'I demand to be treated as the person I am': experiences of accessing primary health care for Australian adults who identify as gay, lesbian, bisexual, transgender or queer

Sexual Health ◽  
2014 ◽  
Vol 11 (3) ◽  
pp. 258 ◽  
Author(s):  
Chee S. Koh ◽  
Melissa Kang ◽  
Tim Usherwood
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Sexual Identity ◽  
Health Care Providers ◽  
Primary Care Providers ◽  
Free Text ◽  
Care Providers ◽  
Care Services ◽  
Primary Health

Background Individuals who identify as gay, lesbian, bisexual, transgender or queer (GLBTQ) suffer higher rates of illness and morbidity compared with the general population but may experience significant barriers to accessing primary health care. Method: We used an online questionnaire to explore GLBTQ adults’ experiences of accessing primary health care in Australia. We developed the questionnaire in consultation with individuals who belonged to or worked closely with the GLBTQ community. Questions were open-ended and sought information about four topic areas: sexual identity and its meaning, utilisation of primary health care services, disclosure of sexual identity to primary care providers and experiences of accessing primary health care. Data were analysed by coding free-text responses into themes. Results: Ninety-nine valid responses were received. Participants were 18–60+ years old (modal age group: 20–29 years); 70% lived in cities. Of these, 49% identified as gay, 35% as lesbian, 13% as bisexual, 8% as queer and 3% as transgender. Some participants indicated more than one identity. GLBTQ-identifying adults often divided care, seeking different primary care services for different health concerns. Themes in relation to disclosure of sexual identity were: taking a rights-based position, experiences of homophobia and clinical context. Themes about access to primary health care were: diversity and heterogeneity, real or perceived discrimination, visual symbols and respect. Conclusion: Despite diversity, GLBTQ adults experience many barriers to accessing health care due to sexual identity. General practitioners and other primary health care providers have a role in ensuring equitable access to health care.

scholarly journals The expectations of transgender people in the face of their health-care access difficulties and how they can be overcome. A qualitative study in France

2020 ◽  
Vol 21 ◽  
Author(s):  
Emmanuel Allory ◽  
Ellie Duval ◽  
Marion Caroff ◽  
Candan Kendir ◽  
Raphaël Magnan ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Access ◽  
Primary Care Providers ◽  
Care Providers ◽  
Transgender People ◽  
Care Access ◽  
Care Services ◽  
Primary Health

Abstract Aim: Our objective was to explore the difficulties experienced by transgender people in accessing primary health-care services and their expectations towards primary care providers to improve their health-care access. Background: Because transgender people are exposed to many discriminations, their health-care access is particularly poor. Guidelines recommend greater involvement of primary care providers in the processes because of the accessibility feature of primary care services. Methods: A qualitative study using semi-directed interviews was conducted among 27 transgender people (February 2018 – August 2018). These voluntary participants were recruited through different means: local trans or LGBTI (lesbian, gay, bisexual, trans, and/or intersex) associations, primary care providers, and social networks. The data analysis was based on reflexive thematic analysis in an inductive approach. Findings: Difficulties in accessing health-care occurred at all the levels of the primary health-care system: primary care providers – transgender people interaction, access to the primary care team facility (starting with the secretariat), access to secondary care specialists, and continuity of care. Transgender people report ill-adapted health-care services as a result of gender-based identification in health-care settings. Their main expectation was depsychiatrization and self-determination. They supported mixed health network comprising primary care providers and transgender people with a coordinating role for the general practitioner. These expectations should be priorities to consider in our primary health-care system to improve access to health-care for transgender people.

scholarly journals Erythematous plaques of the vulvo-perineal region

2021 ◽  
Vol 16 (3) ◽  
pp. 101-103
Author(s):  
Qin Jian Low ◽  
Tzyy Huei Lim ◽  
Shu Ann Hon ◽  
Seng Wee Cheo ◽  
Noranizah Wagino ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Primary Care Providers ◽  
Care Providers ◽  
Primary Health ◽  
Primary Health Care Providers ◽  
Slow Evolution ◽  
Skin Conditions

Skin conditions are a common reason for consulting primary health care. The public frequently expects their primary health care providers to be able to recognise and treat common skin conditions with confidence. Primary care providers must be able to identify ‘red flag’ skin conditions that require dermatology referral. However, diagnosis is often delayed due to the non-specific clinical presentation, low incidence, slow evolution and long-term history of such lesions. We report the case of a patient with extramammary Paget’s disease that presented to her primary care provider and subsequently underwent a wide local excision.

