Qualitative evaluation of a mandatory health insurance ‘wait period’ in a publicly funded health system: understanding health inequities for newcomer im/migrant women

ObjectivesTo evaluate impacts of a residency-based waiting period for health insurance coverage on lived experiences of health and settlement for im/migrant women in British Columbia, Canada.DesignThe IRIS study is a mixed-methods, community-based, qualitative evaluation of recently arrived im/migrant women’s access to sexual and reproductive care. In-depth, semistructured interviews were conducted by trained multilingual and multicultural interviewers with lived migration experience in the participant’s preferred language.SettingMetro Vancouver, British Columbia, Canada from July 2018 to January 2020.ParticipantsData collected from community focus groups (four groups, n=29) of both service providers and im/migrant women was used. Following this, qualitative interviews with service providers (n=10) and im/migrant women (n=47) were conducted. Eligible participants self-identified as women; were aged 18–49 and had arrived in Canada from another country. Eligible providers were employed in the health, social or legal sectors working with im/migrant women.ResultsThe wait period resulted in mistrust and internalised stigma for racialised im/migrant women, for whom the policy resulted in feeling ‘undeserving’ of care. Resulting administrative burden produced delays and unmet need for care, particularly related to sexual and reproductive healthcare and children’s health. Unexpected costs meant difficult choices between survival and care. Negative health outcomes included the inability to family plan, difficulties during pregnancy, as well as hardships related not being able to seek help for sick children. Community-based organisations provided support in many areas but could not fill all gaps produced by this policy.ConclusionsFindings highlight severe, yet commonly overlooked, health inequities produced by a mandatory health coverage wait period within a purportedly ‘universal’ healthcare system. Health system policies such as mandatory ‘waiting periods’ produce discriminatory and inequitable outcomes for im/migrant women. Policy reforms towards full ‘healthcare for all’ are urgently needed to affirm the health and human rights of all im/migrants.

Triadic embeddedness structure in family networks predicts mobile communication response to a sudden natural disaster

Kinship networks are a fundamental social unit in human societies, and like social networks in general, provide social support in times of need. Here, we investigate the impact of sudden environmental shock, the Ms 7.0 2013 Ya’an earthquake, on the mobile communications patterns of local families, which we operationalize using anonymized individual-level mobile telecommunications metadata from family plan subscribers of a major carrier (N = 35,565 people). We demonstrate that families’ communications dynamics after the earthquake depended on their triadic embeddedness structure, a structural metric we propose that reflects the number of dyads in a family triad that share social ties. We find that individuals in more embedded family structures were more likely to first call other family plan members and slower in calling non-family ties immediately after the earthquake; these tendencies were stronger at higher earthquake intensity. In the weeks after the event, individuals in more embedded family structures had more reciprocal communications and contacted more social ties in their broader social network. Overall, families that are structurally more embedded displayed higher levels of intra-family coordination and mobilization of non-family social connections.

The Pioneer Greek Immigrant in the United States and Canada (1880s-1920s): Survival Strategies of a Traditional Family

This paper is a study of the pioneer Greek immigrant and the pioneer Greek immigrant family in the United States and Canada from the 1880s to the 1920s. Our thesis is that the pioneer Greek immigrant was the executor of a well-defined family plan to help preserve as much as possible the physiognomy, identity and economic autonomy of the family unit that was left behind in the mother country. The Greek-American and Greek-Canadian family, limited in scope because of the gender composition of the early immigrants, organized itself in a "defensive" manner, i.e. it "closed" itself to the outside world and remained "frozen in time", as a result of the hardships of immigrant life, including the racism of the host countries.

Pengaruh kampung KB pada intervensi gizi sensitif stunting di Desa Janegara

Background: Stunting in Brebes, Central Java is the highest 100 in Indonesia. Through the Family Plan Village (Kampung KB), National Population and Family Planning Board (BKKBN) was given the mandate to contribute in accelerating the improvement of nutrition, especially the problem of stunting. 15,873 villages in Indonesia were formed as Kampung KB. However, there were no studies that describe the extent to which the program was effective.Objectives: This study aims to determine the effectiveness of the Kampung KB on sensitive intervention to prevent stunting.Methods: Experimental research with and one group only post test study design used. In 60 mothers of children under the age of 24 months starting in March-October 2019 in Janegara Village, Brebes Regency. The intervention carried out was the Kampung KB. Its activities at the study site are conducted from March-October 2019 in the study population's parents. The intervention was family counseling by family planning counselors (PKB). The variables measured included planning for household life, habituation of clean and healthy lifestyles in the family, empowering family at home, and responsive care. Data was collected using a questionnaire that was prepared independently and has been tested for validity and reliability. Analysis of the data used to prove the hypothesis is one sample t test.Results: Most of the mothers understand family life planning (75%), PHBS practices are appropriate (61.37%), the role of fathers is good (83.3%), and mothers have taken responsive care responsive care (55%). Kampung KB is effective for improving the practice of PHBS (p = 0.003) and the role of fathers in the family (p = 0.0001).Conclusion: Kampung KB was effective to increase (PHBS) and the role of fathers in parenting.

