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Zhang L, Chen Y, Li Q, Zhang J, Zhou Y. Barriers and Facilitators to Medical Help-seeking in Rural Patients with Mental Illness: A Qualitative Meta-synthesis. Asian Nurs Res (Korean Soc Nurs Sci) 2024; 18:203-214. [PMID: 38704085 DOI: 10.1016/j.anr.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/25/2024] [Accepted: 04/29/2024] [Indexed: 05/06/2024] Open
Abstract
PURPOSE Numerous barriers hinder individuals with mental illness from seeking medical assistance in rural regions, yet a comprehensive understanding of these challenges remains elusive. This meta-synthesis aims to understand the barriers and facilitators in medical help-seeking among rural individuals with mental illness. METHODS We systematically searched seven databases [PubMed, CINAHL, Medline (OVID), PsycINFO (OVID), Cochrane, Embase, and ProQuest] in May 2023 and included the studies if they reported the barriers or/and facilitators to seek healthcare in rural patients with mental illness. We conducted hand search and citation search on Google Scholar for literature supplements. Thematic analysis was employed. RESULTS The study included 27 articles reporting on the barriers and facilitators to seeking medical help in this population from 2007 to 2023. We ultimately identified themes at three levels: navigating the terrain of vulnerability and empowerment (the individual with mental illness), navigating the terrain of external environment (the external environment) and connectivity within the healthcare ecosystem for mental health (the health service system). CONCLUSIONS We must design more effective strategies to improve mental healthcare access for rural patients, considering cultural nuances and health service utilization patterns. This requires a multi-level approach, tailored to the unique needs of diverse populations.
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Affiliation(s)
- Linghui Zhang
- Department of Nursing, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yubin Chen
- Department of Nursing, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qi Li
- Department of Nursing, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jiayuan Zhang
- Department of Nursing, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yuqiu Zhou
- Department of Medicine, Huzhou University, Huzhou, Zhejiang, China.
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2
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Silaule O, Casteleijn D, Adams F, Nkosi NG. Strategies to Alleviate the Burden Experienced by Informal Caregivers of Persons With Severe Mental Disorders in Low- and Middle-Income Countries: Scoping Review. Interact J Med Res 2024; 13:e48587. [PMID: 38236636 PMCID: PMC10835589 DOI: 10.2196/48587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 08/20/2023] [Accepted: 10/04/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND There is considerable evidence of the burden of care encountered by informal caregivers of persons with severe and enduring mental health conditions in low- and middle-income countries. Previous studies have highlighted the need to support these informal caregivers as key players in the care of these patients. To date, limited evidence exists on the extent and types of strategies for supporting these informal caregivers in low- and middle-income countries. OBJECTIVE This scoping review aims to identify and describe the extent and type of evidence on the existing strategies for alleviating the burden of care among informal caregivers of persons with severe and enduring mental health conditions in low- and middle-income countries. METHODS A systematic literature search was completed following the Joanna Briggs Institute methodology for scoping reviews. The participants, concept, and context framework was used to guide the search for literature sources across 5 databases: PubMed, MEDLINE, CINAHL, and PsycINFO for published literature and ProQuest for unpublished literature. This review included studies that reported on strategies for alleviating the burden of care among informal caregivers of persons with severe and enduring mental health conditions, with a focus on studies that evaluated or recommended caregiver interventions and support strategies in low- and middle-income countries. The search was limited to studies conducted between 2001 and 2021, and only papers written in English were considered for inclusion. Using the Covidence software (Veritas Health Innovation), 2 reviewers independently screened the papers, applied the inclusion and exclusion criteria, and met biweekly to discuss and resolve conflicts. The relevant studies and reported outcomes were summarized, organized, and analyzed descriptively using numeric summary analysis and deductive content analysis. RESULTS Of the 18,342 studies identified, 44 (0.24%) met the inclusion criteria. The included studies were from 16 low- and middle-income countries in Asia, Africa, Europe, and South and North America. Most studies (21/44, 48%) were randomized controlled trials conducted in Asian countries. The identified strategies were grouped into 2 categories: implemented and recommended intervention strategies. Identified strategies included community-based interventions, psychoeducation interventions, support groups, cognitive behavioral therapy, spirituality-based interventions, and smartphone-based interventions. In addition, mindfulness and empowerment, collaborative interventions, standard care, financial and social support, counseling, occupation-based interventions, policy and legislature, and access to mental health care were identified. Psychoeducation and support group interventions were identified as common strategies for alleviating the burden of care among informal caregivers of persons with severe and enduring mental health conditions. CONCLUSIONS This review provides evidence on the types of implemented and recommended strategies for alleviating the burden of care among informal caregivers in low- and middle-income countries. Although psychoeducational interventions were the most preferred strategy for alleviating burden, their benefits were short-lived when compared with peer-led support groups. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/44268.
