender disparities, with males comprising 66.6% of service users compared to 33.4% females. This trend was consistent across age categories, nationalities, and clinical conditions. Healthcare access for women and girls with disabilities was found to be inadequate across all five dimensions of the Levesque framework: adequacy, accessibility, affordability, appropriateness, and availability, as well as their corresponding abilities. While certain challenges such as transportation, financial constraints, inadequate infrastructure, and limited information on available services were common to both genders, gender-specific barriers primarily included societal norms, safety concerns during unaccompanied visits to healthcare facilities, limited access to societal information, economic disparities, preferences for female healthcare providers, and the need for privacy during consultations.ConclusionThis study underscores key barriers hindering healthcare access for women and girls with disabilities in Lebanon, necessitating tailored interventions. Gender-specific challenges, including societal norms and safety concerns, require targeted solutions for improved access and outcomes. This study serves as a call to action for stakeholders at various levels to collaborate and implement concrete measures to bridge the gap in healthcare access and ensure that no one is left behind.

Ensuring safe and effective pharmacotherapy: The role of "community pharmacology" in attaining "health for all" from the Indian perspective.

The novel approach of "Community Pharmacology" integrates pharmacological principles with community health to achieve the "Health for all" goal through safe and efficient health care. Pharmacovigilance, medication errors (ME), irrational prescriptions, and antimicrobial resistance in the community could be the key areas. Though life expectancy and other health indicators have improved in India, the disparity between rural and urban quality healthcare access should be addressed. Despite India's enormous progress in vaccine manufacture, supply, and mass immunization through the Universal Immunization Programme (UIP) and Mission Indradhanush, issues remain in incomplete coverage and vaccine hesitancy. Other key challenges include high health expenditures, shortage of trained healthcare professionals, and lack of patient safety and irrational pharmacotherapy in remote areas. Community Pharmacology offers a multifaceted solution in community healthcare delivery through a well-designed integrated network equipped with skills in practical implications of pharmacology aimed at better medication supply, storage and dispensing, adherence to formularies according to the community needs, preparing Essential Medicine List and implementation of rational prescribing. Antimicrobial stewardship (AMS), adverse drug reaction (ADR) monitoring, and evidence-based usage of different drug formulations or drug delivery systems must be implemented beyond the tertiary level, involving both public and private stakeholders. Integrating Community Pharmacology into public health is crucial for fulfilling the global health initiatives to reach the Sustainable Development Goals (SDGs) as well as attaining India's ambitious overall development targets.

Flexible scan statistic with a restricted likelihood ratio for optimized COVID-19 surveillance.

Disease surveillance remains important for early detection of new COVID-19 variants. For this purpose, the World Health Organization (WHO) recommends integrating of COVID-19 surveillance with other respiratory diseases. This requires knowledge of areas with elevated risk, which in developing countries is lacking from the routine analyses. Focusing on Ghana, this study employed scan-statistic cluster analysis to uncover the spatial patterns of incidence and Case Fatality Rates (CFR) of COVID-19 based on reports covering the four pandemic waves in Ghana between 12 March 2020 and 28 February 2022. Applying flexible spatial scan statistic with restricted likelihood ratio, we examined the incidence and CFR clusters before and after adjustment for covariates. We used distance to the epicentre, proportion of the population aged ≥ 65, male proportion of the population and urban proportion of the population as the covariates. We identified 56 significant spatial clusters for incidence and 26 for CFR for all four waves of the pandemic. The Most Likely Clusters (MLCs) of incidence occurred in the districts in south-eastern Ghana, while the CFR ones occurred in districts in the central and the northeastern parts of the country. These districts could serve as sites for sentinel or genomic surveillance. Spatial relationships were identified between COVID-19 incidence covariates and the CFR. We observed closeness to the epicentre and high proportions of urban populations increased COVID-19 incidence, whiles high proportions of those aged ≥ 65 years increased the CFR. Accounting for the covariates resulted in changes in the distribution of the clusters. Both incidence and CFR due to COVID-19 were spatially clustered, and these clusters were affected by high proportions of the urban population, high proportions of the male population, high proportions of the population aged ≥ 65 years and closeness to the epicentre. Surveillance should target districts with elevated risk. Long-term control measures for COVID-19 and other contagious diseases should consider improving quality healthcare access and measures to reduce growth rates of urban populations.

