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Purpose: The purpose of this paper is to examine lived experiences of opioid agonist treatment (OAT) during and immediately following release from detention in prisons in England and Scotland., Design/methodology/approach: Surveys were completed by serving prisoners in both countries and by those recently released from prison (England only). The survey findings were discussed in focus groups of people with lived experience. The combined findings from the surveys and focus groups were shared with an expert group of prison OAT providers and people with lived experience with the purpose of making recommendations for more accessible and effective OAT in custodial environments and continuity of OAT on release., Findings: The quality and accessibility of OAT varied considerably between establishments. It was reported to be harder to access OAT in Scottish prisons. It was often hard for people in prison to get the dosage of OAT they felt they needed and it was generally harder to access buprenorphine than methadone in English prisons. Only Scottish people in prison were aware of long-lasting forms of buprenorphine. People in English prisons had mixed experiences of the help available in prison, with no improvement recorded since a 2016 study. People in Scottish prisons were more likely to rate the help available as poor., Research Limitations/implications: The number of people accessed while actually in prison (73) was reduced by the impact of the pandemic, making it more difficult to access people in prison and because some were resistant to participating on the basis that they had already been consulted for a wide variety of research projects focused on the impact of COVID. The Scottish cohort (a total of 19 individuals comprising 14 survey respondents and five focus group members) is clearly too small a number on which to base robust claims about differences in OAT provision between the English and Scottish prison systems.., Practical Implications: The study identifies key barriers to accessing OAT in prisons and suggests key components of more user-friendly approaches., Social Implications: This study provides an overview of the recent lived experiences of people accessing OAT in prison and on release and offers valuable recommendations on how to make service provision more effective and consistent., Originality/value: This study provides an overview of the recent lived experiences of people accessing OAT in prison and on release in England and Scotland and offers valuable recommendations on how to make service provision more effective and consistent., (© Emerald Publishing Limited.)

Purpose: The purpose of this paper is to provide a commentary on Griffin et al.'s paper, "Positive family connections: Co-producing a virtual group programme for family carers of children with learning disabilities or who are autistic". Design/methodology/approach: This is a commentary on co-production, drawing on Griffin et al.'s paper and the values base of the field. Findings: Co-production is a valuable approach which seeks to empower and include key people in research. As suggested by Griffin et al., disseminating learning about co-production is an important additional principle of co-production, which demonstrates a values-based commitment to co-production. Originality/value: This commentary is aimed at professionals and researchers working in the field of learning disabilities who are keen to learn about and do co-production. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to evaluate Ghana's National Health Insurance Scheme (NHIS) on healthcare utilisation by exploring its heterogeneous effects based on residential status and wealth. Design/methodology/approach: The study used the Ghana Socioeconomic Panel Survey (GSPS) datasets. An instrumental variable strategy, specifically the two-stage residual inclusion (2SRI), was employed to control endogenous NHIS membership. Findings: Generally, the results show that NHIS improves healthcare utilisation (i.e. visits to a health facility and formal care). Concerning the heterogeneous effects of health insurance on healthcare utilisation, the results revealed that NHIS members are more likely to seek care, irrespective of their residence status. The results further indicate that the probability of visiting a health facility and utilising formal care increases for the poorest NHIS participants. Based on these, the authors conclude that NHIS provides equitable healthcare access and utilisation for its vulnerable populations, who are beneficiaries. Originality/value: To the best of the authors' knowledge, this paper is the first to explore the heterogeneous effects of NHIS on healthcare utilisation across residential and income subpopulations. Splitting the dataset by residential status to examine healthcare utilisation inequality is worthwhile. In addition, analysing utilisation in terms of health care type would show whether Ghana's NHIS may be viewed as welfare-enhancing through increased formal health care utilisation. Peer review: The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-05-2023-0330 [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to analyse the factors influencing migration, the labour migration process and the status of migrant laborers in the informal sector, particularly those working in brick kiln factories. It will shed light on the precarious nature of their work, often characterized by informal and verbal contracts. The paper examines occupational and environmental health hazards affecting the labourers and their impact on their well-being, the vulnerability of women in the precarious work environment and the associated health risks in brick kiln factories in India. Design/methodology/approach: The study relies primarily on primary data collection, supplemented by secondary literature and documents. Balangir district was chosen as the research region due to its historical deprivation, underdevelopment and the historical prevalence of environmental distress, leading to distress-driven migration. To gather primary data, 40 respondents were selected from five selected blocks in Balangir district, resulting in a total of 200 respondents. In addition, in-depth interviews were conducted with 35 individuals across the selected blocks, with approximately seven participants from each block. In addition, interviews of 10 kids were taken and around 10 key informants including the trade union leaders, intellectuals and civil society activists. Findings: Migrant labourers, including men, women and children, face significant health issues and are exposed to similar occupational health hazards. Internal migrant women workers are more vulnerable as they face critical health risks during pregnancy in host areas due to unfavourable working conditions and limited access to health-care services. Factors such as strenuous work, long working hours, poor nutrition and inadequate maternal care contribute to adverse outcomes such as spontaneous abortion, premature delivery and abnormal postnatal development. Research limitations/implications: The brick kiln industry presents a distressing reality for men who are highly vulnerable to occupational accidents, and women workers are exposed to sexual abuse, exploitation and violence. The prevalence of physical harassment, ranging from leering to rape, is alarmingly high among women. These incidents not only inflict physical harm but also cause severe psychological trauma and increase the risk of sexually transmitted diseases. Despite the existence of laws aimed at protecting women's rights and addressing sexual offences, the workers often remain unaware of their rights. This lack of awareness further compounds the vulnerability of women workers and perpetuates their exploitation in the workplace. Practical implications: To address health issues comprehensively, interventions should encompass the entire migrant population, including men and children. Strategies should focus on improving access to health-care services, promoting occupational health and safety measures, ensuring proper immunization and nutrition for children and addressing the broader social determinants of health. Empowering women with knowledge about reproductive health and rights, raising awareness about available health-care services and strengthening health-care providers' capacity to cater to migrant populations are crucial steps towards addressing health disparities. Social implications: Urgent interventions and policies are needed to address the health vulnerabilities of internal migrant workers and women workers. It is required to ensure health-care accessibility, improving working conditions, ensuring access to maternal care and essential supplements and providing health-care services for both pregnant women and their children, regardless of migration status. Originality/value: The study focused on precarious health and occupational hazards and accidents faced by migrant workers. It highlights women migrant labourer's and children's vulnerability in the Brick Klin sector, which is a value addition to the existing knowledge in social science. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to provide new insights into and offer potential solutions to the challenges encountered by mental health services working with remote, rural or underserved communities in the UK. Design/methodology/approach: In this paper, the authors reflect on the utility of integrating conventional clinical approaches, with preventive care and empowering work within the community, to provide culturally sensitive and accessible mental health services. The authors describe an example of community intervention from a mental health service in Ghana designed to enhance reach within remote and rural communities and identify potential lessons for practice in the UK. Findings: The partnership between community mental health services and the rural communities, including families and existing social frameworks, applies collaborative care to overcome the lack of resources and facilitate the acceptability of mental health services to the local population. There are a series of important lessons from this experience including the importance of understanding the culture of a community to optimise reach and the importance of working IN the community and WITH the community. Originality/value: This paper is novel because it provides learning from a model of care applied in the global south that has potential for implementation with underserved populations in the UK. The authors suggest a reframing of the notion of community care to encompass existing frameworks of community, not merely a biomedical conceptualisation. [ABSTRACT FROM AUTHOR]