Overcoming Poverty in Multidimensional Poverty Interventions through Self-assessment and Mentoring

A microfinance organization in Paraguay has developed the “Poverty Stoplight” (PS), an innovative technological tool that allows families to self-assess their level of multidimensional poverty and start an integrated mentoring process whose goal is to empower families to eliminate multidimensional poverty based on what the participants value the most. During the program, a mentor works with participants to design a customized family plan to identify their most significant challenges in order to overcome their deprivations. The PS places human development and poverty elimination as the main objectives for the intervention. This paper has three elements. First, it presents the methodology for poverty intervention and the detailed tool (i.e. a multidimensional metric) used to encourage reflecting and promoting agency. Second, it uses the Capability Approach to explore the potential of the PS intervention to increase agency and decrease multidimensional deprivations. Third, it presents results from an ongoing research project that evaluates the program’s effectiveness in helping participants overcome poverty. This empirical part is based on data collected between August 2015 and June 2017 from over 9,000 microfinance clients and analyzed using the technique of OLS regressions. The results indicate that participation in the program is indeed associated with a higher probability of overcoming multidimensional poverty.

ANALYSIS OF ECONOMIC STATUS WITH SCIENTIFIC CONTRACEPTION SELECTIONS IN BPM MOGITA TLANAKAN PAMEKASAN

In the effort of decreasing the rate of population, government, implement the family plan program in order to make the quality family in year 2018. Many use injection hormonal contraception since it has the effective work, practice, cheap and safe relatively. In selecting the contraception effected by several factors, for instance age, education, work, parity, knowledge, resident, economic status, decision in the household, and culture. Economic status can influence someone in choosing the contraception particularly injection contraceptive. The purpose of this search is to know the relationship between economic status and injection contraception selecting. Research design is using analytic with cross sectional. This research was conducted at BPM Mogita Tlanakan Pamekasan starting from July 01, 2018 to August 31, 20018. Population is all the family plan acceptor and sample taking was done by probability sampling with sampling random simple with sample size is 49 respondents. The research result denoted that from 49 respondents, 10 of then have the high economic statuses who are wearing injection are 3 persons and not are 7 persons. 14 respondents have the mid-economic status are wearing injection us 11 person and not is 3 persons and 25 respondent have the low economic status are wearing injection is 23 person and are not is 2 persons. By using the Mann Whitney statistic with level of significant is 0,05 was obtained count ≤ thus H0 was rejected, meaning that there is difference economic status with selecting the injection contraception and non-injection at di BPM Mogita Tlanakan Pamekasan. Of the result research can be drawn the conclusion that economic status constitutes factor that influence the injection family plan selecting. In which they have the low economic status tend to choose the injection family plan than the high one. However, it needs the further research with seeing and enter the other factors that influence in contraception selecting. Keywords: economic status, injection contraception selecting.

WANITA USIA 26 TAHUN, MULTIGRAVIDA HAMIL 35 MINGGU DENGAN DIAGNOSIS INFEKSI SALURAN KEMIH

Urinary tract infection (UTI) is a disease caused by bacteria that attack theurinary tract. Pregnant women are one of the risk factors for the occurrenceof UTI and are at risk of causing premature birth and low birth weight (LBW).This case report describes multigravida women with G3P1A1Ah1 with agestational age of 35 weeks less 2 days with complaints of tightness,frequent urination at night and lower back pain. The patient has a history ofcesarean section at the birth of the first child and the incidence of UTI beforemarriage. Blood pressure: 102/71 mmHg with pulse 90 times / minute. FH29 cm with EFW ± 2790 grams, right back, head presentation, had enteredthe pelvis with a 4/5 decline, His palpitations were not palpable, fetal heartrate was 135x / minute and irregular rhythm. On laboratory examinationshows the results of hemoglobin (Hb) examination of 12.8 g / dL and leukocytes exceed the normal threshold (5000-15000 / mm3). The patient isthen given calcium lactate, iron fumarate to maintain pregnancy andamoxicillin to treat UTI in patients. Patients are also educated to maintainthe cleanliness of genital organs to prevent further infection and advise ifwant to start family plan program, patient can use Intrauterine Device (IUD)as contraception.

FAKTOR-FAKTOR YANG MEMPENGARUHI PEMILIHAN METODE KONTRASEPSI (Kasus di Kecamatan Seberang Ulu I Kota Palembang)

Trend in the use of contraceptive methods in Palembang city shows that injections and pills are the most dominant method used for family plan. Data from BKKBN of Palembang city in 2014 showed that injections and pills were the most widely used each has for 40% and 27%. Whereas according to the BKKBN is one of right way to limit births following the family planning program through the Long-Term Contraception Method (LTM) such as implants, Intra Uterine Device and Method of Operation.The purposes of this research are to know about the distribution of contraceptive used according to the type and to find out the factors that affect the selection method beetween the dominant long-term contraception and short-term by the woman of fertile ages. The methods used were survey research methods, techniques of data collection were by observation and interview using the questionnaire, the analytical techniques used were univariable (descriptive), bivariable (chi-square and t-test) and multivariable (logistic regression).The results of this study shows that use of injections remains a trend of the election method of contraception by woman of fertile ages in Palembang city. The gender of the child owned by fertile age couple became the dominant factor which influences the selection of long-term contraception method and Non LTM. This was proven by the result of the multivariate logistic regression statistical test with a significant value of 0,000 < 0,05.