Contributory Factors to the Inability of the Poor to Access National Health Protection: A Case Study in Waingapu, Sumba Timur District, Indonesia

Millions of poor Indonesians still need access to Indonesia's National Health Protection (NHP). The study investigated barriers making NHP inaccessible for the poor in Waingapu, Sumba Timur, Indonesia. We used a qualitative approach to identify the contributing factors to why NHP was inaccessible for some populations. A total of 30 residents of Waingapu who attended healthcare in two hospitals and five Community Health Centers were recruited using convenience technic. Twenty residents participated in the semi-structured interview, while ten engaged in casual conversations. We also interviewed three heads of community groups and three health cadres for comparative information. Questions have been developed to guide the interviews and casual conversation. The interviews were audio-taped and transcribed while intensive note-taking was performed during the informal discussion or the conversation was narrated immediately after the talks ended. The information was inductive, analyzed, and coded to produce common information among the participants. The data analysis revealed the factors that contributed to the failure of the resident to enroll in the NHP, such as lack of information about the registration, poor socialization of the program, the ignorance of village officers, unaffordability, and confusion about the parties responsible for the registration. The study concluded that poor people were still vulnerable to access free coverage and healthcare from the NHP. The stakeholders of the NHP, especially the local management of NHP and local government, need to urgently and effectively educate the commoners about the mechanism, benefits, and contribution to the NHP to ensure equity and equality in accessing quality healthcare.

Exploring cultural competence barriers in the primary care sexual and reproductive health centres in Catalonia, Spain: perspectives from immigrant women and healthcare providers

BackgroundImmigrant populations, especially women, continue facing challenges in accessing quality healthcare, particularly sexual and reproductive health services (SRH). Poor cultural competent health systems contribute to communication challenges between immigrant women and healthcare providers perpetuating health disparities. This exploratory study describes these communication barriers from the perspective of Moroccan and Pakistani immigrant women and healthcare providers within the Catalan health system and its implications to ensure an equitable provision of SRH services.MethodsAn exploratory-descriptive qualitative study was conducted in various municipalities of Barcelona with high concentration of immigrants. Eight focus groups (N = 51) and semi-structured interviews (N = 22) with Moroccan and Pakistani immigrant women were combined with key informant interviews (N = 13) with healthcare professionals. Thematic analysis and data triangulation were performed primarily using an inductive approach.ResultsLanguage barriers and cultural differences in health needs, expectations, care-seeking behaviours and understanding of quality healthcare provision hindered the ability of immigrant women and providers to interact effectively. Limited availability of intercultural mediators and inadequate cultural competence training opportunities for health staff were also identified. Findings suggest a lack of minority representation in the Catalan health workforce and leadership roles.ConclusionThis study reinforces the evidence of persistent inequities in accessing healthcare among immigrant populations by focusing on the cultural competence barriers of the Catalan health system in the provision and access to SRH services. The regularization of adequately trained intercultural mediators, quality training in cultural competence for health staff and a commitment to increase workforce diversity would contribute to improve intercultural communication between immigrant patients and providers. An urgent call to action in this direction is needed to ensure an equitable access to SRH services among immigrant women.

Revolutionizing Rural Health Care: The Power of Telehealth and Digital Health Literacy

Abstract For many living in remote areas, accessing quality health care remains a significant hurdle. Long distances, limited specialists, and transportation challenges create a gap in care that telehealth has the potential to bridge. This article explores how telehealth, the use of telecommunication technologies for health-care delivery, can revolutionize rural health care. Telehealth consultations can connect patients with specialists in distant locations, reducing travel burdens and wait times. It can also enhance preventative care through remote monitoring and medication management. However, the success of telehealth hinges on digital health literacy. Equipping rural communities with the skills to navigate these technologies is crucial for maximizing their benefits. This article delves into the challenges and opportunities presented by telehealth in rural areas. It discusses how initiatives promoting digital health literacy can empower communities and ensure equitable access to quality health care. Ultimately, it argues that by embracing technological advancements and fostering digital literacy, we can create a future where location no longer dictates the quality of health care received.

