This study assesses the vulnerability of Haitian women to cervical cancer by looking at the distribution of socio-demographic factors that might prevent their access to health services. Predictor variables of access to health services and variables known to be directly associated to an increased risk for cervical cancer were derived from the Haitian Demographic Health Survey (2005-2006). Five socio demographic predictors of access to health services were considered: Education, wealth index, distance to health services, type of place of residence and whether or not money was a problem to get medical help. The dependent variable used to categorize women into low risk group and high risk group to cervical cancer was created from three variables: young age at first sexual intercourse, more than two sexual partners and can the woman ask her partners to use condom. To study the association between the socio-demographic and economic predictors to access to health services and high risk group of women to cervical cancer, binary logistic regression was conducted. The univariate analysis performed showed that women who were in the high risk group to cervical cancer were more likely to be uneducated (OR= 2.447; p-value<0.0001), poor (OR=2.372; p-value<0.0001), to have economic barriers that prevent their access to health services (OR=1.566; p-value<0.05) and were more likely to live in rural areas (OR=1.705; p-value<0.0001). However, after running the multivariate analysis to control for the other predictors, only level of education (OR= 1.991; p-value<0.0001) and wealth status (OR=1.727; p-value<0.05) were still associated to the dependent variable. These findings proved that interventions that aimed at controlling cervical cancer among Haitian women should take into consideration these indirect socio-demographic and most important economic factors that might prevent the high risk group of women to benefit from the appropriate screening and treatment services, provided that they are available. Finally recommendations to find a better approach to address the cervical cancer burden in Haiti are made. INDEX WORDS: Uterine cervical neoplasmas, risk factors, accessibility to health services, developing countries

<p>The extent of a community experiencing social vulnerability depends on the community&rsquo / s ability to access resources that may contribute to coping mechanisms (either within the household or provided externally by a responsible authority) that decrease the impacts and effects of a disaster. Therefore, the purpose of this research was to identify the existence of social and institutional mechanisms that aim to reduce experiences of water inaccessibility and the causes of social vulnerability, and increase coping mechanisms within Kayamandi. Kayamandi is a low income residential community on the north-westerly periphery of the greater Stellenbosch town in the Western Cape. The research attained&nbsp / responses through questionnaires and surveys from residents, community organisations and responsible personnel. These surveys allowed the researcher to produce raw attribute data for each household that assisted in spatially representing vulnerable households and informing the five priority areas of the Hyogo Framework for Action. Contributing to this method of attaining information, secondary geographic data collection was obtained through the Stellenbosch Local Municipality, the National Geospatial Information Directorate and the National Demarcation Board. The findings of this thesis established that household and public water infrastructure contribute to the risk of experiencing social vulnerability that affects economic standings and quality of health within the community. Contributing to this and due to Kayamandi&rsquo / s politically sensitive and historically fractioned community, social cohesion has also been noted as an area of vulnerability. Although these vulnerabilities are experienced, residents are able to implement technical, social and municipal reliant coping mechanisms. However, although efforts from Stellenbosch Local Municipality do respond to most of the key indicators within the Hyogo Framework for Action, the study found no concrete efforts within the Stellenbosch Local Municipality that illustrate integrated mechanisms to reduce the impacts of disasters and compound effects.</p>

