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At least 19 recordsLinked to original sources

Demand for and accessibility to reproductive health service of urban floating population.

The demand for knowledge of productive health and the current status of productive health services provided by relevant governmental institutions were qualitatively and quantitatively studied. The study identified the key factors that influenced the demand for the productive health services and results of the services. It also discussed the effective approaches to control, planning and sustainable development of the reproductive health services for the floating populations.

Adolescent↗

Improving mental health services for urban First Nations: policy issues relevant to health care reform.

This paper discusses issues related to the development of plans to improve the effectiveness of mental health services for urban First Nations people. The discussion focuses on emerging issues related to health care reform and regionalization. While it is impossible to make specific recommendations without reference to local conditions, developing an awareness of the general issues involved will help in the process of identifying the principles and approaches needed to frame local solutions.

American Indian or Alaska Native↗

Use of traditional and orthodox health services in urban Zimbabwe.

BACKGROUND: Health care in Zimbabwe is provided by both orthodox and traditional care providers. With formal medical services under economic strain it is important to understand the extent of consulting with traditional care providers and their effectiveness. METHODS: A cross-sectional community survey recorded consultations and self-treatment for episodes of illness among 1251 individuals in 222 households randomly selected in two high-density suburbs of Harare, Zimbabwe. Three dependent variables (illness experience, consultation behaviour and choice of care provider) were analysed against a range of sociodemographic, episode-related and outcome measures. RESULTS: More than one-third of the sample had experienced an illness and 83% of these had led to consultation. Medical services were consulted eight times more often than traditional ones. Non-consulting behaviour was associated with lack of money or low perceived significance of problems. Physical problems were usually taken to medical clinics where their outcome was better, but non-specific pain and other problems did no better with medical or traditional care. CONCLUSIONS: While members of the community appear to recognize physical problems and take them to medical care, traditional and orthodox medical consultations appear to be equally effective for non-specific pain or non-specific physical problems. The role of traditional medicine in relation to non-specific physical problems and psychological problems is one which deserves further examination from both clinical and administrative perspectives. Poverty appears to be associated with poorer outcomes; this is a potentially important issue in times of increasing economic hardship.

Adult↗

Utilization of ambulatory health services by urban adolescents.

PURPOSE: To describe adolescents' utilization of ambulatory health services and its association with sociodemographic and health status characteristics. METHODS: Adolescents (N = 199) were selected from a larger group of urban middle and high school students who had previously participated in a health risk survey. Subjects were surveyed about their health status and use of ambulatory medical services. Subjects' parents/guardians were also surveyed about sociodemographic information. Bivariate and multivariate analyses using Chisquare statistics and logistic regression techniques assessed the contribution of hypothesized variables to use of routine medical, illness-related medical, and dental services. RESULTS: Most adolescents reported having seen a physician (70%) or a dentist (79%) within the past year. Subjects reported using a wide variety of practitioners and settings, with family/general practitioners (29%), and the private office setting (23%) most commonly reported. Subjects having a regular source of care and those perceiving their health as "excellent" or "very good" were 2.4 and 3.4 times more likely to have used routine medical services than those without a regular source of care and those reporting their health as "fair" or "poor." In contrast, the strongest predictors of having received illness-related care in the past year were the presence of a current medical problem and an age by gender interaction factor. Those reporting a current medical problem were twice as likely as those not reporting a problem and older females were 6.6 times as likely as younger males to have received illness-related care within the past year. The only significant predictor of recent dental care was having private insurance. CONCLUSION: For adolescents enabling variables, such as having a regular source of care and health insurance, are stronger predictors of routine use of medical and dental care, whereas medical need and sociodemographic factors, such as age and gender, are more important in predicting use of illness-related care. These results support, in part, models that have been previously developed to explain use of ambulatory health services.

Adolescent↗

Definitions of allied health services in urban community contexts: consumer perspectives.

This study, as part of a larger project designed to increase allied health services to underserved urban community agencies, focussed on understanding how consumers defined the services provided in community agencies. Consumers were asked to describe what they defined as service and what constituted good service provision. Qualitative methods were used to conduct key-informant interviews and focus groups with consumers and staff at six community agencies representing different underserved populations, including ethnic and racial minority groups, the homeless, and individuals with disabilities living in the community. Four major themes emerged across the data: 1) the struggle to maintain a stable life with a chronic illness or disability; 2) services need to help solve life challenges; 3) the challenge of accessing and maintaining services; and 4) the need for a peer community. Data analysis revealed that services are difficult to access within and outside community agencies, services need to address short-term as well as long-term issues, and services in the community are still driven by a professional or expert model despite the availability of peer models. Recommendations for health professionals working in community settings are provided.

Activities of Daily Living↗

Changing access to health services in urban China: implications for equity.

The ongoing reform of public institutions and state-owned enterprises in urban China has had a profound impact on the financing, organization and provision of health services. Access to health care by the urban population has become more inequitable. One of the most pressing concerns is that those who have lost jobs have increasing difficulties accessing health care. Using the data from the national household health surveys conducted in 1993 and 1998, this paper presents empirical results of changing utilization of health care among different income groups. Over 16 000 households and 54 000 individuals in the urban areas were randomly selected to collect information on perceived need of and demand for health care and expenditures on the services. The findings show that the income gap between the highest and lowest income groups increased in real terms from 1993 to 1998. There was a significant decline in the population covered by the government insurance scheme (GIS) and the labour insurance scheme (LIS), while the proportion of the population who had to pay for services out-of-pocket increased from 28% in 1993 to 44% in 1998. There was no statistically significant change in self-reported illness in the 2 weeks prior to survey among the study population over the period. While it was found that more people who reported illness from each income group received medical treatment of some kind, there was a decline in seeking care from a health provider. Among those in the lowest income group who reported illness but did not obtain treatment of any kind, nearly 70% (as compared with 38% in 1993) claimed financial difficulty as the major reason in 1998. The use of in-patient services dropped significantly from 4.5% in 1993 to 3.0% in 1998. The decreased use of in-patient services was more serious in the lowest and lower income groups than in higher and highest income groups. The percentage of patients referred for hospital admission but not being hospitalized had a negative relationship with income level. We can conclude from the data analysis that access of the urban population, particularly the poor, to formal health services has worsened and become more inequitable since the early 1990s. Among possible reasons for this trend are the rapid rise of per capita expenditure on health services and the decline in insurance coverage.

China↗