Purpose: Health sector corruption constitutes a pervasive challenge and a major obstacle to the equitable enjoyment of the right to health by exacerbating health inequalities within societies, while often eroding public trust primarily amid public health crises that threaten human security. The purpose of this paper is to examine the value of advancing right to health considerations in national legislative and regulatory responses against health sector corruption. Design/methodology/approach: This paper builds on existing evidence, with focusing attention on international standards that are relevant to the topic under discussion. The literature research included publicly available reports, peer-reviewed studies and other documents primarily of human rights bodies at the United Nations level. Findings: Advancing right to health considerations in national responses against health sector corruption offers comprehensive guidance for the deployment of a strong regulatory anti-corruption framework for action by the governments as part of their health rights obligations. Essentially, the implementation of such a national framework for action, encompassing accountability, participatory decision-making and transparency, constitutes a necessary and an important step towards maintaining well-functioning health systems and a robust social pressure for continued political commitment with the ultimate goal the provision of equitable access to quality health services at all times. Originality/value: By using a rights-based approach, the paper identifies a national framework for state action consisting of legal obligations and tools towards guiding governments, while at the same time empowering civil society groups to demand the implementation of core human rights principles of transparency, participation and accountability within health system governance. It provides insights for the future development, reinforcement and/or reform of national law, policies and practices towards minimizing and eradicating vulnerabilities to health sector corruption. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to introduce the concept of using the well-established Shared Lives approach to support survivors of domestic abuse with complex needs including those with learning and physical disabilities, older people and carers. Design/methodology/approach: Survivors with complex needs are often excluded from traditional domestic abuse support services thus increasing their risk and making recovery impossible. Using the Shared Lives approach in suitable cases could address gaps in provision and improve the outcomes for survivors with disabilities, older survivors and carers. Findings: The paper draws on evidence from reports and research about the experiences of these cohorts of survivors to explain how the Shared Lives approach could increase support options for specific categories of survivors. Practical implications: Using the Shared Lives approach to support cohorts of victims/survivors who experience barriers to accessing support could improve outcomes for these people, reduce risk of serious harm and improve quality of life. Originality/value: With the recent recommendation from Association of Directors of Adult Social Services around increasing use of Shared Lives, this paper provides one potential way to meet this recommendation. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to describe the unique health challenges facing female commercial sex workers (FSWs), including issues related to their marginalisation and difficulty accessing health care. It proposes solutions to some of these problems. Design/methodology/approach: This paper addresses this sensitive subject through the methodology of a literature review, drawing on a variety of relevant published literature to inform a modern understanding of the current health challenges faced by this population. Findings: This paper discusses issues around criminalisation of commercial sex workers, complexities of family planning, sexually transmitted infection prevention, mental health and substance abuse and how increasing health-care worker awareness of the health needs of this vulnerable population can be a positive step in building trust within this relationship. Although adoption of the proposed recommendations put forth in this paper may help to eliminate some of the barriers encountered by female sex workers, further research is recommended. Originality/value: The subject of commercial sex worker health care is neglected in the academic literature. This review explores the topic in an open and balanced manner and presents a broad and updated overview of the current health-care challenges faced by FSWs as well as opportunities for optimising access and quality of sex worker health care. [ABSTRACT FROM AUTHOR]

Purpose: Contextual to the recognition of the complex interplay between health and behavioral aspects, integrated behavioral health (IBH) has emerged. Although this model is becoming popular in the Western world, its presence in the global context is not promising. This paper aims to explore the need for IBH in India and address its barriers to implementation and possible solutions. Design/methodology/approach: We analyzed the case of IBH and its potential implications for India using the current evidence base, authors' reflections and experience of implementing similar programs. Findings: This paper identifies contextual factors, including increased instances of non-communicable diseases and psychosocial and cultural determinants of health, that necessitate the implementation of IBH programs in India. The key features of different IBH models and their applicability are outlined. The current status of IBH and potential challenges in implementation in India in terms of human resources and other factors are delineated. We also discuss the potential models for implementing IBH in India. Originality/value: Integrating behavioral health in primary care is considered an effective and sustainable model to promote health and well-being across various target populations. Towards this end, this paper is the first to discuss the contextual factors of IBH in India. It is a significant addition to the knowledge base on IBH and its possible implementation barriers and strategies in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Purpose: The recommended public healthcare infrastructure and human resources are essential to deliver healthcare services, particularly in tribal areas, as the country's tribal population depends mainly on the public healthcare system for their medical needs. India has a substantial share of the tribal population, accounting for approximately 9% of the total population. The paper reviews the state of public healthcare infrastructure and human resources in tribal areas for a period that spreads over a decade. Design/methodology/approach: The paper relied on data from the Government of India's Rural Health Statistics (RHS) reports (2011–2012 and 2021–2022). From these reports, data on the physical infrastructure and human resources in the tribal areas were extracted. The extracted data were compiled and analyzed using Microsoft Excel. Findings: The analysis showed that the improvement in public healthcare infrastructure and human resource situation in tribal areas of the country was not commensurate with the tribal population growth seen in the last decade. As a result, the average population covered by a health facility was greater than the prescribed norms in the tribal-dominated geographies. The health worker-population ratio at the primary healthcare level was also higher than the national norms. However, there was a substantial improvement in the doctor-population ratio at the primary health center level. In comparison to tribal-lean states, tribal-dominated states faced the concurrent challenge of a growing population and strained healthcare facilities and human resources. As a result, the healthcare infrastructure and human resource gap continued in the tribal-dominated states of the country. The gaps in health infrastructure and human resources in tribal-dominated states must be addressed as a priority under the health infrastructure strengthening efforts to ensure that the tribal population receives and has access to quality health care from publicly funded health facilities, leading to improved health outcomes in the tribal population and the achievement of the sustainable development goals (SDGs). Originality/value: We have not come across any paper that has carried out pancountry analysis of healthcare infrastructure and human resources in tribal areas. [ABSTRACT FROM AUTHOR]

Purpose – During 2011, the Making Every Adult Matter (MEAM) coalition supported three pilots to better coordinate existing local services for people facing multiple needs and exclusions. These individuals experience a combination of problems such as homelessness, substance misuse, mental health problems and offending. Many face difficulties consistent with dual diagnosis in its broadest sense. The purpose of this paper is to summarise the evaluation of the pilots, undertaken by FTI Consulting/Compass Lexecon in partnership with Pro Bono Economics. Design/methodology/approach – The evaluation examined the three pilots, which took place in Cambridgeshire, Derby and Somerset in England. The study looked at two main effects as individuals engaged with better coordinated services: changes in wellbeing and, changes in the use and cost of wider local services. Primary wellbeing data were collected from clients and primary service use data were collected directly from relevant local agencies (police, health, housing etc). The study followed 39 individuals across the pilot sites. The average period between initial and final measurements was nine months.Findings – The findings show significant improvements in wellbeing for nearly all clients across three quantitative measures. The evaluation also recorded changes in the use and cost of local services. Some costs decreased in the first year of the pilot, for example, criminal justice costs in the Cambridgeshire and Somerset pilot areas. Other costs increased in the first year as people accessed the help they needed. In Cambridgeshire, the reduction in crime costs (£100,000 or 31 percent) was large enough to lead to an overall cost reduction. The total cost of service use in the first year increased in the other two areas. Originality/value – Collecting primary data on clients' actual service use directly from local agencies provides a strong methodological base. The evaluation will continue for a further year to examine the longitudinal impact of the pilots. The evaluation findings are of relevance to service providers, commissioners and policy makers interested in improving services for people facing multiple needs and exclusions. [ABSTRACT FROM AUTHOR]