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Affiliation(s)
- Olindah Silaule
- Department of Occupational Therapy, University of the Witwatersrand, Johannesburg, South Africa
| | - Daleen Casteleijn
- Department of Occupational Therapy, University of Pretoria, Pretoria, South Africa
| | - Fasloen Adams
- Division of Occupational Therapy, Stellenbosch University, Cape Town, South Africa
| | - Nokuthula Gloria Nkosi
- Department of Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
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Rabie S, Laurenzi CA, Field S, Skeen S, Honikman S. A mixed-methods feasibility study of Nyamekela4Care: An intervention to support improved quality of care among service providers in low-resource settings. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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4
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Laurenzi CA, Skeen S, Rabie S, Coetzee BJ, Notholi V, Bishop J, Chademana E, Tomlinson M. Balancing roles and blurring boundaries: Community health workers' experiences of navigating the crossroads between personal and professional life in rural South Africa. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1249-1259. [PMID: 32885519 DOI: 10.1111/hsc.13153] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/24/2020] [Accepted: 08/12/2020] [Indexed: 06/11/2023]
Abstract
As demand for health services grows, task-shifting to lay health workers has become an attractive solution to address shortages in human resources. Community health workers (CHWs), particularly in low-resource settings, play critical roles in promoting equitable healthcare among underserved populations. However, CHWs often shoulder additional burdens as members of the same communities in which they work. We examined the experiences of a group of CHWs called Mentor Mothers (MMs) working in a maternal and child health programme, navigating the crossroads between personal and professional life in the rural Eastern Cape, South Africa. Semi-structured qualitative interviews (n = 10) were conducted by an experienced isiXhosa research assistant, asking MMs questions about their experiences working in their own communities, and documenting benefits and challenges. Interviews were transcribed and translated into English and thematically coded. Emergent themes include balancing roles (positive, affirming aspects of the role) and blurring boundaries (challenges navigating between professional and personal obligations). While many MMs described empowering clients to seek care and drawing strength from being seen as a respected health worker, others spoke about difficulties in adequately addressing clients' needs, and additional burdens they adopted in their personal lives related to the role. We discuss the implications of these findings, on an immediate level (equipping CHWs with self-care and boundary-setting skills), and an intermediate level (introducing opportunities for structured debriefings and emphasising supportive supervision). We also argue that, at a conceptual level, CHW programmes should provide avenues for professionalisation and invest more up-front in their workforce selection, training and support.
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Affiliation(s)
- Christina A Laurenzi
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Sarah Skeen
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Stephan Rabie
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Bronwynè J Coetzee
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Vuyolwethu Notholi
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | | | | | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
- School of Nursing and Midwifery, Queens University Belfast, Belfast, United Kingdom
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5
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Rajabzadeh V, Burn E, Sajun SZ, Suzuki M, Bird VJ, Priebe S. Understanding global mental health: a conceptual review. BMJ Glob Health 2021; 6:bmjgh-2020-004631. [PMID: 33758013 PMCID: PMC7993328 DOI: 10.1136/bmjgh-2020-004631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 11/14/2022] Open
Abstract
Background Mental health disorders are viewed as a global concern requiring globally led approaches to address them. Since the publication of the 2007 Lancet series on global mental health (GMH), the term has become widespread. Over the last two decades, GMH has become increasingly affiliated with policy reform, academic courses, funding bodies and research. However, it is not always obvious how those working in the field of GMH are using the term, resulting in a lack of clarity. Therefore, work is needed to synthesise the current understanding(s) of GMH to help characterise its meaning. Aim To synthesise the literature and identify the different ways GMH is understood. Method A conceptual review, using a systematic search and a content analysis, was conducted to develop a conceptual framework of the different conceptual understandings of GMH. Results We developed a conceptual framework of four understandings of GMH. These understandings of GMH are as follows: an area of research generating findings to establish a GMH evidence-base; implementation of research into practice; improving the mental health environment; learning from and supporting low-and-middle-income countries (LMICs). Conclusion Our review proposes a simple framework, clarifying the key characteristics of the GMH landscape. The findings highlight the diversity of usage of the term in the literature, as well as present the wide scope that comprises the field of GMH. Referring to this framework may help those engaged with GMH to be more specific with which aspect of the field they are concerned with.
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Affiliation(s)
- Vian Rajabzadeh
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Erin Burn
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Sana Z Sajun
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Mimi Suzuki
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Victoria Jane Bird
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
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Mkabile S, Swartz L. 'I Waited for It until Forever': Community Barriers to Accessing Intellectual Disability Services for Children and Their Families in Cape Town, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8504. [PMID: 33212851 PMCID: PMC7698324 DOI: 10.3390/ijerph17228504] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Intellectual disability is more common in low- and middle-income countries than in high-income countries. Stigma and discrimination have contributed to barriers to people with intellectual disability accessing healthcare. As part of a larger study on caregiving of children with intellectual disability in urban Cape Town, South Africa, we interviewed a sub-group of families who had never used the intellectual disability services available to them, or who had stopped using them. METHODS We employed a qualitative research design and conducted semi-structured interviews to explore the views and perspectives of parents and caregivers of children with intellectual disability who are not using specialised hospital services. We developed an interview guide to help explore caregivers' and parents' views. RESULTS Results revealed that caregivers and parents of children with intellectual disability did not use the intellectual disability service due to financial difficulties, fragile care networks and opportunity costs, community stigma and lack of safety, lack of faith in services and powerlessness at effecting changes and self-stigmatisation. CONCLUSION Current findings highlight a need for increased intervention at community level and collaboration with community-based projects to facilitate access to services, and engagement with broader issues of social exclusion.
