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Ekezie W, Hopwood E, Czyznikowska B, Weidman S, Mackintosh N, Curtis F. Perinatal health outcomes of women from Gypsy, Roma and Traveller communities: A systematic review. Midwifery 2024; 129:103910. [PMID: 38113569 DOI: 10.1016/j.midw.2023.103910] [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: 08/02/2023] [Revised: 11/10/2023] [Accepted: 12/07/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND GRT communities are disadvantaged minority groups in Europe and experience some of the poorest health outcomes, including maternal and child health. This systematic review aimed to assess the maternal, perinatal and infant health outcomes of women from GRT communities and the factors associated with the reported outcomes. METHODS Database searches were conducted from inception to June 2023 in 4 bibliographic databases supplemented with an additional Google Scholar search. Studies with quantitative data on maternal outcomes published in English were considered. A narrative synthesis was performed, and data were presented in text, figures and tables. FINDINGS Forty-five studies from 13 European countries were included. Outcome factors related to mothers showing low healthcare engagement, high fertility rates and shorter gestation periods among GRT women. Child wantedness was also noted to influence pregnancy completeness, which included abortion and miscarriage. More negative infant outcomes were seen in GRT infants than non-GRT infants; this included higher preterm births, lower birth weight, higher rates of intrauterine growth restriction and infant mortality. Risk factors of poorer maternal outcomes were early reproduction, education, smoking, alcohol consumption, deprivation, poor nutrition and perinatal care. CONCLUSION This review provides evidence that GRT women and children experience more negative outcomes than general populations. It also highlights the gaps in ethnicity and health inequalities more broadly. The significant importance of this research is the need for increased focus on reducing health inequalities, especially among the GRT community.
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Affiliation(s)
- Winifred Ekezie
- Diabetes Research Centre, University of Leicester, Leicester LE5 4PW, United Kingdom; Centre for Ethnic Health Research, University of Leicester, Leicester LE5 4PW, United Kingdom; School of Social Sciences and Humanities, Aston University, Birmingham B4 7ET, United Kingdom.
| | - Ellen Hopwood
- Diabetes Research Centre, University of Leicester, Leicester LE5 4PW, United Kingdom; Department of Population Health Sciences, University of Leicester, Leicester LE1 7RH, United Kingdom
| | - Barbara Czyznikowska
- Centre for Ethnic Health Research, University of Leicester, Leicester LE5 4PW, United Kingdom
| | - Sarah Weidman
- Leicester Institute for Advanced Studies (LIAS), University of Leicester, Leicester LE1 7RH, United Kingdom
| | - Nicola Mackintosh
- Department of Population Health Sciences, University of Leicester, Leicester LE1 7RH, United Kingdom
| | - Ffion Curtis
- Diabetes Research Centre, University of Leicester, Leicester LE5 4PW, United Kingdom; Centre for Ethnic Health Research, University of Leicester, Leicester LE5 4PW, United Kingdom; Institute of Population Health, Liverpool Reviews and Implementation Group (LRiG), University of Liverpool, Liverpool L69 3GF, United Kingdom
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Bosakova L, Dankulincova Veselska Z, Filakovska Bobakova D. How to improve the system of care for adolescents with emotional and behavioural problems from the perspective of care providers: a concept mapping approach. Health Res Policy Syst 2024; 22:9. [PMID: 38225655 PMCID: PMC10789000 DOI: 10.1186/s12961-023-01096-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/18/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Emotional and behavioural problems (EBP) are the most common mental health issues during adolescence, and their incidence has increased in recent years. The system of care for adolescents with EBP is known to have several problems, making the provision of care less than optimal, and attention needs to be given to potential improvements. We, therefore, aimed to examine what needs to be done to improve the system of care for adolescents with EBP and to assess the urgency and feasibility of the proposed measures from the perspective of care providers. METHODS We used Concept mapping, a participatory mixed-method research, based on qualitative data collection and quantitative data analysis. A total of 33 stakeholders from 17 institutions participated in our study, including psychologists, pedagogues for children with special needs, teachers, educational counsellors, social workers and child psychiatrists. RESULTS Respondents identified 43 ideas for improving of the system of care for adolescents with EBP grouped into 5 clusters related to increasing the competencies of care providers, changes at schools and school systems, support for existing services, transparency of the care system in institutions and public administration, and the adjustment of legislative conditions. The most urgent and feasible proposals were related to the support of awareness-raising activities on the topic of EBP, the creation of effective screening tools for the identification of EBP in adolescents, strengthening the role of parents in the process of care, comprehensive work with the family, creation of multidisciplinary support teams and intersectoral cooperation. CONCLUSIONS Measures which are more accessible and responsive to the pitfalls of the care system, together with those strengthening the role of families and schools, have greater potential for improvements which are in favour of adolescents with EBP. Care providers should be invited more often and much more involved in the discussion and the co-creation of measures to improve the system of care for adolescents with EBP.