Darbo tikslas. Numatyti N poliklinikos Moterų konsultacijos teikiamų akušerinių – ginekologinių paslaugų prieinamumo gerinimo perspektyvas. Uždaviniai. Įvertinti N poliklinikos Moterų konsultacijos teikiamų akušerinių – ginekologinių paslaugų prieinamumą pacienčių požiūriu; numatyti N poliklinikos Moterų konsultacijos teikiamų akušerinių – ginekologinių paslaugų prieinamumo gerinimo priemones. Tyrimo metodika. 2007 m. kovo – balandžio mėn. atlikta Moterų konsultacijos pacienčių anketinė apklausa. Išdalinta 400 anketų. Atsakas – 85,5 proc. Statistinė analizė atlikta naudojant SPSS 12 programinį paketą. Ryšys tarp kokybinių požymių buvo vertinamas pagal chi kvadrato (χ²) kriterijų. Kiekybinių rodiklių palyginimui taikytas Stjudento kriterijus (t). Rodiklių ryšys laikytas statistiškai reikšmingu, kai p<0,05. Rezultatai. 85,4 proc. pacienčių tenkino Moterų konsultacijos darbo laikas. Dauguma pacienčių paprastai neturi problemų patekdamos pas norimą gydytoją. 81,9 proc. pacienčių planiniam vizitui pateko pas gydytoją per 2 dienas. 90,2 proc. besikreipusių skubi pagalba buvo suteikta tą pačią dieną. Registratūroje pacienčių sugaišto laiko vidurkis 8,8 min., prie gydytojo kabineto 19,16 min. Personalo teikiamą dėmesį ir norą padėti dauguma apklaustųjų įvertino gerai. 73,9 proc. pacienčių teigė patenkančios pas gydytoją lengvai ir labai lengvai. Daugumai pakako personalo suteiktos informacijos apie gydymą, profilaktiką ir šeimos planavimą. 63,5 proc. pacienčių, žinančių apmokamų... [toliau žr. visą tekstą] / Aim of the study. To foresee prospects for improvement accessibility of obstetric – gynaecologic service in the Women's health department. Objectives. To estimate the accessibility of service in the Women's health department toward patients attitude; to provide the means for improvement of service accessibility. Methods. A survey was carried out at the Women's health department in March - April in 2007. 400 patients participated in it. Response rate was 85,5 %. Statistical analysis was carried out using SPSS 12 programe. Associations between the qualitative variables were tested by chi squared (χ²) test. The quantitative variables were compared using the Student test (t). p<0,05 was considered as statistically significant. Results. 85,4 % of patients were satisfied with the working time of the department. The majority of patients had no problems with visiting desirable doctor. 81,9 % of patients were waiting for visit less than 2 days. 90,2 % of patients have got the necessary urgent service at the same day. The average of waiting time at the registration room was 8,8 minutes, at the doctors room – 19,16 minutes. The majority of patients were satisfied with the staff attention and efforts to help. 73,9 % of patients evaluated the possibility of consultation as easy and very easy. The majority of patients were satisfied with the information about treatment, prevention and family planning. 63,5 % of patients who knew the costs of services evaluated them as reasonable... [to full text]

Sveikatos priežiūros paslaugų prieinamumas – tai kiekvieno gyventojo galimybė ligos ar kito patologinio proceso atveju pasinaudoti sveikatos priežiūros teikiamomis paslaugomis. Darbo tikslas – įvertinti sveikatos priežiūros paslaugų prieinamumą sveikatos priežiūros įstaigoje „Telšių sveikata“, priklausomai nuo demografinių – socialinių pacientų charakteristikų. Tyrimo metodika. 2006 m. balandžio mėn. atliktas anoniminis anketinis pacientų tyrimas. Apklausoje dalyvavo UAB „Telšių sveikata“ pas bendrosios praktikos gydytojus besilankantys pacientai. Buvo išdalinta 400 apklausos anketų, užpildyta ir grąžinta – 359, atsakas – 89,75 proc. Statistinė duomenų analizė atlikta SPSS 10 versijos programiniu paketu. Rezultatai. Daugiau kaip pusė visų respondentų (62,8 proc.) į bendrosios praktikos gydytojus kreipiasi dėl ligos. Dažniau moterys (5,4 karto), negu vyrai (4,5 karto). Pirminės sveikatos priežiūros prieinamumas teritoriniu požiūriu geresnis miesto respondentams. Jie greičiau pasiekia savo gydymo ���staigą, todėl patenkintų kelionės laiku iki UAB „Telšių sveikata“ dvigubai daugiau yra miesto respondentų (92,0 proc.), kaimo (47,3 proc.). Dažniausiai registracijos talone nurodytu laiku pas gydytoją nepatenka vyriausi respondentai (31,6 proc.). Laiku nepatekę, prie gydytojo kabineto durų ilgiau priėmimo laukia kaimo respondentai. Taip pat ilgiau laukia vyrai, negu moterys. Daugiau kaip valandą laukia 11,0 proc. vyrų ir 1,5 proc. moterų. Organizaciniu požiūriu sveikatos... [toliau žr. visą tekstą] / Introduction. The accessibility of primary health care – in the chance for the each citizen to avail oneself of health care services in case of illness or pathological process. The aim of study. To evaluate the accessibility of health care services in primary health care service office „Telšių sveikata“ depending on the patients demografic – social characteristics. Methods. An anonymous questionnaire study was carried out in April 2006. Patients visiting the doctors of primary health care service office “ Telšių sveikata” filled in the questionnaire. 400 questionnaires were distributed among patients, of which 359 questionnaires were completed. The response rate of completed questionnaires was 89,75. Statistical analysis of the data was conducted using SPSS programming packet. Results. More than half of all respondents (62,8%) consulted a doctor due to illness. More frequently female patients (5,4 times), male patients (4,5 times). The territorial access of primary health care is better for urban respondents, because they could easies to reach their health care institution 92 % of them are satisfied in time, reaching the places only 47,3 % of rural patients. 31,6 % of senior patients can’t see the doctor at the fixed time. Rural respondents waited at the physician room longer than urban respondents, longer waited male patients than female. More than one hour had waited 11,0 % males and 1,5 % females. The organizational access was better for urban young... [to full text]