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Affiliation(s)
- Siyabulela Mkabile
- Department of Psychology, Stellenbosch University, Stellenbosch 7602, South Africa;
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town 7735, South Africa
| | - Leslie Swartz
- Department of Psychology, Stellenbosch University, Stellenbosch 7602, South Africa;
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Penner F, Sharp C, Marais L, Shohet C, Givon D, Boivin M. Community‐Based Caregiver and Family Interventions to Support the Mental Health of Orphans and Vulnerable Children: Review and Future Directions. New Dir Child Adolesc Dev 2020; 2020:77-105. [DOI: 10.1002/cad.20352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Carla Sharp
- University of Houston Houston TX 77004 United States
- Centre for Development SupportUniversity of the Free State Bloemfontein 9301 South Africa
| | - Lochner Marais
- Centre for Development SupportUniversity of the Free State Bloemfontein 9301 South Africa
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Dassah E, Aldersey H, McColl MA, Davison C. Factors affecting access to primary health care services for persons with disabilities in rural areas: a "best-fit" framework synthesis. Glob Health Res Policy 2018; 3:36. [PMID: 30603678 PMCID: PMC6305566 DOI: 10.1186/s41256-018-0091-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 12/03/2018] [Indexed: 12/14/2022] Open
Abstract
Background Access to primary health care (PHC) is a fundamental human right and central in the performance of health care systems, however persons with disabilities (PWDs) generally experience greater barriers in accessing PHC than the general population. These problems are further exacerbated for those with disabilities in rural areas. Understanding PHC access for PWDs is particularly important as such knowledge can inform policies, clinical practice and future research in rural settings. Methods We conducted a synthesis of published literature to explore the factors affecting access to PHC for PWDs in rural areas globally. Using an adapted keyword search string we searched five databases (CINAHL, EMBASE, Global Health, Medline and Web of Science), key journals and the reference lists of included articles. We imported the articles into NVivo and conducted deductive (framework) analysis by charting the data into a rural PHC access framework. We subsequently conducted inductive (thematic) analysis. Results We identified 36 studies that met our inclusion criteria. A majority (n = 26) of the studies were conducted in low-and middle-income countries. We found that PWDs were unable to access PHC due to obstacles including the interplay of four major factors; availability, acceptability, geography and affordability. In particular, limited availability of health care facilities and services and perceived low quality of care meant that those in need of health care services frequently had to travel for care. The barrier of geographic distance was worsened by transportation problems. We also observed that where health services were available most people could not afford the cost. Conclusion Our synthesis noted that modifying the access framework to incorporate relationships among the barriers might help better conceptualize PHC access challenges and opportunities in rural settings. We also made recommendations for policy development, practice consideration and future research that could lead to more equitable access to health care. Importantly, there is the need for health policies that aim address rural health problems to consider all the dimensions and their interactions. In terms of practice, the review also highlights the need to provide in-service training to health care providers on how to enhance their communication skills with PWDs. Future research should focus on exploring access in geographical contexts with different health care systems, the perspectives of health care providers and how PWDs respond to access problems in rural settings. Electronic supplementary material The online version of this article (10.1186/s41256-018-0091-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ebenezer Dassah
- 1School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston, Ontario K7L 3N6 Canada
| | - Heather Aldersey
- 1School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston, Ontario K7L 3N6 Canada
| | - Mary Ann McColl
- 1School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston, Ontario K7L 3N6 Canada
| | - Colleen Davison
- 2Department of Public Health Sciences, Queen's University, Carruthers Hall, 62 Fifth Field Company Lane, Kingston, Ontario K7L 3N6 Canada
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Abstract
In this paper, the current situation regarding rural mental health in South Africa is explored. The current status is presented, followed by an attempt to provide approaches and ideas to improve the situation in order to make it more context appropriate and relevant. Issues of staffing, task shifting or sharing, and formal vs informal health care systems are considered and discussed as possible future approaches to improve rural mental health care in South Africa.
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Affiliation(s)
- Richard Vergunst
- a Department of Psychology , Stellenbosch University , Matieland , South Africa
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10
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Vergunst R, Swartz L, Hem KG, Eide AH, Mannan H, MacLachlan M, Mji G, Schneider M. The perceived needs-access gap for health services among persons with disabilities in a rural area within South Africa. Disabil Rehabil 2018; 41:2676-2682. [PMID: 29957079 DOI: 10.1080/09638288.2018.1478001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: Health should be a universal phenomenon. However, little is known about the relationship between disability status and health issues - particularly in rural areas. This study looks at health issues of persons with disabilities in Madwaleni, a rural impoverished area in South Africa in 2011, and compares them to persons with no disabilities. Materials and Methods: Standardized questionnaires were used in the survey to assess disability and health status. The sample comprised of 773 individuals - 322 persons with disability and 451 comparisons (without disability) - covering 527 households. Children under the age of five were excluded from the sample. We used purposive sampling. Results and Conclusion: This study found that persons with disabilities have poorer reported health outcomes than persons with no disabilities. There is also an association between disability severity and mental health issues as assessed by the GHQ-12. A significantly higher percentage of persons with disability did not get health care when needed. Persons with disabilities also have less favorable attitudes toward competence of health care workers. This study has shown greater health needs and less satisfaction with services, which strongly indicates insufficient access for persons with disabilities in a rural impoverished are within South Africa. Implications for rehabilitation Persons with disabilities in rural South Africa have poorer reported health outcomes. Persons with disabilities have less favorable attitudes towards competence of health care workers in rural South Africa. Better access to health care for persons with disabilities is needed in rural South Africa.