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Affiliation(s)
- Lucia Bosakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University in Kosice, Tr. SNP 1, Kosice, 040 01, Slovakia.
- Olomouc University Society and Health Institute (OUSHI), Palacky University in Olomouc, Univerzitni 22, Olomouc, 771 11, Czech Republic.
| | - Zuzana Dankulincova Veselska
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University in Kosice, Tr. SNP 1, Kosice, 040 01, Slovakia
| | - Daniela Filakovska Bobakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University in Kosice, Tr. SNP 1, Kosice, 040 01, Slovakia
- Olomouc University Society and Health Institute (OUSHI), Palacky University in Olomouc, Univerzitni 22, Olomouc, 771 11, Czech Republic
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Pokharel B, Yelland J, Hooker L, Taft A. A Systematic Review of Culturally Competent Family Violence Responses to Women in Primary Care. TRAUMA, VIOLENCE & ABUSE 2023; 24:928-945. [PMID: 34629009 PMCID: PMC10009494 DOI: 10.1177/15248380211046968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Existing culturally competent models of care and guidelines are directing the responses of healthcare providers to culturally diverse populations. However, there is a lack of research into how or if these models and guidelines can be translated into the primary care context of family violence. This systematic review aimed to synthesise published evidence to explore the components of culturally competent primary care response for women experiencing family violence. We define family violence as any form of abuse perpetrated against a woman either by her intimate partner or the partner's family member. We included English language peer-reviewed articles and grey literature items that explored interactions between culturally diverse women experiencing family violence and their primary care clinicians. We refer women of migrant and refugee backgrounds, Indigenous women and women of ethnic minorities collectively as culturally diverse women. We searched eight electronic databases and websites of Australia-based relevant organisations. Following a critical interpretive synthesis of 28 eligible peer-reviewed articles and 16 grey literature items, we generated 11 components of culturally competent family violence related primary care. In the discussion section, we interpreted our findings using an ecological framework to develop a model of care that provides insights into how components at the primary care practice level should coordinate with components at the primary care provider level to enable efficient support to these women experiencing family violence. The review findings are applicable beyond the family violence primary care context.
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Affiliation(s)
- Bijaya Pokharel
- Judith Lumley
Centre, School of Nursing and
Midwifery, La Trobe
University, Bundoora, VIC, Australia
- Bijaya Pokharel, Judith Lumley Centre,
School of Nursing and Midwifery, La Trobe University, Plenty Rd &, Kingsbury
Dr, Bundoora VIC 3086, Australia.