Right Care, Right Time, Right Place: Real-life Challenges in Delivering Sláintecare – A Multi-Centre Survey of Multidisciplinary Team Members

Abstract Background Sláintecare launched in 2018 seeks to reform the delivery of healthcare services in Ireland towards equity of access based on patient need1. However, delivering the right care, in the right place at the right time is, as yet an aspirational goal. We sought to identify the on-the ground challenges that exist in delivering Sláintecare in the day-to-day practice of multidisciplinary team members. Methods An online survey questionnaire was distributed to medical social workers, occupational therapists, and physiotherapists. Respondents were asked about their experience in applying for community-based care in their practice including home care packages, community occupational therapy and home equipment. Descriptive statistics were applied to numerical data and a thematic analysis was performed on free text responses. Results There were 31 respondents from 10 clinical sites including acute and rehabilitation settings. All nine community healthcare organisations (CHOs) were represented. 29/31 (94%) felt that access to community-based care differed based on the patient’s residential address. 23/31 (74%) stated the referral documentation and process for home care packages varied depending on the patients’ CHO. Qualitative analysis identified three core themes; Unfulfilled care hours due to dearth of carer availability differed across CHOs; inconsistencies in the application process that exists between CHO’s and incongruities in the availability of and accessibility to publicly funded services on hospital discharge. Conclusion Our survey highlights the practical challenges of delivering Sláintecare currently. It reinforces the health inequities that limits patients’ ability to access quality healthcare because of their geographical location.

Poverty as a Hindrance to Accessing Quality Healthcare in Ghana: A Theological and Pastoral Reflection

Access to quality healthcare is a key requirement in every modern society. In developed countries, majority of the populace has access to quality and affordable healthcare. However, in developing countries such as Ghana, hospitals with quality infrastructure, healthcare equipment, drugs, and well-trained health practitioners are limited and expensive to access. Given the significant number of people living in extreme poverty in Ghana, it is not surprising that many people experience deterioration in their health and eventually die due to the inability to access and/or afford quality healthcare. In the current situation, where economic hardship keeps increasing in the country, there is a need to engage in a discussion on how healthcare can be made available and affordable to people of all economic classes. The purpose of this paper, therefore, is to assess the limitations that poverty places on people in their quest to access healthcare and offer solutions from theological and pastoral perspectives. This paper employed qualitative and historical descriptive research designs to describe the current state of affairs of the impact that poverty has on access to health care in Ghana. The paper used data collected from secondary sources such as books, journal articles and dissertations. After a careful analysis of the subject matter from the Ghanaian and biblical perspectives, the paper made recommendations for the nation (Ghana), the church, and all stakeholders to contribute to the provision of quality, accessible, and affordable healthcare for all irrespective of one’s financial background or economic status. Keywords: Poverty, Hindrance, Quality Health, Ghana

THE IMPACT OF DRUG COST ON MEDICATION ADHERENCE IN NIGERIA: A PERCEPTION AMONG PHARMACISTS

Background: Given Nigeria's huge economic instability, medication expenses may significantly impact medication adherence, creating a barrier to the treatment of various ailments. The study aimed to assess pharmacists' perceptions about the impact of drug costs on medication adherence in Nigeria. Methods: The study was cross-sectional among practicing pharmacists across Nigeria. The 25 items semi-structured questionnaire was administered online using simple random sampling with the snowballing technique to recruit the pharmacists for the study. The collected data was coded into Microsoft Excel 2016 and subsequently analyzed using IBM SPSS Statistics for Windows, Version 21.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics were utilized to summarize the data, providing an overview of the demographic characteristics and key findings. Inferential statistics, specifically Pearson’s Chi-square test, were employed where applicable to determine the relationships between variables. Results: Total 161 pharmacists responded to the survey, giving an 80.5% response rate. The respondent rate was mainly young pharmacists (20–30 years old; 82.6%) and predominantly male (51.6%). Almost all the respondents possess only a bachelor of pharmacy degree (91.9%). Total 90% have practiced for 5 years or less, mostly in community settings (60.9%). Generic substitution has been cited as the most important technique to manage drug costs. Non-adherence due to cost was associated with practice settings, whereas adherence counseling was correlated with gender and setting of practice. All differences were not statistically significant at p<0.05. Conclusions: Most participants believe that the cost of medication is a major barrier to accessing quality healthcare and drives massive non-adherence among those who can barely afford the medicines. Implementing a comprehensive national strategy to enhance the healthcare system, expand the reach of the national health insurance program, and promote cooperation among healthcare practitioners will result in improved clinical outcomes for patients. Peer Review History: Received 22 May 2024; Revised 11 July 2024; Accepted 26 August; Available online 15 September 2024 Academic Editor: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, amaka_mgbahurike@yahoo.com Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Prof. Hassan A.H. Al-Shamahy, Sana'a University, Yemen, shmahe@yemen.net.ye Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, sansan4240732@163.com