Enhancement of the quality of outpatient services and the problems of accessibility of services become more and more important part of the health care reform. The importance of increasing the provision of the services in outpatient institutions and developing of outpatient services of physicians-specialists are the priorities in the plan of re-structuring of health care. Aim of the study. To analyze the provision and tendencies of the secondary and tertiary level outpatient services to inhabitants of the area Vilnius Territorial Patient Fund in 2003-2005. Objectives. To evaluate the provision of the secondary level outpatient services by specialty, by municipalities and age groups. To analyze the tertiary level outpatient services by municipalities. To evaluate the changes and tendencies in providing secondary and tertiary level outpatient services. Materials and methods. Analysis was done using the data of health insurance information system SVEIDRA on inhabitants registered to primary health care institutions and outpatient services provided to inhabitants of the area of Vilnius Territorial Patient Fund in 2003-2005. In order to evaluate distribution of services by municipalities, the number of outpatient services per one inhabitant, registered to primary health care institution, was calculated. Four age groups (0-5, 5-18, 18-65, over 65 years old) were chosen to analyze distribution of services by age groups. The existence of statistically significant differences was... [to full text]

Aim of the study. To evaluate patients’ attitude towards the accessibility of primary odontology care and their satisfaction with the services in public health care institution. Investigation methods. The patients were questionared in Odontology department for primary health care of public institution Kaunas “Kalniečių“ policlinic. 230 questionnaires were delivered, 198 respondents answered the questions (response rate 86%). Statistical data analysis was carried out on the basis of program package SPSS 10.0. Correlation between peculiarities was estimated according to the Chi square criterion test (χ2). The hypothesis concerning the comparison of two independent variables average was tested on the basis of Stjudent ( t ) criterion. Correlation strength among range variables was tested on the basis of Spearman correlation coefficient. As the basis for hypotheses checking was chosen significance level equal to 0,05 or less. Results. The majority of respondents evaluated primary health care odontolgy department from the financial point of view, communication and organization as satisfactory. The bigger part of respondents did not face any problems in: fee for odontology materials (73,2%), arrival to doctor – odontologist (66,5%), 79,2% claimed having had a possibility to select a doctor, 42,8% of the respondents had to spend up to 10 minutes at the receptionists’, while 42,3% of them spent at the receptionists from 10 to 15 minutes. Some accessibility specimen had a primary... [to full text]

