Persons struggling with housing remain significantly disadvantaged when considering access to health care. Effective advocacy for their needs will require understanding the factors which impact their health care, and which of those most concern patients themselves. A qualitative descriptive study through the lens of a transformative framework was used to identify barriers and facilitators to accessing health care as perceived by people experiencing homelessness in the regional municipality of Niagara, Canada. In-person, semi-structured interviews with 16 participants were completed, and inductive thematic analysis identified nine barriers and eight facilitators. Barriers included affordability, challenges finding primary care, inadequacy of the psychiatric model, inappropriate management, lack of trust in health care providers, poor therapeutic relationships, systemic issues, and transportation and accessibility. Facilitators included accessibility of services, community health care outreach, positive relationships, and shelters coordinating health care. Knowledge of the direct experiences of marginalized individuals can help create new health policies and enhance the provision of clinical care.
A cross sectional study was carried out among school going children of Ganaktuli slum area in Dhaka city, Bangladesh. A total of 183 stool samples were collected from children of age between 5 and 16 years of both sexes during May, 2017 to April, 2018. Collected samples were examined using Formal-Ether Concentration technique. 61.20% samples were found positive for intestinal parasites. Eight species of parasites were identified, where Entamoeba histolytica (3.83%), Giardia lamblia (6.01%), Diphyllobothrium latum (3.28%), Paragonimus westermani (3.83%), Ascaris lumbricoides (24.59%), Trichuris trichiura (12.02%), Ancylostoma duodenale (5.46%) and Enterobius vermicularis (2.19%) was recorded. Male children showed higher (63.95%) prevalence than female (58.76%). The highest and lowest prevalence (82.46 and 39.29%) were found among 8 - 10 and 14 - 16 years children, respectively. The highest prevalence of E. histolytica (7.02%), A. lumbricoides (38.60%), T. trichiura (14.04%) and A. duodenale (8.77%) were observed in 8 - 10 years age group; G. lamblia (7.41%), P. westermani (5.56%) and E. vermicularis (3.70%) in 11 - 13 years age group and D. latum (6.90%) was found highest in 14 - 16 years age group. Statistically it was observed that age groups had significant association with parasitic infestation (p < 0.05) but prevalence did not alter significantly according to sexes (p > 0.05). Highest abundance of parasites was recorded for A. lumbricoides.
Bangladesh J. Zool. 47(1): 67-75, 2019
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