,
| | - Jane Yelland
- Murdoch Children’s Research
Institute, Parkville, VIC,
Australia
| | - Leesa Hooker
- Judith Lumley
Centre, School of Nursing and
Midwifery, La Trobe
University, Bundoora, VIC, Australia
| | - Angela Taft
- Judith Lumley
Centre, School of Nursing and
Midwifery, La Trobe
University, Bundoora, VIC, Australia
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Carneiro JB, Gomes NP, Estrela FM, da Silva AF, Carvalho MRDS, Webler N. Care Provided to Women Victims of Intimate Partner Violence From the Perspective of Health Professionals. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580211064105. [PMID: 35341335 PMCID: PMC8958700 DOI: 10.1177/00469580211064105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Intimate Partner Violence (IPV) is a recurring phenomenon in society and can have important repercussions for the lives and health of women worldwide. Even in this alarming global scenario, many health workers still have difficulties approaching IPV with women and providing care for the victims of this type of violence. Given this context, this qualitative study aims at understanding how primary health care professionals provide care for women victims of violence by intimate partners. In view of the methodology design proposed in the Grounded Theory, data collection took place through theoretical sampling. Data collection was carried out in 22 institutions offering primary health care, with 31 female workers from different professional categories being interviewed individually and in depth, including physicians, nurses, dentists, psychologists, and social workers. The results show that, in order to overcome the difficulties encountered in caring for victims of IPV, primary health care workers have been developing strategies for the care of these women. These strategies include identification of such cases through questions about the woman’s intimate relationship, by establishing a bond with the victim so that she feels welcomed, and through articulation with other team professionals to propose expanded health care. The interventions carried out by these professionals include meeting the demands of women in the health institution where they work, referral to other services in the network, if necessary, and notification of IPV cases to epidemiological surveillance. Based on this understanding of the care offered by the professionals to women who are victims of IPV in primary health care, the research aims at contributing to the sensitization of professionals working in health institutions regarding the identification of signs that raise suspicion of IPV, as well as at addressing such cases in a way to fully meet these women’s needs.
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Carneiro JB, Gomes NP, Campos LM, Estrela FM, Webler N, Santos JLGD, Carvalho AADS. THEORETICAL-EXPLANATORY MODEL OF THE CARE PROVIDED TO WOMEN IN SITUATIONS OF VIOLENCE IN PRIMARY HEALTH CARE. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2020-0639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to develop a theoretical-explanatory model of the care provided to women in situations of intimate partner violence in the context of Primary Health Care. Method: a study with a qualitative approach, whose theoretical-methodological contribution adopted was the updated Straussian strand of the Grounded Theory. Between February and December 2019, individual interviews were conducted with 31 professionals who worked in Family Health Units in the Health District of a capital from northeastern Brazil, members of the minimum team (first sample group) and of the Expanded Family and Primary Care Health Center (second sample group). The data were organized using an analytical tool called Paradigmatic Model, consisting of three components: condition, action-interaction and consequences. Results: the theoretical-explanatory model of the phenomenon called “enabling the empowerment of women in situations of intimate partner violence” allowed understanding the meanings attributed by the professionals to the care offered to women in situations of intimate partner violence within the scope of the Family Health Strategy. Conclusion: the model of care provided to women in situations of intimate partner violence, based on identification of the problem and intervention in the cases, is limited due to the characteristics of the organization of the services. In this sense, the study points to the importance of managerial actions to achieve favorable outcomes for female empowerment and consequent confrontation of violence.
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Vilarins GCM, Pinho DLM. [Application of conceptual mapping in the regulation of access to public health services in the Federal District, Brazil]. CIENCIA & SAUDE COLETIVA 2021; 26:5829-5840. [PMID: 34852112 DOI: 10.1590/1413-812320212611.30732020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 10/04/2020] [Indexed: 11/21/2022] Open
Abstract
Health regulation in the pursuit of equity is the goal of management and requires evaluation methods that improve work processes. The scope of this article is to analyze the application of conceptual mapping in the regulation of access to public health services. It is an exploratory and descriptive study, using a mixed approach, carried out at the Health Regulatory Complex of the Federal District. The data were collected between August and October 2019 and analyzed with the assistance of IRaMuTeQ and Concept Systems® software. There is a convergence of the 25 statements generated by the 71 participants, grouped into 4 clusters, on regulation towards the principle of equity. The healthcare priority level was presented as the focus of regulation and management, the driving force behind the integration of processes. Conceptual mapping is a tool that can support regulation planning and evaluation, as it makes it possible to identify priority points to be worked on by management in improving the regulatory processes identified in this study. These include the training of professionals, the transparency of information and the level of priority healthcare, for effective, equitable, rational and timely access for users of the health system.