scholarly journals Impact of mental health and addiction NIMHANS ECHO on primary care physicians: study from a rural state of India

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S157-S157
Author(s):  
Shabinabegam A M Sheth ◽  
Bhavya Bairy ◽  
Aurobind Ganesh ◽  
Sumi Jain ◽  
Prabhat Chand ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Mental Health Problems ◽  
Health Problems ◽  
Care Providers ◽  
Primary Health ◽  
Secondary Outcomes

AimsAs per National Mental Health Survey-2015-16, 83 out of 100 people having mental health problems do not have access to care in India. Further, primary health care providers (PCPs) have not been adequately trained in the screening, diagnosis, and initial management of common mental health conditions. There is thus a need to train health care providers at the State level to incorporate mental health into primary health care. In this paper, we report the findings of a collaborative project between the National Institute of Mental Health and Neuro Sciences (NIMHANS) Bangalore India, and the state of Chhattisgarh incorporating mental health into primary care and addressing urban-rural disparities through tele-mentoring.MethodWe assessed the impact of the NIMHANS Extended Community Health Care Outcome (ECHO), an online, blended training program on participants' knowledge and competence (primary outcome) and commitment, satisfaction, and performance (Secondary outcomes) using Moore's evaluation framework. Primary and secondary outcomes were determined through a pre-post evaluation, assessment of trainee participation in the quarterly tele ECHO clinic as well as periodic assignments, respectively.ResultOver ten months of the NIMHANS ECHO program, there was a significant improvement in the participants' knowledge post-ECHO (p < 0.05, t = −3.52). Self-efficacy in diagnosis and management of mental health problems approached significance; p < 0.001. Increased engagement in tele-ECHO sessions was associated with better performance for declarative and procedural knowledge. The attrition rate was low (5 out of 30 dropped out), and satisfaction ratings of the course were high across all fields. The participants reported a 10- fold increase in the number of patients with mental health problems they had seen, following the training. A statistically significant increase in the number of psychotropic drugs prescribed post ECHO with t = −3.295, p = 0.01.ConclusionThe outcomes indicate that the NIMHANS ECHO with high participant commitment is a model with capacity building potential in mental health and addiction for remote and rural areas by leveraging technology. This model has the potential to be expanded to other states in the country in providing mental health care to persons in need of care.

scholarly journals Experiences of homosexual patients’ access to primary health care services in Umlazi, KwaZulu-Natal

Curationis ◽  
2015 ◽  
Vol 38 (2) ◽  
Author(s):  
Nokulunga H. Cele ◽  
Maureen N. Sibiya ◽  
Dudu G. Sokhela
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Nursing Education ◽  
Health Care Providers ◽  
Health Care Services ◽  
Health Care Facilities ◽  
Easy Access ◽  
Care Providers ◽  
Care Services ◽  
Primary Health

Background: Homosexual patients are affected by social factors in their environment, and as a result may not have easy access to existing health care services. Prejudice against homosexuality and homosexual patients remains a barrier to them seeking appropriate healthcare. The concern is that lesbians and gays might delay or avoid seeking health care when they need it because of past discrimination or perceived homophobia within the health care thereby putting their health at risk.Aim of the study: The aim of the study was to explore and describe the experiences of homosexual patients utilising primary health care (PHC) services in Umlazi in the province ofKwaZulu-Natal (KZN).Method: A qualitative, exploratory, descriptive study was conducted which was contextual innature. Semi-structured interviews were conducted with 12 participants. The findings of this study were analysed using content analysis.Results: Two major themes emerged from the data analysis, namely, prejudice against homosexual patients by health care providers and other patients at the primary health care facilities, and, homophobic behaviour from primary health care personnel.Conclusion: Participants experienced prejudice and homophobic behaviour in the course of utilising PHC clinics in Umlazi, which created a barrier to their utilisation of health services located there. Nursing education institutions, in collaboration with the National Department of Health, should introduce homosexuality and anti-homophobia education programmes during the pre-service and in-service education period. Such programmes will help to familiarise health care providers with the health care needs of homosexual patients and may decrease homophobic attitudes.

scholarly journals The status of the Primary Health Care Plus pilot project in Poland

2019 ◽  
Vol 13 (2) ◽  
pp. 1-14
Author(s):  
Katarzyna Wiktorzak
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Current System ◽  
Pilot Project ◽  
Care Providers ◽  
Primary Health ◽  
The Status