Purpose: This article aims to clarify the concepts used to understand, analyze and improve a patient's progress through a health service system. A patient pathway describes plans and intentions. Within it, we distinguish between the clinical pathway of decisions and interventions and the care pathway of supportive activities. As a patient pathway is implemented, it turns into a patient journey of what is done, what happens to a patient's medical condition and what is experienced and felt. We introduce "patient journey disruption" (PJD) as a concept describing the events that need to be prevented from happening to accomplish integrated, coordinated and seamless care. Design/methodology/approach: The method used in this paper is concept analysis. First, an expert steering group worked to refine the concept of PJDs; second, an analysis of similar concepts from related fields was done to root the concept into existing theories, and third, semi-structured interviews with professionals and patients were done to test the concept of PJDs in the home care context. Findings: PJDs are agency-based harmful events in the execution of the care pathway that deviate the patient journey from what can be reasonably expected. PJDs are management failures, which is why they should be studied by healthcare operations management (HOM) and service science scholars with the intention to find ways to prevent them from happening. Research limitations/implications: This study has limitations, including presenting conceptual ideas and preliminary results that are only indicative. Practical implications: We believe that the introduction of the concept of PJDs into the literature provides a new, systematic way of approaching the different shortcomings in our healthcare production systems. Moreover, by systematically identifying different PJDs, interventions can be designed and targeted more appropriately. Originality/value: Managerial challenges regarding healthcare processes have been studied but have not been well defined. The concept of PJDs is an original, well-thought-out definition. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to discuss the methodological challenges to evaluating one of the 50 vanguard sites of the new care model (NCM) programme for integrated care in England, and make the case for a modified realist approach to this kind of evaluation. Design/methodology/approach: The paper considers three challenges to evaluating the NCM in this particular vanguard: complexity, strategy and rhetoric. It reflects on how the realist approach negotiates these philosophical challenges to delivering integrated care, in order to provide contextualised accounts of who a programme works for, in what context, and why. Findings: The paper argues that, in the case of this particular vanguard site, the tangible benefit of the realist approach was not in providing a firm epistemological basis for evaluation, but rather in drawing out and articulating the ontological rhetoric of such large-scale transformation programmes. By understanding the work of the NCM less as an objective "system", and more as a dynamic form of persuasion, aimed at securing the "adherence of minds" (Perelman and Olbrechts-Tyteca, 2008, p. 8) in multiple audiences, the paper suggests that realist evaluation can be used to address both the systematic issues and localised successes the NCMs encountered. Originality/value: The paper identifies a number of aspects of new models of integrated care for evaluators to consider. It offers ways of negotiating the challenges to conventional outcome-focused evaluation, by drawing attention to the need for contextualised, time-situated and audience-sensitive value of NCMs. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the intersection of cultural processes and immigration in parental understanding of adolescent mental health and mental health seeking behaviors among African immigrants in Western countries. The present study examines the perspectives of Congolese immigrant parents on adolescent mental health in Brussels, Belgium, and Raleigh, North Carolina, USA – two geographic regions with relatively large Congolese migrant populations. This study highlights a needed understanding of cultural and acculturative context in shaping the beliefs of Congolese immigrants and explores potential barriers of seeking health services. Additionally, it recognizes health issues among this underrepresented and underserved population. Design/methodology/approach: Fifteen Congolese immigrant parents, eight in the USA and seven in Belgium, participated in structured qualitative interviews using an adapted version of Kleinman Questions and behavioral scenarios on depression, post-traumatic stress disorder and oppositional defiant disorder. Interviews were audio recorded, and participants were assigned pseudonyms to de-identify responses. English interviews were transcribed verbatim by a trained team of undergraduate research assistants, and French interviews were transcribed verbatim by the first author and a graduate research assistant. Following transcription, the first and second authors used a rapid analytic approach (Hamilton, 2013). The first and second authors conducted a matrix analysis to observe thematic patterns. Findings: Parents interpreted adolescent behavior to be more problematic when the scenarios were overtly outside of their cultural realm of values and beliefs. Parents preferred methods of intervention through religious practices and/or family and community efforts rather than seeking mental health services in their host countries as a secondary option. The authors' findings provide an understanding of the values and beliefs of this underrepresented demographic, which may be useful to guide health professionals on how to support this community in a culturally responsive way. Research limitations/implications: Limitations to the current study include the structured nature of the interview guide that did not allow for in-depth qualitative exploration. Interviewed participants had lived in their host countries for more than 10+ years. Thus, the authors' findings are not reflective of new immigrants' experiences. Parents' perspectives were likely shaped by exposure to Western beliefs related to support for mental health (e.g. knowledge of psychologists). Future studies should focus on recent refugees due to exposure to traumatic events and experiences reflective of the Democratic Republic of Congo's (DRC's) current socio-political situation, and how these are understood in the context of adolescent mental health. Further, due to the hypothetical nature of the scenarios, the authors cannot be sure that participants would engage in the identified approaches with their children. Additionally, hearing from the youth's perspective would provide a clearer insight on how mental health and seeking professional help is viewed in a parent–child relationship. Finally, the data for this study were collected in 2019, prior to the COVID-19 pandemic. Although the authors cannot speak directly to Congolese refugee and immigrant experiences during this significant historical period, given the rise in mental health concerns in refugee populations more broadly (Logie et al., 2022), the authors' findings speak to how parents may have responded to increased mental health symptoms and point to additional barriers that these populations may have faced in accessing support. The authors' study emphasizes the need for dedicating resources and attention to this population, especially the development of culturally tailored messaging that invites community members to support the mental health needs of their community. Practical implications: The authors' findings provide important implications for mental health professionals. This study provides a clearer understanding of how Congolese immigrant parents view mental health and help-seeking within their cultural frame. Although parents may seek professional help, a distrust of mental health services was expressed across both cohorts. This suggests that mental health professionals should acknowledge potential distrust among this population and clarify their role in supporting the mental health of adolescent immigrants. Clinicians should inquire about familial cultural beliefs that are parent- and child-centered and modify their interventions to fit these belief structures. Originality/value: This paper addresses the gap in knowledge about mental health perspectives of Sub-Saharan African immigrant populations, specifically those from the DRC. [ABSTRACT FROM AUTHOR]