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Affiliation(s)
- Richard Vergunst
- Department of Psychology, Alan J Flisher Centre for Public Mental Health, Stellenbosch University , Stellenbosch , South Africa
| | - Leslie Swartz
- Department of Psychology, Alan J Flisher Centre for Public Mental Health, Stellenbosch University , Stellenbosch , South Africa
| | - Karl-Gerhard Hem
- Department of Health, SINTEF Technology and Society , Oslo , Norway
| | - Arne Henning Eide
- Department of Health, SINTEF Technology and Society , Oslo , Norway.,Centre for Rehabilitation Studies, Stellenbosch University , Stellenbosch , South Africa
| | - Hasheem Mannan
- School of Nursing Midwifery & Health Systems, Health Sciences Centre University College Dublin , Dublin , Ireland
| | - Malcolm MacLachlan
- Centre for Rehabilitation Studies, Stellenbosch University , Stellenbosch , South Africa.,Assisting Living & Learning (ALL) Institute, Maynooth University , Ireland.,Olomouc University Social Health Institute, Palacky University , Olomouc , Czech
| | - Gubela Mji
- Centre for Rehabilitation Studies, Stellenbosch University , Stellenbosch , South Africa
| | - Marguerite Schneider
- Department of Psychiatry & Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town , Cape Town , South Africa
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Eide AH, Dyrstad K, Munthali A, Van Rooy G, Braathen SH, Halvorsen T, Persendt F, Mvula P, Rød JK. Combining survey data, GIS and qualitative interviews in the analysis of health service access for persons with disabilities. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2018; 18:26. [PMID: 29940955 PMCID: PMC6019232 DOI: 10.1186/s12914-018-0166-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 06/13/2018] [Indexed: 11/10/2022]
Abstract
Background Equitable access to health services is a key ingredient in reaching health for persons with disabilities and other vulnerable groups. So far, research on access to health services in low- and middle-income countries has largely relied on self-reported survey data. Realizing that there may be substantial discrepancies between perceived and actual access, other methods are needed for more precise knowledge to guide health policy and planning. The objective of this article is to describe and discuss an innovative methodological triangulation where statistical and spatial analysis of perceived distance and objective measures of access is combined with qualitative evidence. Methods The data for the study was drawn from a large household and individual questionnaire based survey carried out in Namibia and Malawi. The survey data was combined with spatial data of respondents and health facilities, key informant interviews and focus group discussions. To analyse access and barriers to access, a model is developed that takes into account both measured and perceived access. The geo-referenced survey data is used to establish four outcome categories of perceived and measured access as either good or poor. Combined with analyses of the terrain and the actual distance from where the respondents live to the health facility they go to, the data allows for categorising areas and respondents according to the four outcome categories. The four groups are subsequently analysed with respect to variation in individual characteristics and vulnerability factors. The qualitative component includes participatory map drawing and is used to gain further insight into the mechanisms behind the different combinations of perceived and actual access. Results Preliminary results show that there are substantial discrepancies between perceived and actual access to health services and the qualitative study provides insight into mechanisms behind such divergences. Conclusion The novel combination of survey data, geographical data and qualitative data will generate a model on access to health services in poor contexts that will feed into efforts to improve access for the most vulnerable people in underserved areas.
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Affiliation(s)
- Arne H Eide
- SINTEF, Department of Health, P.B.124, N-0314, Oslo, Norway.
| | - Karin Dyrstad
- Department of Sociology and Political Science, Norwegian University of Science and Technology, NO-7491, Trondheim, Norway
| | - Alister Munthali
- Centre for Social Research, University of Malawi, P.O. Box 280, Zomba, Malawi
| | - Gert Van Rooy
- Multidisciplinary Research Centre, University of Namibia, P. B. 13301, Windhoek, Namibia
| | | | - Thomas Halvorsen
- SINTEF, Department of Health, P.B. 4760, Torgarden, N-7465, Trondheim, Norway
| | - Frans Persendt
- Department of Geography, History and Environmental Studies, University of Namibia, P.B. 13301, Windhoek, Namibia
| | - Peter Mvula
- Centre for Social Research, University of Malawi, P.O. Box 280, Zomba, Malawi
| | - Jan Ketil Rød
- Department of Geography, Norwegian University of Science and Technology, NO-7491, Trondheim, Norway
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Bakow BR, Low K. A South African Experience: Cultural Determinants of Ukuthwasa. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2018. [DOI: 10.1177/0022022117753546] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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13
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Vergunst R, Swartz L, Hem KG, Eide AH, Mannan H, MacLachlan M, Mji G, Braathen SH, Schneider M. Access to health care for persons with disabilities in rural South Africa. BMC Health Serv Res 2017; 17:741. [PMID: 29149852 PMCID: PMC5693516 DOI: 10.1186/s12913-017-2674-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 11/03/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Global research suggests that persons with disabilities face barriers when accessing health care services. Yet, information regarding the nature of these barriers, especially in low-income and middle-income countries is sparse. Rural contexts in these countries may present greater barriers than urban contexts, but little is known about access issues in such contexts. There is a paucity of research in South Africa looking at "triple vulnerability" - poverty, disability and rurality. This study explored issues of access to health care for persons with disabilities in an impoverished rural area in South Africa. METHODS The study includes a quantitative survey with interviews with 773 participants in 527 households. Comparisons in terms of access to health care between persons with disabilities and persons with no disabilities were explored. The approach to data analysis included quantitative data analysis using descriptive and inferential statistics. Frequency and cross tabulation, comparing and contrasting the frequency of different phenomena between persons with disabilities and persons with no disabilities, were used. Chi-square tests and Analysis of Variance tests were then incorporated into the analysis. RESULTS Persons with disabilities have a higher rate of unmet health needs as compared to non-disabled. In rural Madwaleni in South Africa, persons with disabilities faced significantly more barriers to accessing health care compared to persons without disabilities. Barriers increased with disability severity and was reduced with increasing level of education, living in a household without disabled members and with age. CONCLUSIONS This study has shown that access to health care in a rural area in South Africa for persons with disabilities is more of an issue than for persons without disabilities in that they face more barriers. Implications are that we need to look beyond the medical issues of disability and address social and inclusion issues as well.