Background The National Health Fund (NHF) is the public payer solely accountable for securing and organizing access to health care services in Poland. The NHF is responsible for implementing a project entitled “Primary Health Care PLUS” which aims to introduce a primary care centered model, based on coordinated, proactive and preventive methods relevant to patients’ needs and furthermore, works to keep patients well-informed and active participants in health care decision-making. The implementation period of the project is July 1, 2018 through Dec. 31, 2021. Aim of the study The purpose of this study is to outline patient demographics and staff structures of providers that took part in the PHC PLUS pilot program, as well as the status of the program throughout the first year of its implementation. Materials and Methods Following an open and transparent recruitment process, 42 urban and rural primary health care providers were selected. The purpose of the providers’ geographic spread was to ensure the model was tested in all representative regions of the country. Results 42 PHC PLUS providers attending to 288,392 patients are participating in the project. Approximately 1,100 medical staff members are involved in the project. PHC PLUS medical teams consist of specialists including physicians, coordinators, nurses, dietitians, psychologists, physiotherapists and health educators. Out of 41,022 health risk assessments declared to be conducted during the project, 18,058 (43.1%) were performed from July 1, 2018 to April 30, 2019, including 4,537 basic and 13,521 extended assessments. Furthermore, 15,020 patients in total, participated in the disease management programs, which are also paid from the project. Conclusions A Polish health care pilot project that centers primary care can help shift the focus toward preventive interventions, rather than the current system, which often focuses on providing medical care to patients who have already been diagnosed with diseases, often in their more advanced stages.

scholarly journals Access to Primary Health Care Services for Youth Experiencing Homelessness: “You shouldn’t need a health card to be healthy.”

2019 ◽  
Vol 1 (2) ◽  
pp. 73-92
Author(s):  
Claire Pitcher ◽  
Elizabeth Saewyc ◽  
Annette Browne ◽  
Paddy Rodney
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Homeless Youth ◽  
Care Providers ◽  
Urban Centre ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services

On any given night, thousands of Canadian youth face homelessness in either absolute (living on the street) or relative (couch surfing, staying in emergency shelters) terms.  This study explores influences primary health care access among youth experiencing homelessness in a large Canadian urban centre.  Using a qualitative research design and convenience sampling, 8 youth participated in in-depth individual interviews and 4 clinicians with expertise in working with youth in primary care settings participated in a facilitated solutions-focused dialogue based on findings from the youth interviews.  Data collection occurred from January to November 2016.  Main findings included: (1) Youth experiencing homelessness feel powerless when interacting with health care providers, (2) Health care systems exist as rule-based bureaucracies and (3) Homeless youth are in survival mode when it comes to their health.  The authors offer recommendations to promote more equitable access to primary health care services for homeless youth.

scholarly journals Provision of mental health care within primary care in Peru: A qualitative study exploring the perspectives of psychologists, primary health care providers, and patients

2018 ◽  
Vol 3 ◽  
pp. 9 ◽  
Author(s):  
Victoria Cavero ◽  
Francisco Diez-Canseco ◽  
Mauricio Toyama ◽  
Gustavo Flórez Salcedo ◽  
Alessandra Ipince ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Perceived Need ◽  
Primary Health ◽  
Primary Health Care Providers

Background: This study aimed to understand the offer of mental health care at the primary care level, collecting the views of psychologists, primary health care providers (PHCPs), and patients, with a focus on health services in which patients attend regularly and who present a higher prevalence of mental disorders. Methods: A qualitative study was conducted in antenatal care, tuberculosis, HIV/AIDS, and chronic diseases services from six primary health care centers. Semi-structured interviews were conducted with psychologists, PHCPs, and patients working in or attending the selected facilities.  Results: A total of 4 psychologists, 22 PHCPs, and 37 patients were interviewed. A high perceived need for mental health care was noted. PHCPs acknowledged the emotional impact physical health conditions have on their patients and mentioned that referral to psychologists was reserved only for serious problems. Their approach to emotional problems was providing emotional support (includes listening, talk about their patients’ feelings, provide advice). PHCPs identified system-level barriers about the specialized mental health care, including a shortage of psychologists and an overwhelming demand, which results in brief consultations and lack in continuity of care. Psychologists focus their work on individual consultations; however, consultations were brief, did not follow a standardized model of care, and most patients attend only once. Psychologists also mentioned the lack of collaborative work among other healthcare providers. Despite these limitations, interviewed patients declared that they were willing to seek specialized care if advised and considered the psychologist's care provided as helpful; however, they recognized the stigmatization related to seeking mental health care. Conclusions: There is a perceived need of mental health care for primary care patients. To attend these needs, PHCPs provide emotional support and refer to psychology the most severe cases, while psychologists provide one-to-one consultations. Significant limitations in the care provided are discussed.