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Affiliation(s)
- Geisa Cristina Modesto Vilarins
- Programa de Pós-Graduação em Ciências e Tecnologias em Saúde, Universidade de Brasília (UnB). Campus Universitário Darcy Ribeiro s/n, Asa Norte. 70910-900 Brasília DF Brasil.
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Briones-Vozmediano E, Castellanos-Torres E, Goicolea I, Vives-Cases C. Challenges to Detecting and Addressing Intimate Partner Violence Among Roma Women in Spain: Perspectives of Primary Care Providers. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP10433-NP10452. [PMID: 31524040 DOI: 10.1177/0886260519872299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The objective of this study is to identify challenges and facilitators for detecting and addressing cases of intimate partner violence (IPV) against Roma women, from the perspectives of health personnel and representatives of Roma organizations, and to compare both perspectives. A total of 28 semi-structured interviews were carried out between November 2014 and February 2015 in different Spanish cities. A thematic analysis was carried out, guided by Aday and Andersen's model regarding barriers to access to health services. Both groups signaled the following as principal challenges: (a) consideration of IPV as a private problem among the Roma population, (b) little use of primary care providers for prevention, (c) distrust of Roma women toward primary care professionals as resources for seeking help, (d) the inexistence of Roma professionals in health services, (e) health professionals' lack of cultural sensitivity related to Roma people, and (f) the focus of health protocols for action against IPV on filing a police report. Potential facilitating factors included Roma women's trust in nurses, social workers, and pediatricians and ethnic heterogeneity. There is need to promote action to address the identified challenges through a health equity approach that includes greater training and awareness raising among health professionals about Roma culture and the specific needs of Roma women.
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Affiliation(s)
- E Briones-Vozmediano
- Faculty and Department of Nursing and Physiotherapy, University of Lleida, Spain
- Biomedical Research Institute (IRB), Lleida, Spain
- Public Health Research Group of the University of Alicante, University of Alicante, Spain
| | - E Castellanos-Torres
- Public Health Research Group of the University of Alicante, University of Alicante, Spain
| | - I Goicolea
- Public Health Research Group of the University of Alicante, University of Alicante, Spain
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - C Vives-Cases
- Public Health Research Group of the University of Alicante, University of Alicante, Spain
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Vives-Cases C, La Parra-Casado D, Gil-González D, Caballero P. Acceptability of Violence Against Women Among the Roma Population in Spain. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:5795-5812. [PMID: 30353765 DOI: 10.1177/0886260518807910] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Acceptability of violence against women (VAW) is a key dimension in addressing this social problem, given its influence on both the violent conduct of aggressors and the decisions of affected women. This study analyzes, for the first time, the magnitude of acceptability of VAW and associated factors in the Roma population in Spain. The Roma population is the largest ethnocultural minority in Europe. Data were analyzed from the Spanish National Health Survey of the Roma Population of 2014, a survey of 1,167 people identified as members of the Roma community. The results indicate that 70.9% of those surveyed completely reject VAW, with lower probability of acceptability among women than men (odds ratio [OR]: 0.66; 95% confidence interval [CI]: [0.51, 0.86]). There is also a decrease in probability as income increases, in people who identify themselves as evangelical (OR: 0.5; 95% CI: [0.36, 0.71]) and among those who report being acquainted with a battered woman (OR: 0.68; 95% CI: [0.48, 0.97]), similarly in women and men. It has to be highlighted that the observed associations between socioeconomic conditions and acceptability of VAW should be considered when designing strategies for raising awareness about the consequences of VAW for the Roma population.