Preparedness of Filipino Neurologists on the Provision of Medical Care Toward Patients of the Lesbian, Gay, Bisexual, Transgender, Queer Plus Community

ABSTRACT The study aimed to describe the preparedness of active members of the Philippine Neurological Association (PNA) in providing medical care to LGBTQ+ patients. We electronically sent out a 21-item self-administered online survey adapted from the 2019 American Academy of Neurology LGBTQ+ Survey Task Force to 511 active members of PNA that included questions about demographic information, knowledge, attitude, and clinical practices. Descriptive statistics were used to analyze variables. Text responses were transcribed and summarized. Seventy-nine (15.5%) of 511 PNA members participated. Most participants were aware of local (53%) and national (56%) barriers that preclude patients in the LGBTQ+ sector from accessing quality health care. The majority (90%) of participants agreed that LGBTQ+ patients experience disproportionate levels of physical and psychological problems. Forty-two percent (42%) of respondents believed that sexual and gender issues have no bearing on neurological management, although a majority (53%) reported individualizing their management considering these issues. The majority were cognizant of the challenges that LGBTQ+ patients face in the health care system. However, awareness has not translated into modifications in neurological management. The openness of the participants to educational opportunities concerning health care related to LGBTQ+ can be leveraged to address this gap.

Advancing Vaccinology Capacity: Education and Efforts in Vaccine Development and Manufacturing across Africa.

Africa, home to the world's second-largest population of approximately 1.3 billion, grapples with significant challenges in meeting its medical needs, particularly in accessing quality healthcare services and products. The continent faces a continuous onslaught of emerging infectious diseases, exacerbating the strain on its already fragile public health infrastructure. The COVID-19 crisis highlighted the urgency to build local vaccine production capacity and strengthen the health infrastructure in general. The risks associated with a heavy reliance on imported vaccines were exposed during the COVID-19 pandemic, necessitating the need to nurture and strengthen the local manufacturing of vaccines and therapeutic biologics. Various initiatives addressing training, manufacturing, and regulatory affairs are underway, and these require increasing dedicated and purposeful financial investment. Building vaccine manufacturing capacity requires substantial investment in training and infrastructure. This manuscript examines the current state of education in vaccinology and related sciences in Africa. It also provides an overview of the continent's efforts to address educational needs in vaccine development and manufacturing. Additionally, it evaluates the initiatives aimed at strengthening vaccine education and literacy, highlighting successful approaches and ongoing challenges. By assessing the progress made and identifying the remaining obstacles, this review offers insights into how Africa can enhance its vaccine manufacturing capacity to respond to vaccine-preventable disease challenges.

Barriers to Healthcare for Transgender Individuals.

Background: Transgender (TG) clients experience provider bias, erasure, refusal to treat, and violence. Objective: The purpose of this article is to identify barriers to healthcare for TG individuals and discuss recommendations for providers treating this population. Methods: Literature review of prime research was conducted using the Whittemore and Knafl methodology (2005). Results: Evidence suggests that barriers to TG healthcare include lack of provider TG knowledge and trans sensitivity, lack of provider communication, and lack of emotional and physical safe healthcare environments. Conclusions: TG clients face barriers to accessing healthcare, and specific recommendations to improve provider practice will decrease these barriers. Implications for Practice: Lack of provider education affects TG individuals accessing quality healthcare. Recommendations to improve provider practice are essential to improve care.

Provider's satisfaction with telemedicine services for tribals of Western Rajasthan: A qualitative analysis.