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Affiliation(s)
- R. Vergunst
- Alan J Flisher Centre for Public Mental Health, Department of Psychology, Stellenbosch University, PO Box X1, Stellenbosch, Matieland 7602 South Africa
| | - L. Swartz
- Alan J Flisher Centre for Public Mental Health, Department of Psychology, Stellenbosch University, PO Box X1, Stellenbosch, Matieland 7602 South Africa
| | - K.-G. Hem
- SINTEF Technology and Society, Department of Health Research, PB 124 Blindern, 0314 Oslo, Norway
| | - A. H. Eide
- SINTEF Technology and Society, Department of Health Research, PB 124 Blindern, 0314 Oslo, Norway
- Centre for Rehabilitation Studies, Stellenbosch University, Stellenbosch, South Africa
| | - H. Mannan
- School of Nursing, Midwifery & Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - M. MacLachlan
- Centre for Rehabilitation Studies, Stellenbosch University, Stellenbosch, South Africa
- ALL Institute and Department of Psychology, Maynooth University, Maynooth, Ireland
- Olomouc University Social Health Institute, Palacký University Olomouc, Olomouc, Czech Republic
| | - G. Mji
- Centre for Rehabilitation Studies, Stellenbosch University, Stellenbosch, South Africa
| | - S. H. Braathen
- Alan J Flisher Centre for Public Mental Health, Department of Psychology, Stellenbosch University, PO Box X1, Stellenbosch, Matieland 7602 South Africa
- SINTEF Technology and Society, Department of Health Research, PB 124 Blindern, 0314 Oslo, Norway
| | - M. Schneider
- Alan J Flisher Centre for Public Mental Health Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
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Ned L, Cloete L, Mji G. The experiences and challenges faced by rehabilitation community service therapists within the South African Primary Healthcare health system. Afr J Disabil 2017; 6:311. [PMID: 29062760 PMCID: PMC5645568 DOI: 10.4102/ajod.v6i0.311] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 05/23/2017] [Indexed: 11/25/2022] Open
Abstract
Background Twenty-two years after the promulgation of a plethora of progressive health policies since 1994, the South African public health system reflects a number of stumbling blocks regarding implementation. Rehabilitation professionals are not sufficiently equipped nor allowed the opportunity to comprehensively implement Primary Healthcare (PHC) from a bottom-up approach, thus engaging communities. Training on addressing social health determinants and their impact on ill-health and health outcomes is inadequate. The inadequate understanding of the advocacy role that rehabilitation professionals could play in addressing social health determinants remains a challenge in healthcare. Rehabilitation, a pillar of PHC, remains poorly understood in terms of its role within the health system. Aim We argue for rehabilitation as a vehicle for addressing social determinants of health with community service practitioners playing a critical role in addressing the inequities within the healthcare package. Setting The article reflects the opportunities and challenges faced by rehabilitation community service therapists in the delivery of rehabilitation services in a rural area of the Eastern Cape province of South Africa. Methods A single case study from the perspective of a researcher was used to explore the experience and reflection of the first author during her community service as an occupational therapist. Results The case study highlights some existing gaps within the delivery of rehabilitation services in the rural Eastern Cape. A community service package with a specific approach towards addressing social determinants of health for persons with disability at a community level is suggested. Conclusion Advocating for a rehabilitation service package to shift to community-based levels is critical. It is envisaged that a community-based approach will facilitate an understanding of the barriers faced by persons with disabilities as constituting disability, thus facilitating learning about the disabling consequences of the rural environment coupled with the system as experienced by persons with disabilities.
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Affiliation(s)
- Lieketseng Ned
- Centre for Rehabilitation Studies, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Lizahn Cloete
- Division of Occupational Therapy, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, University of Stellenbosch, South Africa
| | - Gubela Mji
- Centre for Rehabilitation Studies, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
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15
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Hussey M, MacLachlan M, Mji G. Barriers to the Implementation of the Health and Rehabilitation Articles of the United Nations Convention on the Rights of Persons with Disabilities in South Africa. Int J Health Policy Manag 2017; 6:207-218. [PMID: 28812804 PMCID: PMC5384983 DOI: 10.15171/ijhpm.2016.117] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 08/15/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) is a milestone in the recognition of the human rights of persons with disabilities, including the right to health and rehabilitation. South Africa has signed and ratified the CRPD but still has a long way to go in reforming policies and systems in order to be in compliance with the convention. This paper seeks to fill a gap in the literature by exploring what the barriers to the implementation of the health and rehabilitation articles of the CRPD are, as identified by representatives of the disability community. METHODS This investigation used a qualitative, exploratory methodology. 10 semi-structured interviews of a purposive sample of representatives of disabled persons organizations (DPOs), non-governmental organizations (NGOs), and service providers in South Africa were conducted. Participants were drawn from urban, peri-urban, and rural settings in order to reflect diverse perspectives within South Africa. Data was analysed using a multi-stage coding process to establish the main categories and relationships between them. RESULTS Six main categories of barriers to the implementation of the health and rehabilitation articles of the CRPD were identified. Attitude barriers including stigma and negative assumptions about persons with disabilities were seen as an underlying cause and influence on all of the other categories; which included political, financial, health systems, physical, and communication barriers. CONCLUSION The findings of this study have important implications for strategies and actions to implement the CRPD. Given the centrality of attitudinal barriers, greater sensitization around the area of disability is needed. Furthermore, disability should be better integrated and mainstreamed into more general initiatives to develop the health system and improve the lives of persons living in poverty in South Africa.