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Affiliation(s)
- Carmen Vives-Cases
- University of Alicante, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | | | - Diana Gil-González
- University of Alicante, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
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Svobodova I, Filakovska Bobakova D, Bosakova L, Dankulincova Veselska Z. How to improve access to health care for Roma living in social exclusion: a concept mapping study. Int J Equity Health 2021; 20:61. [PMID: 33579295 PMCID: PMC7881662 DOI: 10.1186/s12939-021-01396-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 01/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Half of the people living in social exclusion in the Czech Republic are of Roma origin. The worse health of Roma could be partly explained by numerous barriers to accessing health care. Therefore, our study aimed to explore the perceptions of various stakeholders and experts who may have an impact on the inclusion of Roma and/or their access to health care on how to improve health care access for Roma living in social exclusion in the Czech Republic. Methods We conducted a concept mapping study and obtained data from 32 participants from health and social services, policymakers and others who were involved in different study phases (brainstorming, sorting, rating, interpretation). Results Out of 64 proposed measures sorted into six distinct clusters, 20 were rated as the most urgent and the most feasible and should be implemented with a priority to improve access to health care for Roma living in social exclusion. The proposed measures covered various topics, such as education and awareness of the target group as well as education and supervision of helping professionals, strengthening capacities and streamlining the health care system, health promotion and associated services and increasing the local and financial accessibility of health care. Overall, measures concerning the education and supervision of helping professionals were rated as both the most urgent and the most feasible. Individual priority measures targeted, for example, the health needs assessment of Roma living in social exclusion to set up interventions or to include topics such as participation, empowerment, cultural competence and communication training in the curricula of health care and helping professionals in postgraduate and continuing studies. Conclusions Stakeholders proposed a set of relevant and acceptable measures that may help improve access to health care for Roma living in social exclusion. The way they rated the proposed measures reflects both the current unfavourable mainstream and public discourse concerning Roma living in social exclusion and the most acute policy issues identified by several European and national bodies. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-021-01396-4.
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Affiliation(s)
- Ivana Svobodova
- Palacky University in Olomouc, Olomouc University Social Health Institute, Olomouc, Czech Republic.
| | - Daniela Filakovska Bobakova
- Palacky University in Olomouc, Olomouc University Social Health Institute, Olomouc, Czech Republic.,Department of Health Psychology and Research Methodology, University of Pavol Jozef Safarik in Kosice, Faculty of Medicine, Kosice, Slovak Republic
| | - Lucia Bosakova
- Palacky University in Olomouc, Olomouc University Social Health Institute, Olomouc, Czech Republic.,Department of Health Psychology and Research Methodology, University of Pavol Jozef Safarik in Kosice, Faculty of Medicine, Kosice, Slovak Republic
| | - Zuzana Dankulincova Veselska
- Department of Health Psychology and Research Methodology, University of Pavol Jozef Safarik in Kosice, Faculty of Medicine, Kosice, Slovak Republic
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Kozubik M, van Dijk JP, Rac I. Health Risks Related to Domestic Violence against Roma Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17196992. [PMID: 32987921 PMCID: PMC7579367 DOI: 10.3390/ijerph17196992] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 11/16/2022]
Abstract
Background: Data on Roma women's experience of violence from their male partners are very scarce. We explored the process of actual domestic violence against Roma women, the threat of violence and its health consequences. We further focused on barriers in the availability of specialized support services aimed at eliminating domestic violence. Methods: The sample included 20 Roma women living throughout Slovakia: scattered among the majority (45.0%), in crisis centers and sheltered houses (40.0%), and in segregated Roma settlements (15.0%). Data were obtained through qualitative research by means of semi-structured interviews in 20 individual case studies. All 20 women had experienced a combination of violence: physical, psychological and economic, all of them connected with social isolation. Results: Prevailing gender stereotypes are a precondition of domestic violence against women, regardless of their status. Violence against Roma women resulted in several health consequences, and all of the 20 women suffered from these. Most of them reported general psychological problems (75%), among which anxiety and depression (25%), headache (25%), weight loss (10%) and health problems connected with motor activity (5%). The barriers include lack of awareness among Roma women of any specialised support services and the absence of such services for abused women in the region. Conclusions: Domestic violence results in serious psychological and physical health consequences. Violence elimination is generally set up without a specific ethnic or gender approach. Disregard of these specifics can lead to deepening of the uneven position of Roma women within the family, community and society, and the acceptance of violence against Roma women.