There are significant barriers to healthcare access in tribal areas, even though for every 834 people, there is one public physician (registered allopathic and AYUSH doctors). More than 86% of hospital visits occur in rural areas. Furthermore, the bulk of them travel long distances to reach hospitals. A telemedicine center was established in the aspirational tribal district of Sirohi, Rajasthan, to provide accessible quality health care. To understand providers' attitudes and satisfaction with telemedicine services for tribal populations. This cross-sectional, mixed-method study enrolled consultants from various clinical departments of AIIMS Jodhpur (n = 23) who provide teleconsultations to the tribal population. The mean score of the satisfactory index was 54.7 ± 22.04. The higher score is 87.4 regarding the ability to use the technology platform during teleconsultation. The lower score was 34.7 for video quality during teleconsultation at STHR. 91.3% found this a beneficial model for the tribal population. Consultants providing teleconsultations expressed that this model is a boon for tribal patients as a screening tool and will save time and money for improved accessibility. Positive indications of teleconsultation with a provider's utility, acceptability, and satisfaction. Most marginalized people can efficiently access all levels of (primary, secondary, or tertiary) health care from experts through telemedicine, which will broaden outreach in hard-to-reach or inaccessible tribal or rural areas.

Inclusivity in health professional education: how can virtual simulation foster attitudes of inclusion?

Disparities in accessing quality healthcare persist among diverse populations. Health professional education should therefore promote more diversity in the health workforce, by fostering attitudes of inclusion. This paper outlines the potential of virtual simulation (VS), as one method in a system of health professional education, to promote inclusion and diversity. We conceptualise how VS can allow learners to experience an alternative to what HPE currently is by drawing on two social justice theorists, Paulo Freire, and Nancy Fraser and their ideas about ‘voice’ and ‘representation’. We present two principles for VS design and implementation: (1) giving voice to learners has the power to transform; and (2) representation in VS builds inclusion. We provide practical means of building voice and representation into VS learning activities, followed by an example. Purposeful and thoughtful integration of these principles paves the way for a more diverse and inclusive healthcare workforce.

Automatic Medical Dispatcher with Dynamic Telemonitoring System Using IoT in Rural Areas

Accessing quality healthcare in rural areas can be challenging, often requiring individuals to travel long distances to nearby towns or cities. To address this issue, the Anytime Medical Machine (AMM) project was developed, leveraging Internet of Things (IoT) technology to provide on-the-spot medical consultations. AMM, a part of the Internet of Medical Things (IoMT), is designed for primary deployment in rural areas. Through AMM, individuals can receive consultations from qualified doctors without the need to travel. Doctors can prescribe medications and provide treatment recommendations, reducing both time and expenses associated with travel. The system collects patient data using sensors for temperature, heart rate, and blood oxygen saturation (SPO2), transmitting this information to doctors via a Wi-Fi module. The doctor-patient interaction is facilitated through secure video conferencing, requiring a unique username and password for each user to prevent misuse. After analyzing the patient's health parameters, the doctor prescribes appropriate medication, which is then dispensed through AMM. Patient information is securely uploaded to a cloud server for future reference, and the system is maintained by an administrator who refills medications as needed. Keywords- Rural Healthcare, Remote Consultation, IoT Healthcare, Medical IoT, Telemedicine, Remote Monitoring, Cloud-Based Healthcare, Healthcare Accessibility

Empowering Expecting Women to Obtain High-Quality Healthcare in Pakistan: An Evaluation of Khyber Pakhtunkhwa's Conditional Cash Transfer Program.

Maternal mortality, largely stemming from complications during pregnancy and childbirth, impacts poor expecting women with limited healthcare access in rural Pakistan. Conditional Cash Transfers (CCTs), commonly implemented in developing nations, are designed to improve the well-being of vulnerable populations by focusing on health and education. A CCT initiative named Chief Minister's Special Initiative for Mother and Child Health (CM-SIMCH) was launched in Khyber Pakhtunkhwa (KP), one of the less-developed provinces of Pakistan, to empower expecting women to access quality healthcare. This study investigates the factors influencing CM-SIMCH program participation and assesses its impact on the health of expecting women by analyzing health-seeking hospital visits in KP, Pakistan. The study utilizes the Propensity Score Matching (PSM) technique to analyze cross-sectional data obtained from 303 expecting women residing in the Nowshera district of KP. The PSM allows for a balanced comparison of participants who received the CM-SIMCH transfers with those who did not, assessing its impact on maternal healthcare access and outcomes. Empirical results show that factors such as education and family system positively influence the participation of expecting women in the CM-SIMCH program, whereas travel costs exert a negative effect. The intervention leads to a notable increase in hospital visits among these women, contributing to improved health outcomes in KP. This underscores the program's potential effectiveness in addressing maternal healthcare challenges and enhancing healthcare access for vulnerable women in less-developed areas. Therefore, empirical evidence supports the CM-SIMCH program's potential to promote maternal health and improve healthcare access in KP. The study recommends government intervention in health sector as a strategic imperative to empower women and enhance infant health.