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Affiliation(s)
- Meghan Hussey
- Centre for Global Health, Trinity College Dublin, Dublin 2, Ireland
| | | | - Gubela Mji
- Centre for Rehabilitation Studies, Department of Interdisciplinary Health Sciences, School of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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16
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Mji G, Braathen SH, Vergunst R, Scheffler E, Kritzinger J, Mannan H, Schneider M, Swartz L, Visagie S. Exploring the interaction of activity limitations with context, systems, community and personal factors in accessing public health care services: A presentation of South African case studies. Afr J Prim Health Care Fam Med 2017; 9:e1-e9. [PMID: 28240032 PMCID: PMC5320466 DOI: 10.4102/phcfm.v9i1.1166] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 07/29/2016] [Accepted: 10/11/2016] [Indexed: 01/02/2023] Open
Abstract
Background There are many factors that influence access to public health services, such as the context people live in, the existing health services, and personal, cultural and community factors. People with disabilities (activity limitations), through their experience of health services, may offer a particular understanding of the performance of the health services, thus exposing health system limitations more clearly than perhaps any other health service user. Aim This article explores how activity limitations interact with factors related to context, systems, community and personal factors in accessing public health care services in South Africa. Setting We present four case studies of people with disabilities from four low-resource diverse contexts in South Africa (rural, semi-rural, farming community and peri-urban) to highlight challenges of access to health services experienced by people with activity limitations in a variety of contexts. Methods One case study of a person with disabilities was chosen from each study setting to build evidence using an intensive qualitative case study methodology to elucidate individual and household experiences of challenges experienced by people with activity limitations when attempting to access public health services. In-depth interviews were used to collect data, using an interview guide. The analysis was conducted in the form of a thematic analysis using the interview topics as a starting point. Results First, these four case studies demonstrate that equitable access to health services for people with activity limitations is influenced by a complex interplay of a variety of factors for a single individual in a particular context. Secondly, that while problems with access to public health services are experienced by everyone, people with activity limitations are affected in particular ways making them particularly vulnerable in using public health services. Conclusion The revitalisation of primary health care and the introduction of national health insurance by the Health Department of South Africa open a window of opportunity for policy makers and policy implementers to revisit and address the areas of access to public health services for people with activity limitations.
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Affiliation(s)
- Gubela Mji
- Centre for Rehabilitation Studies, Stellenbosch University.
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17
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Addressing Adolescent Depression in Tanzania: Positive Primary Care Workforce Outcomes Using a Training Cascade Model. DEPRESSION RESEARCH AND TREATMENT 2017; 2017:9109086. [PMID: 29333294 PMCID: PMC5733241 DOI: 10.1155/2017/9109086] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/15/2017] [Accepted: 07/26/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND This is a report on the outcomes of a training program for community clinic healthcare providers in identification, diagnosis, and treatment of adolescent Depression in Tanzania using a training cascade model. METHODS Lead trainers adapted a Canadian certified adolescent Depression program for use in Tanzania to train clinic healthcare providers in the identification, diagnosis, and treatment of Depression in young people. As part of this training program, the knowledge, attitudes, and a number of other outcomes pertaining to healthcare providers and healthcare practice were assessed. RESULTS The program significantly, substantially, and sustainably improved provider knowledge and confidence. Further, healthcare providers' personal help-seeking efficacy also significantly increased as well as the clinicians' reported number of adolescent patients identified, diagnosed, and treated for Depression. CONCLUSION To our knowledge, this is the first study reporting positive outcomes of a training program addressing adolescent Depression in Tanzanian community clinics. These results suggest that the application of this training cascade approach may be a feasible model for developing the capacity of healthcare providers to address youth Depression in a low-income, low-resource setting.
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18
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Vergunst R, Swartz L, Mji G, Kritzinger J, Braathen SH. Beyond the checklist: understanding rural health vulnerability in a South African context. Glob Health Action 2016; 9:33272. [PMID: 27914191 PMCID: PMC5134832 DOI: 10.3402/gha.v9.33272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 11/06/2016] [Accepted: 11/07/2016] [Indexed: 11/15/2022] Open
Abstract
Background Vulnerability in the past has sometimes been measured and understood in terms of checklists or common understanding. It is argued here that vulnerability is a more complex issue than this. Although checklists of vulnerable groups are important, they do not capture the essence and dynamics of vulnerability. Objective The case of rural health vulnerability in South Africa is discussed to show that classifying people into vulnerable groups does not portray the complexity and intricacies of what it means to have vulnerability. We also wish to show that there are different kinds of vulnerabilities, and the difference between access vulnerability and illness vulnerability is highlighted. Methods As part of a larger study, this case study is presented to show how vulnerability in a poor rural community in South Africa has to be understood in a contextual and dynamic manner as opposed to a static manner. Results Family and social dynamics can influence health. For example, fractured families were seen as a vulnerable issue within the community, while being a person with a disability can lead to isolation and callous attitudes towards them. It is these family and social dynamics that lead proximally to vulnerability to ill health. Conclusions A contextual approach can assist in giving a more layered understanding of vulnerability than a checklist approach can do. Interventions to change health cannot be addressed simply by medical means. Social conditions need to be changed, and part of changing social conditions is the process of assisting those who are isolated or experience themselves as vulnerable to reconnect with others in the community. Poverty leads to social exclusion; social and family inclusion may be key to well-being.