Purpose: Health in low-income countries has become associated with the provision of minimum guaranteed public health services though Essential Health Packages (EHPs). How far do EHPs deliver the human right to health for all? This study addresses this question through qualitative research into access to health care for vulnerable communities, using Malawi as a case study. This study shows that there are significant accountability gaps and perceptions of weak service provision in Malawi's EHP in relation to some particularly marginalised (and stigmatised) groups that limit the right to health and the promise of "health for all". Design/methodology/approach: This study extends the body of qualitative work on EHPs in general and on Malawi in particular by exploring the perceptions of key stakeholders in relation to inclusivity and the delivery of health policies to particularly vulnerable groups. To do so, this study adopted an approach based on interpretive epistemologies (Scott, 2014). This study conducted largely unstructured interviews with a range of health stakeholders, speaking to stakeholders individually, rather than through focus groups due to the potentially sensitive nature of the topic. Findings: The findings of this study are as follows: limited inclusion of civil society actors and local communities; local communities and local policymakers feel frustration with the gap between the promises of consultation in the EHP and the reality, and the difficulties of not having effective channels of communication; and exclusionary health practices for particularly vulnerable groups. Research limitations/implications: There are limitations based on the qualitative methodology, and in terms of the particularly vulnerable groups – the authors studied two such groups (people with disabilities and those who identify as LBTQ) but a wider survey of vulnerable groups is needed to extend and confirm the findings. Practical implications: Greater attention to the health rights of vulnerable groups would improve access and services, even in the context of resource restrictions. This study suggests that a deeper engagement with human rights-based approaches would pay dividends in terms of increasing access to health in Malawi, even within the constraints of the EHP process. Furthermore, without this, there is the risk that discrimination and exclusion will become more embedded in health policies, rather than progressively minimised. Social implications: Without addressing these issues, there is the risk that discrimination and exclusion will become more embedded in health policies, rather than progressively minimised. Originality/value: This paper makes an important contribution to the growing literatures on EHP in sub-Saharan Africa and Malawi in particular and to the importance of listening to stakeholder perceptions. It provides original data on stakeholder perspectives of the challenges associated with universalising health care in resource-constrained countries. To the best of the authors' knowledge, it is one of the first papers to focus on the rights of disabled and LBTQ people in relation to EHPs. [ABSTRACT FROM AUTHOR]

Purpose: Population ageing is a demographic transition and burdens every country's health sector. A lack of social security combined with low government health-sector spending has made health-care utilisation difficult among elderly in many developing countries like India. This makes population ageing a global phenomenon for policymakers, researchers and stakeholders to discuss and debate in 21st century. The purpose of this paper is to examine the behavioural determinants of health-care utilisation among elderly population in Punjab. Design/methodology/approach: This study examines health-care utilisation among the elderly population in Punjab. A structured questionnaire was used to collect the data in the state of Punjab, with a multi-stage stratified random sample of 385 respondents. Logit regression was used to analyse the association between several behavioural factors like age, gender, place of residence, source of livelihood, education and frequency of visits with health-care utilisation among elderly aged 60 and above. Findings: This study revealed that gender, age, place of residence, source of livelihood, education and frequency of visits were significant determinants of health-care utilisation among elderly population. Originality/value: This study directs the need to improve health-care utilisation in a country, reducing inequalities that exist among the elderly population with respect to socio-economic and demographic differences. [ABSTRACT FROM AUTHOR]

Purpose: India has been on the pathway of improvement concerning healthcare and health outcomes of its population. However, India must overcome its unique challenges and cover a long journey ahead. This mandates a need for a high-quality, contemporary and community-based health system that promises consistent and quality healthcare, is trusted and valued by all its citizens, considers the changing population needs and should be affordable and accessible. Design/methodology/approach: The study examines various dimensions and elements associated with the integrated healthcare system in India and uses input, process and output structural measures. Findings: The present paper proposes an integrated, comprehensive healthcare system in India that endorses participation from diverse stakeholders such as the government, organizations, the community and individuals who can contribute uniquely. It also focuses on defined and measurable output that can make health a topic of social movement or "Jan Andolan" and create a sustainable and integrated care system. Originality/value: The study is unique as it focuses on the role of stakeholders in health care. The research emphasized the involvement of the government, community, people and organizations in developing an integrated healthcare ecosystem that includes modern technology, skilled employees, enough finance, governance, efficient delivery platforms and top-tier infrastructure. The model's output is focused on healthcare that is inexpensive, accessible, available, accountable and user-centered. This would gradually improve everyone's health and well-being. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper was to establish how the phenomenon of mental health issues among young people has translated into the reality of Irish schools through the lens of Irish teachers. Design/methodology/approach: This wholly qualitative study adopted a post-positivist and phenomenological approach to gathering data by way of semi-structured interviews of 16 participants, 8 from primary backgrounds and 8 from post-primary backgrounds. Analysis of the data highlighted what teachers perceive to be ongoing issues with the mental health and well-being of pupils and the challenges that both teachers and pupils must overcome. Findings: Interviewing the participants unearthed three sub-themes with regard to mental health in Irish schools, namely, the prevalence of psychiatric disorders/symptoms of mental ill-health among Irish children and adolescents, the barriers preventing help-seeking and the role of mental health support services in Irish schools. Research limitations/implications: One limitation in this study was that a wider variety in sample could have yielded a more in-depth volume of results. Furthermore, the study by semi-structured interview presented challenges, such as the use of other people's viewpoints to support the perceptions of the participants, which could not be validated. Practical implications: Among the recommendations made by the participants were that schools engage in policy development to combat mental health and well-being issues, that teachers engage in continuous professional development in the area and that mental health support services are sufficiently staffed and funded. Social implications: The general public should engage more in activities that promote a healthy dialogue around the topic of mental health to reduce stigma. It is recommended that campaigns to raise awareness are continued and bolstered. Originality/value: Irish teachers are being confronted by a contemporary discourse that has materialised as a by-product of an evolving society. Cultural development has led to increased focus on mental health and well-being in recent years, with this body of research exploring its emergence into school life from teachers' perspectives. [ABSTRACT FROM AUTHOR]

Purpose: Several countries, such as South Africa and India, believe that intellectual property rights (IPRs), including patents, impede the efficient increase in vaccine production to inoculate the global population as they scramble to recover from the COVID-19 pandemic. Their proposal at the World Trade Organization (WTO) to waive these pharmaceutical patents has been met with resistance from a few developed countries, who believe that the abrogation of IPRs is unnecessary, even during a pandemic. The purpose of this paper is to discuss the impact of a potential waiver of medical patents at the WTO versus the status quo of IPR laws in the global economy. Design/methodology/approach: This study examines key arguments from economic and moral standpoints regarding the provisions of the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement and other related international agreements and their validity based on the premise of the internalisation of positive externalities posed by vaccines. Findings: The effectiveness of the TRIPS agreement in securing medical access is weak on account of the ability of profit-making multinationals to secure IP rights and on account of the Trans-Pacific Partnership, a multilateral agreement that supports patent evergreening and a period of protection on test data which challenges the access to medicines and the fundamental human right to health. Originality/value: This study examines international IPRs through the lens of human rights and proposes a new system that balances the two. [ABSTRACT FROM AUTHOR]