Understanding Caretakers' Treatment Facility Preferences for Children with Febrile Illnesses: Insights from Ishaka Town, Bushenyi District, Uganda

This study was carried out to assess the factors that influence choice of treatment facility by the caretakers of children with febrile illnesses in Ishaka town, Bushenyi district. A total of 50 questionnaires were issued to respondents after attaining their consent. The respondents were chosen randomly. The study showed that transport costs, good customer care and quality of health care were the major factors that influenced the choice of treatment facility for children in Ishaka town. The biggest number of caretakers is the mothers of these children, who are mostly housewives. These caretakers usually seek treatment from private providers near them, such as clinics and drug shops. Caretakers prefer treatment facilities with a constant supply of drugs, knowledge of health care provider, and diagnostic services as they have a perception that quality of care provided depends on these factors. To increase access of quality health care for children with febrile illness, all aspects need to be addressed. Health care providers need to be accessible and avail the community with appropriate medication. The community need to be sensitized on the signs and symptoms commonly affecting children with febrile illnesses, as well as training the drug shop owners on how to diagnose diseases based on the symptoms manifested. Keywords: Febrile illnesses, Treatment, facility, Caretakers, Healthcare.

A perspective on policies and practices regarding access to and quality of healthcare for people with intellectual disabilities in Zambia

AbstractZambia is a low‐income country on the African continent which is facing a high rate of health inequalities. Although the government has made efforts to reform the organization of healthcare to reduce inequalities, the practical implementation of disability policies remains challenging. Specifically, people with intellectual disabilities (ID) face barriers to accessing healthcare services in Zambia, due to geographic or socioeconomic factors, stigma, and limited specialized health professionals. This perspective paper provides an overview of the current policy and organization on the healthcare provision for people with ID. It presents the key challenges people with ID face in Zambia to access quality healthcare services. Additionally, we provide examples of good practices with a community approach. We discuss policy implementation of disability rights, including access to healthcare, the impact of raising knowledge and awareness about people with ID, and how gathering contextual information through research can help to reduce inequalities. Community and culturally sensitive approaches to improve access to healthcare for people with ID in Zambia are crucial. We call for close collaboration between the fields of research and practice to combine expertise and strengthen the impact and possibilities of scaling good practices within Zambia.

Shaping the future rural healthcare landscape: perspectives of young healthcare professionals.

Rural communities continue to struggle to access quality healthcare services. Even in countries where the majority of the population live in rural and remote areas, resources are concentrated in big cities, and this is continuing. As a result, countries with the highest proportion of rural residents correlate with the poorest access, which has negative implications for the health and wellbeing of people. Healthcare professionals (HCPs) have been identified as key informants in the construction and implementation of policies aimed at addressing rural health issues. We sought to understand the perspectives of young HCPs, representing the potential future rural workforce, regarding the future of rural health care. An interpretivist paradigm was adopted for the study. Data were collected in two phases over Zoom using semi-structured individual interviews and focus group discussions (FGDs). Participants included selected HCPs who are members of Rural Seeds, which is a global movement for young HCPs. A total of 11 exploratory interviews and six FGDs were conducted. The 11 interviewees consisted of medical doctors and medical students from 10 countries classified at different levels of development by the WHO. The six FGDs ranged from three to nine participants, and they included medical doctors and medical students, nurses and rehabilitation therapists. Participants came from South Asia, Africa, Asia-Pacific, North America and Europe, and South America. Both interviews and FGDs were conducted in English, recorded, and transcribed verbatim. Data were analysed utilising thematic analysis. Similar themes were identified across both individual interviews and FGDs. The state of rural health care was perceived to be problematic by all the participants. Access to care, lack of equity and multiple socioeconomic challenges, particularly in relation to living conditions, human resources and infrastructure, were seen as the most significant issues in rural health care. Several ideas for addressing rural health issues, with examples, were proposed by the young HCPs from their perspectives as frontline healthcare providers. They particularly recognised the importance of addressing the local socioeconomic and developmental needs of rural communities, and the needs of present and future HCPs. Young health professionals from across the world interested in a rural career have common concerns about the state of rural health in their countries and constructive insights into how these can be addressed. They suggest effective solutions that must include listening to their voices. This article is a step in that direction.