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Affiliation(s)
- Richard Vergunst
- Department of Psychology, University of Stellenbosch, Stellenbosch, South Africa;
| | - Leslie Swartz
- Department of Psychology, University of Stellenbosch, Stellenbosch, South Africa
| | - Gubela Mji
- Centre for Rehabilitation Studies, University of Stellenbosch, Stellenbosch, South Africa
| | - Janis Kritzinger
- Department of Psychology, University of Stellenbosch, Stellenbosch, South Africa
| | - Stine Hellum Braathen
- Department of Psychology, University of Stellenbosch, Stellenbosch, South Africa.,SINTEF Technology and Society, Department of Health, PB 124 Blindern, 0314 Oslo, Norway
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19
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Braathen SH, Sanudi L, Swartz L, Jürgens T, Banda HT, Eide AH. A household perspective on access to health care in the context of HIV and disability: a qualitative case study from Malawi. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2016; 16:12. [PMID: 27036489 PMCID: PMC4818417 DOI: 10.1186/s12914-016-0087-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 03/22/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Equitable access to health care is a challenge in many low-income countries. The most vulnerable segments of any population face increased challenges, as their vulnerability amplifies problems of the general population. This implies a heavy burden on informal care-givers in their immediate and extended households. However, research falls short of explaining the particular challenges experienced by these individuals and households. To build an evidence base from the ground, we present a single case study to explore and understand the individual experience, to honour what is distinctive about the story, but also to use the individual story to raise questions about the larger context. METHODS We use a single qualitative case study approach to provide an in-depth, contextual and household perspective on barriers, facilitators, and consequences of care provided to persons with disability and HIV. RESULTS The results from this study emphasise the burden that caring for an HIV positive and disabled family member places on an already impoverished household, and the need for support, not just for the HIV positive and disabled person, but for the entire household. CONCLUSIONS Disability and HIV do not only affect the individual, but the whole household, immediate and extended. It is crucial to consider the interconnectedness of the challenges faced by an individual and a household. Issues of health (physical and mental), disability, employment, education, infrastructure (transport/terrain) and poverty are all related and interconnected, and should be addressed as a whole in order to secure equity in health.
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Affiliation(s)
- Stine Hellum Braathen
- />Department of Health, SINTEF Technology and Society, PB 124 Blindern, 0314 Oslo, Norway
| | - Lifah Sanudi
- />REACH Trust, P.O. Box 1597, Lilongwe, Malawi
- />Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7602 South Africa
| | - Leslie Swartz
- />Department of Psychology, Stellenbosch University, Alan J Flisher Centre for Public Mental Health, Private Bag X1, Matieland, 7602 South Africa
| | - Thomas Jürgens
- />LHL International Tuberculosis Foundation, Grensen 3 (7th floor), 0159 Oslo, Norway
| | | | - Arne Henning Eide
- />Department of Health, SINTEF Technology and Society, PB 124 Blindern, 0314 Oslo, Norway
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20
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Wilson A, Somhlaba NZ. The position of Ghana on the progressive map of positive mental health: A critical perspective. Glob Public Health 2016; 12:579-588. [PMID: 26999029 DOI: 10.1080/17441692.2016.1161816] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
According to the World Health Organisation (WHO), mental health is a state of well-being and not just the absence of diseases. With this definition, there has been a surge of mental health research, albeit still predominantly in Western countries, which is reflected in contemporary theories on positive mental health that include 'flourishing mental health', 'salutogenesis', and 'fortigenesis'. However, in low- and middle-income countries (LMICs), mental health research is slowly receiving scholarly attention. The aim of this paper was twofold: Firstly, to highlight progress that had been made in some LMICs, giving consideration to research across different settings and populations as a basis to argue for more research on positive mental health in the Ghanaian context. Secondly, to present a critical perspective on the current mental health research trends in Ghana, thus discussing important recommendations for future research.
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Affiliation(s)
- Angelina Wilson
- a Department of Psychology , University of Stellenbosch , Stellenbosch , South Africa
| | - Nceba Z Somhlaba
- a Department of Psychology , University of Stellenbosch , Stellenbosch , South Africa
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21
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Sharp C, Jardin C, Marais L, Boivin M. Orphanhood by AIDS-Related Causes and Child Mental Health: A Developmental Psychopathology Approach. ACTA ACUST UNITED AC 2015; 1. [PMID: 27668289 DOI: 10.16966/2380-5536.114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
While the number of new HIV infections has declined, the number of orphans as a result of AIDS-related deaths continues to increase. The aim of this paper was to systematically review empirical research on the mental health of children affected by HIV/AIDS in the developing world, specifically with an eye on developing a theoretical framework to guide intervention and research. Articles for review were gathered by following the Preferred Reporting Items for Systemic Reviews and Meta Analyses (PRISMA standards), reviewed and then organized and synthesized with a Developmental Psychopathology framework. Results showed that the immediate and longterm effects of AIDS orphanhood are moderated by a number of important risk and protective factors that may serve as strategic targets for intervention. Research and clinical implications are discussed.
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Affiliation(s)
- Carla Sharp
- Department of Psychology, University of Houston, Houston, TX 77024, USA
| | - Charles Jardin
- Department of Psychology, University of Houston, Houston, TX 77024, USA
| | - Lochner Marais
- Centre for Development Support, University of the Free State, South Africa
| | - Michael Boivin
- Department of Neurology & Ophthalmology, Michigan State University, USA
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22
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Scheffler E, Visagie S, Schneider M. The impact of health service variables on healthcare access in a low resourced urban setting in the Western Cape, South Africa. Afr J Prim Health Care Fam Med 2015; 7:820. [PMID: 26245611 PMCID: PMC4656938 DOI: 10.4102/phcfm.v7i1.820] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 05/19/2015] [Accepted: 05/06/2015] [Indexed: 11/30/2022] Open
Abstract
Background Health care access is complex and multi-faceted and, as a basic right, equitable access and services should be available to all user groups. Objectives The aim of this article is to explore how service delivery impacts on access to healthcare for vulnerable groups in an urban primary health care setting in South Africa. Methods A descriptive qualitative study design was used. Data were collected through semi-structured interviews with purposively sampled participants and analysed through thematic content analysis. Results Service delivery factors are presented against five dimensions of access according to the ACCESS Framework. From a supplier perspective, the organisation of care in the study setting resulted in available, accessible, affordable and adequate services as measured against the District Health System policies and guidelines. However, service providers experienced significant barriers in provision of services, which impacted on the quality of care, resulting in poor client and provider satisfaction and ultimately compromising acceptability of service delivery. Although users found services to be accessible, the organisation of services presented them with challenges in the domains of availability, affordability and adequacy, resulting in unmet needs, low levels of satisfaction and loss of trust. These challenges fuelled perceptions of unacceptable services. Conclusion Well developed systems and organisation of services can create accessible, affordable and available primary healthcare services, but do not automatically translate into adequate and acceptable services. Focussing attention on how services are delivered might restore the balance between supply (services) and demand (user needs) and promote universal and equitable access.