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Affiliation(s)
- Michal Kozubik
- Department of Social Work and Social Sciences, Faculty of Social Sciences and Health Care, Constantine the Philosopher University in Nitra, 949 74 Nitra, Slovakia
- Correspondence:
| | - Jitse P. van Dijk
- Department Community & Occupational Medicine, University of Groningen, University Medical Centre Groningen, 9713 AV Groningen, The Netherlands;
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Safarik University, 040 01 Kosice, Slovakia
- Olomouc University Social Health Institute, Theological Faculty, Palacky University Olomouc, 771 11 Olomouc, Czech Republic
| | - Ivan Rac
- Institute of Romani Studies, Faculty of Social Sciences and Health Care, Constantine the Philosopher University in Nitra, 949 74 Nitra, Slovakia;
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Ioannoni V, Vitale T, Costa C, Elliott I. Depicting communities of Romani studies: on the who, when and where of Roma related scientific publications. Scientometrics 2020. [DOI: 10.1007/s11192-020-03352-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Heaslip V, Wilson D, Jackson D. Are Gypsy Roma Traveller communities indigenous and would identification as such better address their public health needs? Public Health 2019; 176:43-49. [PMID: 31079879 DOI: 10.1016/j.puhe.2019.02.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 10/01/2018] [Accepted: 02/25/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Across Europe, large numbers of Gypsy Roma Traveller communities experience significant health inequities such as higher morbidity, mortality and infant mortality. This health inequity is perpetuated by wider determinants such as a lower social status, lower educational attainment and substandard accommodation. This is not dissimilar to other indigenous peoples, even though many Gypsy Roma Traveller communities are not identified as indigenous. METHODS This article presents contemporary literature and research alongside the internationally agreed principles of indigenous peoples, examining similarities between Gypsy Roma Traveller communities and other indigenous peoples. RESULTS We argue that Gypsy Roma Traveller communities could be recognised as indigenous in terms of the internationally agreed principles of indigeneity and shared experiences of health inequity, colonisation and cultural genocide. Doing so would enable a more robust public health strategy and development of public health guidelines that take into account their cultural views and practices. CONCLUSION Recognising Gypsy Roma Traveller communities in this way is important, especially concerning public health, as formal recognition of indigeneity provides certain rights and protection that can be used to develop appropriate public health strategies. Included within this are more nuanced approaches to promoting health, which focus on strengths and assets rather than deficit constructs that can perpetuate problematising of these communities.
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Affiliation(s)
- V Heaslip
- Principal Academic Department of Nursing and Clinical Science, Faculty of Health and Social Science, Bournemouth University, UK; Department of Social Studies, University of Stavanger, Norway.
| | - D Wilson
- Māori Health, Taupua Waiora Centre for Māori Health Research, Faculty of Health and Environmental Sciences, Auckland University of Technology, New Zealand
| | - D Jackson
- Nursing, Faculty of Health, University of Technology, Sydney (UTS), Australia
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What affects technology transfer in emerging knowledge areas? A multi-stakeholder concept mapping study in the bioeconomy. JOURNAL OF TECHNOLOGY TRANSFER 2018. [DOI: 10.1007/s10961-018-9702-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Choi AWM, Wong JYH, Lo RTF, Chan PY, Wong JKS, Lau CL, Kam CW. Intimate partner violence victims' acceptance and refusal of on-site counseling in emergency departments: Predictors of help-seeking behavior explored through a 5-year medical chart review. Prev Med 2018; 108:86-92. [PMID: 29278677 DOI: 10.1016/j.ypmed.2017.12.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 11/14/2017] [Accepted: 12/13/2017] [Indexed: 10/18/2022]
Abstract