Purpose: Population Health Management (PHM) is a methodology which has the potential to help support the aspirations of the NHS's Integrated Care Systems to address health inequalities, shift from reactive to proactive care and prevention, work in a more integrated manner, and deliver person-centered care tailored to the individual's needs. Although PHM is featured in a number of key national policy documents, moving from the conceptual to widespread adoption requires some key conditions to be in place and barriers to be overcome. It may also require a wider cultural change amongst teams as part of a more truly integrated, holistic ethos. Design/methodology/approach: This Viewpoint Paper sets out the advantages and challenges associated with the adoption of PHM. Findings: Key features of PHM are outlined, as well as the conditions needed for successful adoption. Key barriers which need to be overcome are discussed, not least occasional scepticism from clinical colleagues and how this can be addressed and translated into a source of energy and enthusiasm for a new approach. Originality/value: This is a viewpoint based on the author's personal experience of supporting the implementation and spread of PHM in England's NHS, summarising shared learning and suggesting practical strategies. [ABSTRACT FROM AUTHOR]

Purpose: Repetitive transcranial magnetic stimulation (rTMS) is a well-established treatment with efficacy for several psychiatric disorders and has yielded promising yet mixed data showing reductions in craving for substance use. Patients with substance use disorders and comorbid depression may encounter obstacles to receiving rTMS in outpatient settings for treatment of depression. In turn, implementation of rTMS in residential substance use programs would greatly benefit those with comorbid treatment resistant depression. This paper aims to provide recommendations for implementing rTMS within residential substance use treatment centers. Design/methodology/approach: Using PubMed, the authors conducted a narrative review of manuscripts using various combinations of the following search terms: rTMS, depression, substance use and substance use disorder. The authors read manuscripts for their methodology, outcomes and adverse events to synthesize their results, which correspond to their recommendations for patient selection, safely implementing rTMS in residential substance use facilities and optimal rTMS protocols to start with. Findings: Advantages of this approach include increased compliance, monitoring and access to care. Recommendations to safely incorporate rTMS in residential substance use disorder treatment centers revolve around selection of patients eligible for rTMS, allowing for sufficient time to elapse prior to commencing rTMS, monitoring for signs of recent substance use or withdrawal and using rTMS protocols compatible with the therapeutic programming of a treatment center. Originality/value: This paper details the challenges and benefits of implementing rTMS for patients with dual diagnosis and provides recommendations to safely do so. To the best of the authors' knowledge, this is a novel and unpublished endeavor. [ABSTRACT FROM AUTHOR]

Purpose: Unequal social conditions that provide people with unequal opportunities to live healthy lives are considered unjust and associated with "health inequity". Governing power is impacting people's lives through laws, policies and professional decisions, and can be used intentionally to combat health inequity by addressing and changing people's living- and working conditions. Little attention is paid to how these ways of exercising governing power unintentionally can structure further conditions for health inequity. In this paper, the authors coin the term "governance determinants of health" (GDHs). The authors' discussion of GDHs potential impact on health inequity can help avoid the implementation of governing strategies with an adverse impact on health equality. This paper aims to discuss the aforementioned objective. Design/methodology/approach: The authors identify Governance Determinants of Health, the GDHs. GDHs refer to governance strategies that structurally impact healthcare systems and health equality. The authors focus on the unintended, blind sides of GDHs that maintain or reinforce the effects of socioeconomic inequality on health. Findings: The power to organize healthcare is manifested in distinct structural approaches such as juridification, politicalization, bureaucratization and medical standardization. The authors explore the links between different forms of governance and health inequalities. Research limitations/implications: The authors' discussion in this article is innovative as it seeks to develop a framework that targets power dynamics inherent in GHDs to help identify and avoid GDHs that may promote unequal access to healthcare and prompt health inequity. However, this framework has limitations as the real-world, blurred and intertwined aspects of governing instruments are simplified for analytical purposes. As such, it risks overestimating the boundaries between the separate instruments and reducing the complexity of how the GDHs work in practice. Consequently, this kind of theory-driven framework does not do justice to the myriad of peoples' complex empirical practices where GDHs may overlap and intertwine with each other. Nevertheless, this framework can still help assist governing authorities in imagining a direction for the impacts of GDHs on health equity, so they can take precautionary steps to avoid adverse impacts. Originality/value: The authors develop and explore – and demonstrate – the relevance of a framework that can assist governing authorities in anticipating the impacts of GDHs on health inequity. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to identify human rights violations of patients during the early periods of the COVID-19 pandemic in Ghana by investigating the experiences of people on how health-care professionals discharged their responsibilities during the time in question. Design/methodology/approach: Explanatory design of the mixed methods approach was adopted, with the intention of collecting both quantitative and qualitative data sequentially, and then integrating the results at the interpretation stage. The approach enriched the quality of data collected as it offered the advantage of shedding light on the primary motivations and reasons for attitudes and behaviours and helped to provide an in-depth understanding of how individuals interpret the happenings around them and their experiences. Thus, although some amount of quantitative method was used in the data collection, the core of this paper is based on the qualitative interpretations. Findings: The study reveals that health-care professionals, especially those in the Tema Metropolis, undermined certain fundamental human rights of patients during the early period of the COVID-19 pandemic. This includes failure to provide information to patients about treatment options and potential risks of medications; failure to seek the informed consent of patients before performing medical procedures; denial of access to medical files of patients for transfer; and inability or failure to provide medical ambulances services to patients on time. Originality/value: Although many publications on human rights dimensions and health protective issues on COVID-19 pandemic are available on a global scale, still little information pertaining to experiences of individuals with health-care professionals during the early days of the COVID-19 pandemic, especially in Ghana through the lens of patient's rights exists. This paper, therefore, fills an important gap in health-care management information, critical for policy decision-making processes regarding patient's rights in times of pandemic control. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to critically examine the multinational oil companies' (MOCs) corporate social responsibility (CSR) initiatives in Nigeria. Its special focus is to investigate the impact of the global memorandum of understanding (GMoU) on gender difference in nutrition and health in the Niger Delta region of Nigeria. Design/methodology/approach: This paper adopts a survey research technique, aimed at gathering information from a representative sample of the population, as it is essentially cross-sectional, describing and interpreting the current situation. A total of 800 women respondents were sampled across the rural areas of the Niger Delta region. Findings: The results from the use of a combined propensity score matching and logit model indicate that CSR of the MOCs using GMoU model has made significant success in closing the gender difference in nutrition and health in agricultural household in the Niger Delta region. The findings also show that mainstreaming gender in nutrition within the field of agriculture is a critical aspect of strengthening gender and nutrition/health linkages, in recognition of women's substantial contribution to agriculture production and their central role in household food collection, preservation/processing and preparation. Practical implications: This suggests that mainstreaming gender in nutrition offers opportunities to integrate agriculture and health approaches in GMoU projects, which will require increased collaboration and coordination between the MOCs' and CBD clusters in the field of gender and nutrition to exploit existing complementary and comparative advantages, and to apply a holistic approach in host communities. Social implications: This implies that gender and nutrition/health have multiple dimensions and are highly context-specific; and the pathway towards improved food and nutrition security for all should be a gender-equitable process incorporated in CSR programmes and projects in sub-Saharan Africa. Originality/value: This research contributes to the gender debate in agriculture from a CSR perspective in developing countries and rationale for demands for social project by host communities. It concludes that business has an obligation to help in solving problems of public concern. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to highlight lessons from the COVID-19 pandemic for planning for the future of our ageing society. It looks at trends, changes in our society and implications for people of all ages. It focusses on the importance of planning and whether COVID-19 will lead to long-term changes. Design/methodology/approach: This paper draws on the author's experiences running an intergenerational organisation during the pandemic and other work associated with ageing well. Findings: This paper highlights some of the risks and unknowns we face going forwards and points to lessons and opportunities for "building back better". Research limitations/implications: This paper is based on a review of published articles and viewpoints. Practical implications: The COVID-19 pandemic has challenged people of all ages in different ways, some of which have tested intergenerational solidarity. At the same time, the pandemic has raised issues which we must all address going forward: planning for future pandemics, planning for an ageing society and ensuring that future planning works for all generations. This paper explores all these themes in the light of lessons from COVID-19. Firstly, despite much risk assessment and scenario planning, we were not well placed in the UK or across the world to respond to the multiple challenges of COVID-19. Have we learned the lessons to be able to deal better with the inevitable pandemics that will follow in the future? It is also well documented that the pandemic has exacerbated existing inequalities in our society. What will the long-term impact be for longevity and will less healthy lives reverse the trend of increasing life expectancy? Secondly, what are the lessons for our ageing society? As life expectancy rises, what will the quality of life be like in those added years? Many of today's babies can expect to have a 100-year life. What does that mean for the way we lead our lives and can we ensure that everyone can age well? Third, these are not just issues for older people, but for people of all ages and generations. The Covid-19 experience has been different for younger and older people – whether it has been health or job security, income, taxation or housing. Questions of intergenerational fairness have again raised their heads, alongside the longer term impact for future generations. Social implications: Firstly, despite much risk assessment and scenario planning, we were not well placed in the UK or across the world to respond to the multiple challenges of COVID-19. Have we learned the lessons to be able to deal better with the inevitable pandemics that will follow in the future? It is also well documented that the pandemic has exacerbated existing inequalities in our society. What will the long-term impact be for longevity and will less healthy lives reverse the trend of increasing life expectancy? Secondly, what are the lessons for our ageing society? As life expectancy rises, what will the quality of life be like in those added years? Many of today's babies can expect to have a 100-year life. What does that mean for the way we lead our lives and can we ensure that everyone can age well? Thirdly, these are not just issues for older people, but for people of all ages and generations. Measures that bring older and younger people together and encourage meaningful mixing will help increase understanding and awareness between generations. This has huge implications for our society and communities. Originality/value: This paper reaches two main conclusions. Firstly, the well-known saying: "failing to plan is planning to fail". This applies to all the issues discussed in this paper re future pandemics, our ageing society and future generations. Secondly, the experience of the COVID-19 pandemic should be the catalyst for changing the way we live and lead to new beginnings. We cannot just carry on as before. [ABSTRACT FROM AUTHOR]