Įvadas. Pertvarkant pirminės sveikatos priežiūros (PSP) įstaigų tinklą, siekiama gerinti sveikatos priežiūros paslaugų prieinamumą, priimtinumą ir kokybę. Todėl, aktualu periodiskai tirti pacientų požiūrį į sveikatos priežiūros paslaugų prieinamumą bei priimtinumą įvairioms socialinėms grupėms. Darbo tikslas: nustatyti ir įvertinti pacientų požiurį į sveikatos paslaugų prieinamumą bei priimtinumą Varėnos pirminės sveikatos priežiūros įstaigoje ir jų ryšius su socialiniais demografiniais veiksniais. Tyrimo metodika. 2006.03.01 – 2006.03.10 laikotarpiu VšĮ Varėnos PSP centre buvo atliekama anoniminė anketinė pacientų apklausa. Apklausoje dalyvavo VšĮ Varėnos PSP centre(miesto gyventojai) ir jo filialuose (kaimo gyventojai) besilankantys pacientai. Buvo išdalinta 280 anketų, atsakė – 208 respondentai (atsakas – 74 proc.). Statistinė duomenų analizė atlikta SPSS 9 versijos programiniu paketu. Rezultatai. Pagrindinis šeimos gydytojo pasirinkimo motyvas yra gydytojo profesionalumas, žinios ir patirtis (72,6 proc.).Centre sveikatos priežiūros paslaugų teritorinis, finansinis, organizacinis ir informacinis prieinamumas buvo geresnis negu jo filialuose.Visi centro pacientai per vieną valandą pasiekdavo PSP įstaigą, tuo tarpu filialų – tik 54,1 proc. respondentų (p<0,05). 32,3 proc. centro respondentų buvo finansiškai pajėgūs įsigyti vaistus, o filialų – tik 15,6 proc. (p<0,05). Prie registratūros langelio ilgiau negu 15 min. laukė 11,1 proc. centro respondentų, o filialų – 26... [toliau žr. visą tekstą] / Introduction. The reorganization of the network of primary healthcare (PHC) institutions is aimed at the improvement of the accessibility, acceptability, and quality of healthcare services. For this reason, periodical investigations of the patients’ attitude towards the accessibility and acceptability of healthcare services to various social groups are relevant. The aim of the study was to determine and evaluate patients’ attitudes towards the accessibility and acceptability of healthcare services in Varėna district primary healthcare unit, and to evaluate the relationships of these attitudes with socio-demographic factors. The methods of the study. During the period of March 1, 2003 to March 10, 2006, we performed an anonymous questionnaire-based inquiry of patients at Public institution Varėna PHC center. The participants of the inquiry were patients who visited Public institution Varėna PHC center (patients living in the city) and its branch offices (patients living in the countryside). In total, 280 questionnaires were distributed, 208 of which were returned (the response rate was 74%). Statistical analysis of the obtained data was performed using the SPSS v. 9 software package. Results. The main motive for the choice of the family physician was the physician’s professionalism, knowledge, and experience (72.6% of answers). The territorial, financial, organizational, and informational accessibility of services at the PHC center was better than in its branch offices... [to full text]

Tyrimo metodai. 2006 kovo-balandžio mėnesiais atlikta pacientų anoniminė apklausa trijose poliklinikose: Antakalnio, Karoliniškių ir Šeškinės. Apklausti pirminio lygio paslaugomis (išskyrus moterų konsultacijas ir odontologų paslaugas) pasinaudoję pacientai (n=700). Užpildytos 534 anketos - atsako dažnis 76,28%. Statistinė duomenų analizė buvo atlikta personaliniu kompiuteriu, panaudojant statistinės analizės SPSS programinį paketą. Rezultatai: 79% apklaustųjų per paskutinius dvejus metus lankėsi sveikatos priežiūros įstaigose. Daugiau negu pusė (nuo 60,3% iki 73,6%) apklaustųjų nurodo, kad per paskutinius dvejus metus „pagerėjo“, net „labai pagerėjo“ gydytojų ir slaugytojų darbo kokybė bei dėmesys pacientui. Registratūros darbuotojų dėmesio pacientui ir poliklinikos darbo organizavimo pokyčius teigiamai vertina kiek mažiau nei pusė apklaustųjų – 49,3% ir 48,5% atitinkamai. 45,9% respondentų nurodė, kad patekimas pas gydytoją-konsultantą per paskutinius kelerius metus „pasunkėjo“, tačiau 46,3% respondentų nurodė, kad ambulatorinio ištyrimo galimybės pagerėjo. Jei reiktų kreiptis į gydytoją-specialistą, esantį kitoje gydymo įstaigoje, net 76,2% respondentų tai sukeltų nepatogumų. 63,3% respondentų vertina palankiai faktą, kad gydytojas rašydamas nukreipimą pas gydytoją-specialistą, nenurodo konkrečios gydymo įstaigos. 60,9% respondentų vertina nepalankiai, kad vietoj specialisto reikia kreiptis į bendrosios praktikos (BPG) / šeimos gydytoją. 72,5% respondentų nemano, kad... [toliau žr. visą tekstą] / Methods. Anonymous questionnaire survey of the patients (n=700) was carried out in March-April 2006 at three out- patients’ clinics in Vilnius city: Antakalnis, Karoliniškės and Šeškinė. The interview was conducted only with those patients who were seeking primary care service (excluding gynecology/obstetrics and odontologists). 534 questionnaires were filled in – the response rate was 76.28 %. The data were analyzed on PC using statistical analysis package SPSS. Results: 79 % of respondents indicated that during recent two years they visited medical care institution. More than a half (60.3 %-73.6 %) of respondents indicated that the attention to patients and the quality of work performed by doctors and nurses during recent two years became „better“ or even „extremely better“. Less than a half of respondents gave a positive evaluation concerning the changes of registration personal‘s attention to patients and organization of work at medical care institution – 49.3 % and 48.5 % respectively. 45.9 % of respondents indicated that access to a specialist doctor during recent several years became „more difficult“, but 46.3 % of respondents indicated that the capacity of medical investigation/diagnostics at primary care institution became better. 76.2 % of respondents would experience difficulties if they would be referred to a specialist based in another medical care institution. 63.3 % of respondents are positive towards the fact that in a referral to specialist there is no... [to full text]