Healthcare services constitute the first formal support that many intimate partner violence (IPV) victims receive and a link to formal welfare and psychological support. The help-seeking behavior for psychosocial support, e.g., Accident and Emergency Departments (AED) onsite counseling, is key to developing effective support for IPV victims. This study aimed to strengthen the health-welfare support link to aid IPV prevention in AEDs by investigating the acceptance and refusal of on-site counseling by IPV victims. A retrospective cohort study retrieved and reviewed all records of IPV victims presenting at the AEDs of two Hong Kong hospitals between 2010 and 2014. A total of 157 male and 823 female IPV victims were identified, 295 of whom refused on-site counseling. Bivariate and multivariate analyses were performed to examine the association between help-seeking and demographic and violent injury-related factors. The odds of help-seeking via on-site counseling were significantly lower for victims with mental illness (aOR=0.49; 95% CI=0.27, 0.88). After controlling for all demographic characteristics, mental illness, and drug abuse information, sex remained an independent predictor of help-seeking (aOR=2.62; 95% CI=1.45, 4.74); victims who had experienced >2 abuse incidents were more likely to seek help than those who had experienced ≤2 abuse incidents (aOR=1.90; 95% CI=1.11, 3.26). The factors associated with help-seeking from on-site services by IPV victims reflect the need for multidisciplinary collaborative work aimed at IPV prevention. Healthcare professionals require training on how to promote help-seeking behavior targeted specifically for male and female IPV victims according to their needs and preferences.
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Affiliation(s)
- Anna Wai-Man Choi
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, 5/F, Jockey Club Tower, Pokfulam, Hong Kong, China.
| | - Janet Yuen-Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Ruby Tsz-Fung Lo
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, 5/F, Jockey Club Tower, Pokfulam, Hong Kong, China
| | - Pik-Ying Chan
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, 5/F, Jockey Club Tower, Pokfulam, Hong Kong, China
| | - John Kit-Shing Wong
- Department of Accident and Emergency Medicine, Tuen Mun Hospital, Tuen Mun, Hong Kong, China
| | - Chu-Leung Lau
- Department of Accident and Emergency Medicine, Pok Oi Hospital, Yuen Long, Hong Kong, China
| | - Chak-Wah Kam
- Department of Accident and Emergency Medicine, Tuen Mun Hospital, Tuen Mun, Hong Kong, China
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15
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Aiello E, Flecha A, Serradell O. Exploring the Barriers: A Qualitative Study about the Experiences of Mid-SES Roma Navigating the Spanish Healthcare System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020377. [PMID: 29470450 PMCID: PMC5858446 DOI: 10.3390/ijerph15020377] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/02/2018] [Accepted: 02/07/2018] [Indexed: 11/29/2022]
Abstract
Whereas the topic of the ‘cultural sensitivity’ of healthcare systems has been addressed extensively in the US and the UK, literature on the subject in most European countries, specifically looking at the situation of Roma, is still scarce. Drawing on qualitative research conducted mainly in the city of Barcelona under the communicative approach with Roma subjects who have stable socioeconomic positions and higher cultural capitals (end-users, professionals of the healthcare system, and key informants of a regional policy oriented to the improvement of Roma living conditions), the present study aims to fill this gap. We explore the barriers that the Roma face in accessing the healthcare system, reflecting on how these barriers are accentuated by the existing anti-Roma prejudices and institutional arrangements that do not account for minority cultures. Our results point out a series of obstacles at two levels, in the interaction with healthcare professionals, and in relation to existing institutional arrangements, which prevent Roma families from having equal access to the healthcare system. Education stands up as a mechanism to contest anti-Roma sentiments among healthcare professionals.
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Affiliation(s)
- Emilia Aiello
- Community of Researchers on Excellence for All (CREA), University of Barcelona, Avinguda Diagonal 690, 08034 Barcelona, Spain.
| | - Ainhoa Flecha
- Department of Sociology, Universitat Autònoma de Barcelona, Campus de la UAB, Edifici B, 08193 Bellaterra, Barcelona, Spain.
| | - Olga Serradell
- Department of Sociology, Universitat Autònoma de Barcelona, Campus de la UAB, Edifici B, 08193 Bellaterra, Barcelona, Spain.
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