The article discusses race inequality in England in terms of accessing health services. It highlights the barriers faced by older people in ethnic groups in availing quality health services, which include lack of information, communication barriers and the expectations on the services available. An overview of the government solutions to mitigate the gap and inequality is given, such as the programs under the Race Relations Act of 2000 and Equality and Human Rights Commission. These initiatives include training of medical staff and investment in interpreting services to lessen language barriers.

Purpose: Refugees and asylum seekers worldwide face numerous barriers in accessing health systems. The evidence base regarding who and what helps refugees and asylum seekers facilitate access to and the navigation of the health system in the UK is small. This study aims to address this gap by analysing 14 semi-structured, in-depth interviews with refugees and asylum seekers of different countries of origin in the UK to identify where, when and how they came into contact with the health-care system and what the outcome of these interactions was. Design/methodology/approach: Semi-structured, in-depth interviews were chosen as the key method for this study. In total, 14 individual interviews were conducted. A trauma-informed research approach was applied to reduce the risk of re-traumatising participants. Findings: The paper identifies key obstacles as well as "facilitators" of refugees' and asylum seekers' health-care experience in the UK and suggests that host families, friends and third-party organisations all play an important role in ensuring refugees and asylum seekers receive the healthcare they need. Originality/value: To the best of the authors' knowledge, this is the first qualitative study in the UK that looks at comprehensive health journeys of refugees from their first encounter with health services through to secondary care, highlighting the important role along the way of facilitators such as host families, friends and third-party organisations. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to analyse in the health access of Indonesian illegal migrant workers in Malaysia, during which time they were not covered by Indonesia's national social health insurance. Design/methodology/approach: This study adopted a sociolegal approach, the research approach is conducted to understand the effect of a law, policy and regulation on access to health-care access among Indonesian migrant workers working illegally in Malaysia. This research involved 110 respondents who work illegally in Malaysia. The research explored the perceptions of respondents concerning to health access services of illegal migrant workers. Findings: The study demonstrated the weakness of provisions intended to guarantee the health access to health care of migrant workers from Indonesia illegally working in Malaysia. A decline in health status was observed, but it was not significant. Bilateral cooperation between Indonesia and Malaysia is necessary to provide a framework for Indonesia providing health care to its citizens working in Malaysia, regardless of their legal status. Originality/value: This paper concerns on the Indonesia illegal migrant workers experiencing illness and the access to the health service in Malaysia, and also the implementation of international regulation to protect Indonesian illegal migrant workers in Malaysia under ASEAN Consensus on the Protection and Promotion of the Rights of Migrant Workers. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this research is to identify novel ways of tackling health inequalities of underserved populations. It explores the opportunities presented by the changes in health and social care legislation to employ historically underused services, such as police custody healthcare providers, in addressing health inequalities. Design/methodology/approach: This research analyses the policy approaches to tackling health inequalities in the UK in the past 40 years with an emphasis on those experienced by the people detained in English police custodies. It analyses the current model of healthcare in police custody and proposes a novel integrated model of care and joint commissioning opportunities in funding it. Findings: Policies to tackle health inequalities have largely failed, as they became entrenched. But recent changes in the health and social care legislation in England offer opportunities to address them by employing historically underused healthcare services, such as those operating in police custodies. Research limitations/implications: The research does not touch upon ethical considerations related to the patient privacy aspect of integrated care. Interventions by and interactions with police custody healthcare providers would be visible to all professionals with access to the patient's health record. As with all novel interventions or innovative models of care, the effectiveness of such clinical interventions remains to be established by further research. It opens a new line of research on quality improvement through integration of care and explores understudied aspects of joint commissioning of integrated care. Practical implications: It offers health commissioners and public health leaders the opportunity to employ police custody healthcare services in reaching their population health management objectives and meeting their health inequalities objectives at local level. It also gives police and crime commissioners the opportunity to address the health drivers of criminal behaviour that overlap with health inequalities. It offers funding opportunities presented by jointly commissioning services at lower costs to both police and health commissioners alike. It improves the health outcomes of historically underserved populations by facilitating access to health and social care services and facilities. Social implications: Reducing health inequalities and disparities in health outcomes can decrease the costs of the healthcare services over the long term and might contribute to reducing criminality by addressing inequities and some health drivers of criminal behaviour. Originality/value: The paper explores understudied opportunities offered by the recent changes in health and social care legislation in England and includes underused resources to tackle health inequalities. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to review the approach used by the Ugandan Government in implementing the Covid-19 mitigation model and establish whether it did not expose government's failure to soundly protect and respect all her citizens' right to health during the first four months of the Covid-19 crisis in the country. Design/methodology/approach: The study was qualitative focusing on a population of households of vulnerable and chronically ill patients in Mukono and Wakiso districts of Uganda. The sample was identified through purposive and snowball sampling techniques. Purposive and snowball sampling was chosen for this study to select unique informative cases which were subjected to in-depth interviews. Findings: The findings of the study revealed that disadvantaged and vulnerable citizens of Uganda experienced severe and increased shortages of food, increased cases of ill-health, compromised ability and mobility to access health services as a result of the government's Covid-19 mitigation model. Research limitations/implications: The data collection exercise was conducted during the Covid-19 lockdown when the mobility was restricted to only essential services so data was collected in the two districts of Mukono and Wakiso in Uganda. Practical implications: Pandemic mitigation models ought to be people-centred executed by a multidisciplinary team which are empathetic towards the views of disadvantaged communities and thereby cultivate a culture of care over time. Social implications: Public health models and policies work more effectively if they are contextualized to work for both the high and low classes of people across the whole spectrum. Originality/value: Given this awareness of the Covid-19 mitigation model, this paper unveils the immediate consequential effects of the model considering the manner under which it was formulated and implemented in the Ugandan society. While the government implemented the model in exercise of its obligations, contextual factors had advance limitations to the efficacy of the model. Most significantly, among the expectant mothers, the old, the sick with terminal illnesses, the physically challenged and hunger-stricken families with no daily sources of income. [ABSTRACT FROM AUTHOR]