Darbe atlikta teorinė ankstyvosios intervencijos sampratos, raidos, probleminių klausimų analizė Lietuvoje bei lyginimas su kitomis Europos šalimis. Iškelta hipotezė, kad ankstyvosios pagalbos prieinamumas miesto ir kaimo vaikams bei jų šeimoms yra nevienodas. Rajonuose, kur nėra ankstyvosios pagalbos tarnybų, ankstyvojo amžiaus vaikų ir jų šeimų specialieji poreikiai yra tenkinami tik iš dalies arba visai netenkinami. Tyrimo tikslas – įvertinti ankstyvojo amžiaus vaikų specialiųjų poreikių tenkinimą pagalbos prieinamumo aspektu miesto ir kaimo vietovėse. Empirinėje dalyje taikyti šie metodai: dokumentų, antrinių duomenų (Europos Specialiojo ugdymo plėtros agentūros ataskaita) bei kitų šaltinių turinio analizė, anketinė apklausa, specialistų anketinės apklausos analizė, interviu, deskriptyvinė pusiau standartizuotu bei standartizuotu klausimynu gautų duomenų analizė. Duomenys apdoroti MS Office Excel 2007, SPSS (Statistical Package for the Social Sciences 11.0) programine įranga. Statistinėms tendencijoms ir ryšiams nustatyti taikyti deskriptyvinės analizės metodai (dažniai, vidurkiai, procentai). Anketinės apklausos metu dalyvavo 100 Lietuvos specialistų, teikiančių ankstyvąją pagalbą specialiųjų poreikių turintiems vaikams ir jų šeimoms. Interviu žodžiu bei raštu dalyvavo 12 respondentų (N=6 iš Lietuvos, N=4 iš Airijos, N=2 iš Anglijos). Svarbiausios empirinio tyrimo išvados: 1. Lietuvoje ankstyvosios pagalbos sistema vaikui ir šeimai sparčiai tobulėja, tačiau dar yra... [toliau žr. visą tekstą] / There has been performed in this work the theoretical analysis of the conception, development and the problematical questions of the early intervention in Lithuania as well as the comparison with other European countries. A hypothesis is raised, stating that the accessibility of early support for children and their families in towns and villages is unequal. The special needs of the early age children and their families in the regions, where there are no Early intervention services, are being met only partly or not at all. The aim of the research is to estimate from the aspect of support accessibility, how the special needs of the early age children in towns and villages are being met. There have been used in the empirical part the following methods: the analysis of the documents, secondary material (the report of the European Agency for Development in Special Needs Education) and other sources, questionnaire survey, the analysis of the survey of specialists, interview, descriptive analysis of the material acquired using semi-standardized and standardized questionnaire. The statistical data has been analysed using MS Office Excel 2007 and SPSS software. In order to estimate the statistical tendencies and connections there have been used the methods of descriptive analysis (rates, averages, percents). One hundred specialists, providing early support for the children with special needs and for their families, participated in the questionnaire survey. 12 respondents (6 from... [to full text]

In virtually all rural areas in Ontario the limited transportation alternatives means that rural residents without access to a personal vehicle are at great risk of transportation disadvantage. The primary research method for this research involved testing a transportation disadvantage framework using fourteen Key Informant Interviews undertaken with service providers operating within the case study of Huron County. The research found that residents within five demographic groups are at risk of transportation disadvantage within Huron County: older adults, those with physical or mental disabilities, youth, low-income households, and women. The research confirmed that transportation disadvantage exists on a continuum with some groups more disadvantaged than others, but also within groups with some accessibility needs more attainable than others. The research concludes with suggestions for a public transportation system to improve unmet transportation needs in Huron County along with recommendations for improving transportation access within the county.