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Affiliation(s)
- Elsje Scheffler
- Centre for Rehabilitation Studies, Stellenbosch University and Psychology Department, Stellenbosch University.
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23
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MacLachlan M, Amin M, Mji G, Mannan H, McVeigh J, McAuliffe E, Amadhila E, Munthali A, Eide AH, Dube AK. Learning from doing the EquitAble project: Content, context, process, and impact of a multi-country research project on vulnerable populations in Africa. Afr J Disabil 2014; 3:89. [PMID: 28730013 PMCID: PMC5442513 DOI: 10.4102/ajod.v3i2.89] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 05/28/2014] [Indexed: 11/04/2022] Open
Abstract
Background The ‘EquitAble’ project carried out content analyses of policies and collected and analysed qualitative and quantitative data concerning access to health services in Sudan, Malawi, Namibia and South Africa. Our particular concern was to address the situation of people with disabilities, although not in isolation from other marginalised or vulnerable groups. Objectives This article reports on the content, context, process and impact of project EquitAble, funded by the European Commission Seventh Research Framework Programme, which brought together researchers from Ireland, Norway, South Africa, Namibia, Sudan and Malawi. Method After the 4-year project ended in February 2013, all members of the consortium were asked to anonymously complete a bespoke questionnaire designed by the coordinating team. The purpose of the questionnaire was to capture the views of those who collaborated on the research project in relation to issues of content, context, process and impact of the EquitAble project. Results Our results indicated some of the successes and challenges encountered by our consortium. Conclusion We identified contextual and process learning points, factors often not discussed in papers, which typically focus on the reporting of the ‘content’ of results.
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Affiliation(s)
- Mac MacLachlan
- Centre for Global Health and School of Psychology, Trinity College Dublin, Ireland.,Centre for Rehabilitation Studies, Stellenbosch University, South Africa
| | - Mutamad Amin
- Research & Grants, Ahfad University for Women, Omdurman, Sudan
| | - Gubela Mji
- Centre for Rehabilitation Studies, Stellenbosch University, South Africa
| | - Hasheem Mannan
- Centre for Global Health and School of Psychology, Trinity College Dublin, Ireland.,Nossal Institute for Global Health, University of Melbourne, Australia
| | - Joanne McVeigh
- Centre for Global Health and School of Psychology, Trinity College Dublin, Ireland
| | - Eilish McAuliffe
- Centre for Global Health and School of Psychology, Trinity College Dublin, Ireland
| | - Elina Amadhila
- Multidisciplinary Research Centre, University of Namibia, Namibia
| | | | | | - A Kudakwashe Dube
- Secretariat of the African Decade of Persons with Disabilities, Pretoria, South Africa
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24
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Lees J, Macaskie J, Freshwater D. Social and political perspectives on the psychotherapy and counselling profession: Returning caravelles. EUROPEAN JOURNAL OF PSYCHOTHERAPY & COUNSELLING 2014. [DOI: 10.1080/13642537.2014.956772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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25
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Marais L, Sharp C, Pappin M, Rani K, Skinner D, Lenka M, Cloete J, Serekoane J. Community-based mental health support for orphans and vulnerable children in South Africa: A triangulation study. VULNERABLE CHILDREN AND YOUTH STUDIES 2014; 9:151-158. [PMID: 24799952 PMCID: PMC4007579 DOI: 10.1080/17450128.2013.855345] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Community-based care is receiving increasing global attention as a way to support children who are orphaned or vulnerable due to the HIV/AIDS pandemic. Using both qualitative and quantitative methodology, this study assesses community-based responses to the well-being of orphans and vulnerable children (OVC) and compares these responses with the actual mental health of OVC in order to evaluate the South African government's approach of funding community-based organisations (CBOs) that support and care for OVC. The study results show that the activities of CBOs mainly extend government services and address poverty. Although this should not be seen as insignificant, the paper argues that CBOs give very little attention to the mental health of OVC.
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Affiliation(s)
- Lochner Marais
- Centre for Development Support, University of the Free State, South Africa
| | - Carla Sharp
- Department of Psychology, University of Houston, United States
| | - Michelle Pappin
- Centre for Development Support, University of the Free State, South Africa
| | - Kholisa Rani
- Centre for Development Support, University of the Free State, South Africa
| | - Donald Skinner
- Research on Health and Society, Faculty of Health Sciences, Stellenbosch University, South Africa
| | - Molefi Lenka
- Centre for Development Support, University of the Free State, South Africa
| | - Jan Cloete
- Centre for Development Support, University of the Free State, South Africa
| | - Joe Serekoane
- Department of Anthropology, University of the Free State, South Africa
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26
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Tomlinson M. Global mental health: a sustainable post Millennium Development Goal? Int Health 2013; 5:1-3. [DOI: 10.1093/inthealth/iht001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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