Purpose: Migrants face some unique health-care challenges, which often remain unaddressed by the health system. The purpose of this study is to determine health-care access among migrants in Chhattisgarh, from a lens of health equity. Design/methodology/approach: This study was conducted in a government-built tenement under the Integrated Housing and Slum Development program in Bilaspur district of Chhattisgarh state of India. It is a mixed-methods study which used a survey method, focus group discussion, in depth-interviews, semi-structured interviews and non-participant observations of health facilities in the area. Respondents included residents (migrants) and other local stakeholders like the Chief Medical Officer of the district, elected representatives of the local government and frontline health workers. This paper focuses on the findings from the qualitative component of the study. Findings: The move to resettle the people living in the slums to the periphery of the city had a negative impact on their health-care access. They find it difficult to access public health services, given the services are concentrated in the city. Women, elderly people and disabled people grapple with additional challenges in being able to access basic reproductive health services and care for chronic illnesses. Equity in health-care access is linked to various social determinants of health including access to housing and social security. However, the authors found that the migrant community is being deprived of appropriate housing facilities and social security. Originality/value: This paper explores the health-care access of internal migrants in Chhattisgarh state of India in the larger context of urban development with a focus on health equity. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper was to explore the health of trafficking survivors in Spain, which is relatively unstudied (Sweileh, 2018). Therefore, the objectives of this study are to describe the health conditions, access to health-care facilities, COVID-19 protection and health challenges in relation to the COVID-19 pandemic reported by women survivors of human trafficking in Spain. Design/methodology/approach: Due to the pandemic situation, limited research and the complexity of the issue, the authors took a qualitative approach. A cross-sectional study was carried out through interviews with women survivors of human trafficking for sexual exploitation in Spain. Prior to the interviews, the researchers conducted written interviews with social workers to understand the most important challenges that the women survivors were experiencing during confinement. As a result of these written interviews, the interview script for the survivors was modified. Findings: To sum up, the COVID-19 situation poses several challenges, including social difficulties (food insecurity; violence; terrible housing conditions; working pressure; poor sleeping habits; and cultural, linguistic and religious challenges), medical insecurity (due to lockdowns, negative experiences in care, lack of official documents, collapse of hospitals, telephone monitoring and fear of contagion), great emotional distress reported by women (anxiety, fear, sadness, post-traumatic stress disorder, stigma and substance use) and physical health problems (serious weight loss, muscle pains, dental problems and sexual and reproductive health-care limitations). Research limitations/implications: As is usual in qualitative research, rather than obtain generalizable results, the main objective was to delve deeper into under-researched or complex issues (Polit and Beck, 2010). While this report provides a timely overview marked by COVID-19 of an important population, there are some limitations. The major limitation of this research was the sample representativity, because the sample was conducted with only one non-governmental organization and only individuals who voluntarily agreed to make the interview; as such, other victim profiles may not be represented. Practical implications: The findings can provide information for detecting victims of human trafficking for sexual exploitation and contribute to understanding the pandemic's impact. Furthermore, the paper emphasizes the need to adopt measures for the recovery of victims, such as medical and psychological assistance, in accordance with the Palermo Protocol. As people transition out of the pandemic, it is crucial for Spain, along with other European countries, to guarantee that all residents, particularly the victims of human trafficking, have access to social and health-care protections during times of crisis. Social implications: As already mentioned, further investigation should be done to fill the gaps on health of human trafficking (Sweileh, 2018) and improve the recovery of victims of trafficking (García-Vázquez and Meneses-Falcón, 2023 0; Sweileh, 2018). The paper acknowledges the existing research gap in the field and emphasizes the importance of future studies to delve deeper into the challenges faced by victims, calling for a more nuanced understanding of health. Originality/value: The Coronavirus pandemic has increased and reinforced the vulnerability of sex-trafficked victims, especially creating different mental health problems. One of the biggest concerns for this group has been the difficulty of access to basic goods such as food. Furthermore, psychological distress impacted the well-being of trafficking victims, and many suffered from eating disorders. Less than half of the women who were forced to continue in prostitution did not have the means to protect themselves against COVID-19 and did not have easy situations to overcome illness. [ABSTRACT FROM AUTHOR]

Purpose: Informed by health activism (Zoller, 2005), the purpose of this paper is to explore the communicative processes of organizations working with women migrants in countries of destination. In particular, it explored the definitions of and explanations for health of organizations, their solutions to disease and illness, as well as, the methods and tactics they use to communicate health. Design/methodology/approach: It employed qualitative approach specifically in-depth interviews with leaders or core members of not-for-profit and faith-based organizations working with Filipina migrants in Japan. Field notes from participant observations in formal meetings and informal gatherings were likewise used as data sources. Findings: While organizations also recognized physical and spiritual health, they placed strong emphasis on mental well-being. Other than translation service, pastoral care, and shelter, coordinating with other not-for-profit and faith-based organizations, international centers, and governments was solution for addressing illness and disease. Together with face-to-face, digital media were used as method and tactic to communicate within and outside organizations. It likewise found that the organizations included were inclusive such that they also worked with other Filipinos in Japan. Originality/value: This paper contributed to migration health literature by discussing the central role of organizations for mental well-being activism, favorable consequences of coordination among organizations to promote access to quality healthcare and information and dual characterization of digital media for organizing publics. Overall, it is one of the few to explore the ways into which organizations communicatively challenge health structures in countries of destination. [ABSTRACT FROM AUTHOR]