scholarly journals Innovation in primary health care responses to COVID-19 in Sub-Saharan Africa

2021 ◽  
Vol 22 ◽  
Author(s):  
Sunanda Ray ◽  
Robert Mash
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Family Medicine ◽  
Health Services ◽  
Primary Care Providers ◽  
Sub Saharan Africa ◽  
Care Providers ◽  
Primary Health ◽  
Lessons Learnt

Abstract Background: In May 2020, the African Journal of Primary Health Care and Family Medicine invited submissions on lessons learnt from responses to the COVID-19 pandemic from primary care providers in Africa. This included descriptions of innovations and good practices, the management of COVID-19 in district health services and responses of communities to the outbreak. Aim: To synthesise the lessons learnt from the COVID-19 pandemic in the Africa region. Methods: A thematic document analysis was conducted on twenty-seven short report publications from Botswana, Ghana, Nigeria, South Africa, Uganda and Zimbabwe. Findings: Eight major themes were derived from the data: community-based activities; screening and testing; reorganisation of health services; emergency care for COVID-19; maintenance of essential non-COVID-19 health services; caring for the vulnerable; use of information technology; and reframing training opportunities. Community health workers were a vital community resource, delivering medications and other supplies to homes, as well as following up on patients with chronic conditions. More investment in community partnerships and social mobilisation was proposed. Difficulties with procurement of test kits and turn-around times were constraints for most countries. Authors described how services were reorganised for focused COVID-19 activities, sometimes to the detriment of essential services and training of junior doctors. Innovations in use of internet technology for communication and remote consultations were explored. The contribution of family medicine principles in upholding the humanity of patients and their families, clear leadership and planning, multidisciplinary teamwork and continuity of care was emphasised even in the context of providing critical care. Conclusions: The community-orientated primary care approach was emphasised as well as long-term benefits of technological innovations. The pandemic exposed the need to deliver on governmental commitments to strengthening primary health care and universal health coverage.

scholarly journals Primary Health Care Services of Urban Villages

2020 ◽  
Author(s):  
Ramonita J. Sencio ◽  
Mauro Allan Padua Amparado
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Health Workers ◽  
Care Providers ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services ◽  
Significant Difference

Objectives: The study determined the awareness on Primary Health Care (PHC) services as perceived by the residents and the level of implementation of PHC services as perceived by the Volunteer Health Workers in Bulacao and Pardo, Cebu City, Cebu, Philippines. The findings served as basis for a series of re-orientation seminars on PHC programs. Specifically, the study answered the following questions:1.What is the level of awareness on PHC services as perceived by the residents in terms of:1.1.health education;1.2.locally endemic disease control;1.3.expanded program on immunization;1.4.maternal health, child health and family planning; 1.5.provision of essential drugs;1.6.adequate food and proper nutrition;1.7.control of communicable diseases;1.8.environmental sanitation; and1.9.provision of medical care and emergency treatment?2.What is the level of implementation on PHC services as perceived by Volunteer Health Workers in the same areas?3.Is there a significant difference in the level of awareness and the level of implementation of the PHC programs as perceived by the respondents?4.What problems were encountered by health care providers on the implementation of the PHC programs?5.Based on the findings of the study, what appropriate series of re-orientation seminars can be proposed?Methods:This study utilized the descriptive-evaluative design. The study was conducted in two villages in Cebu City, namely, Bulacao and Pardo. The study includes 379 community residents and 26 volunteer health workers. A researcher-made tool composed of 45 items on the nine components of PHC was used. An interview guide was prepared to gather more information and confirm responses from the tool. Findings and Conclusion:The study revealed that the residents were aware of the PHC services. It also showed that the level of implementation of the volunteer health workers on PHC services was high. There was a significant difference in the perceptions of the residents on the level of awareness and the volunteer health workers’ level of implementation of PHC services. The top three problems encountered by the health care providers were inadequate medicines, inadequate clinic space for consultation, and availability of medical doctors. In conclusion, when the targeted beneficiaries are aware of the primary health care services, the volunteer health workers will feel more determined to perform their roles to render improved primary health care services. Recommended citation:Sencio, Ramonita J. &amp; Amparado, M. A. P. (2010, March). PrimaryHealth Care Services of Urban Villages. 2010 Southwestern University Research Congress, 2(1), 22-24.

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