Purpose: This paper presents a thematic synthesis of mental health policies published in England from 1999 to 2020. Design/methodology/approach: This paper aims to present a thematic synthesis of mental health policies published in England from 1999 to 2020. The authors specifically focus on ethnicity-related mental health issues highlighted in policies, policy recommendations and performance measurements of policy implementation. Findings: Findings from this synthesis demonstrate that ethnic mental health inequalities remain comparable over the past two decades. Ongoing issues include a lack of data on the ethnicity of mental health services users. Where data is available, these highlight ethnic inequalities in access to, experiences of and outcomes of mental health services, as well as a lack of cultural capability in health-care professionals. Policy recommendations have also remained the same during this time and include: collecting data on the ethnicity of service users, raising awareness of the cultural needs of Black and Minority ethnic populations amongst health-care professionals, recruiting BME staff into mental health care services and improving community engagement. The synthesis identified poor indicators of performance measurement on policy implementation and weak monitoring regimes. Practical implications: The synthesis identified poor indicators of performance measurement on policy implementation and weak monitoring regimes. Originality/value: This paper presents a thematic synthesis of mental health policies published in England from 1999 to 2020. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to provide an overview of the emerging AgeTech sector and highlight key areas for research and development that have emerged under COVID-19, as well as some of the challenges to real-world implementation. Design/methodology/approach: The paper is a commentary on emerging issues in the AgeTech sector, with particular reference to COVID-19. Information used in this paper is drawn from the Canadian AGE-WELL network. Findings: The COVID-19 pandemic has particularly impacted older adults. Technology has increasingly been seen as a solution to support older adults during this time. AgeTech refers to the use of existing and emerging advanced technologies, such as digital media, information and communication technologies (ICTs), mobile technologies, wearables and smart home systems, to help keep older adults connected and to deliver health and community services. Research limitations/implications: Despite the potential of AgeTech, key challenges remain such as structural barriers to larger-scale implementation, the need to focus on quality of service rather than crisis management and addressing the digital divide. Practical implications: AgeTech helps older adults to stay healthy and active, increases their safety and security, supports independent living and reduces isolation. In particular, technology can support older adults and caregivers in their own homes and communities and meet the desire of most older adults to age in place. Social implications: AgeTech is helpful in assisting older adults to stay connected. The COVID-19 pandemic has shown the importance of the informal social connections and supports within families, communities and voluntary organizations. Originality/value: The last months have seen a huge upsurge in COVID-19-related research and development, as funding organizations, research institutions and companies pivot to meet the challenges thrown up by the pandemic. This paper looks at the potential role of technology to support older adults and caregivers. [ABSTRACT FROM AUTHOR]

Purpose: Theoretically, a health system has been described in terms of integration being the coordination of health services and collaboration amongst provider organizations. The components of an integrated health system remain inconclusive. Although senior healthcare executives establish structures and designs which facilitate the delivery of integrated care, their perspectives of a health system have not been explored. The purpose of this paper is to present senior healthcare executives' perspectives of a health system which, when combined, form a model for developing an integrated health system. Design/methodology/approach: Using a qualitative methodology and a multi-case study design, 11 presidents and 4 senior vice presidents of major healthcare organizations or systems in Ontario Canada were selected from a target population of 246 senior healthcare executives to engage in 1 h interviews each. Critical case sampling was applied in the selection of the study sample. Interviews were conducted between December 2017 and February 2018. Findings: Senior healthcare executives expressed four distinct perspectives of a health system: systems, institutional, clinical and governance. When combined, the four perspectives form an original research-based concept or model for an integrated health system. Originality/value: This paper conveys results of personal interviews with senior healthcare executives and presents a proposed model for an integrated health system based on their four distinct perspectives of a health system. [ABSTRACT FROM AUTHOR]

Purpose: Community-based forensic support services (CBFSSs) were commissioned nationally by National Health Service (NHS) England in 2017 in response to "Building the Right Support" (NHS England, 2015). CBFSSs provide multidisciplinary support to adults with intellectual disabilities and/or autism who are in (or at risk of) contact with the criminal justice system and those transitioning from inpatient secure care. This paper aims to highlight potential systemic barriers to accessing community forensic services for people from an ethnic minority background. in one CBFSSs in Northern England. Design/methodology/approach: This paper provides preliminary reflections on potential systemic barriers within the criminal justice system and health-care services that have implications for service users from ethnic minority backgrounds accessing CBFSSs. Findings: There is a paucity of data, policy and literature that focuses on people with intellectual disabilities and autism with forensic needs from ethnic minority backgrounds. This lack of data obstructs further reforms to meet the needs of this population. Originality/value: CBFSSs are commissioned across England. While some regional variation is to be expected, services should be aware of the systemic barriers people from ethnic minority backgrounds within their region face. These barriers should be considered and addressed when evaluating service efficacy and delivery. Recommendations are made to review and address issues of under-representation of ethnic minorities within CBFSSs. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore the experiences of black Sub-Saharan African (BSSA) migrants from war-torn zones in accessing health services in the West Midlands region of the UK. This may help to inform on factors influencing the uptake of health services for new migrant communities. Design/methodology/approach: This study explored the experiences of BSSA migrants from war-torn zones in accessing health services in the West Midlands using an explorative qualitative approach. Ten focus groups made up of seven participants each were followed up with three in-depth one-to-one interviews from each focus group using a conversational approach where research participants were encouraged to direct and shape the discussion in accordance with their own experiences, views and particular concerns (Kvale, 1996) as opposed to responding to a pre-determined agenda. Findings: Following transcription, coding and analysis of the focus group discussions and follow-up interviews, this study found that perceptions and attitudes of BSSA communities in accessing health services included difficulties in navigating the health system, intrusive and embarrassing questions from clinicians, stigmatisation through offering an HIV test, culturally unfriendly counselling support, unconfidently services and episodes of trauma flashbacks. Originality/value: The experiences of BSSA migrants who sought health services in the West Midlands in the UK demonstrated important implications for future practice and informed service delivery. There is a need to consider cultural education for both BSSA migrants and health professionals to enhance understanding and trust between the groups. Basic professional training for health professionals should also encompass the needs of the growing ethnic populations in the UK. [ABSTRACT FROM AUTHOR]

Purpose: The new Italian National Recovery and Resilience Plan (NRRP) has prioritised a new healthcare model that will establish the additional community healthcare facilities (CHFs). The paper proposes a methodology for supporting decision-making on location of the future facilities according to new parameters that consider how proximity to healthcare benefits communities. Rethinking the spatial parameters for locating future CHFs, focusing on fragile areas, creates a novel decision support system. Design/methodology/approach: The methodology is based on multifactor analysis and on geographic information system (GIS) mapping to simulate the potential and risks associated with the proposed location of CHFs, focusing on territorial contexts of metropolitan cities, medium-sized cities, and Inner Areas, characterized by different fragilities. This method aims to innovate urban planning practices by updating the practice of per-capita urban planning standards and promoting implementation of the 15-minute city model. Findings: The method defines new spatial parameters useful to inform the appropriate location of CHFs in Italy's Inner Areas. This offers a new integrated approach to spatial design mixing urban planning and healthcare dimensions. Originality/value: The methodology will bring about an integrated urban planning approach, which guides both transformative urban choices and health services' implementation according to the needs of communities. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the experiences of living through the COVID-19 pandemic for people who faced homelessness and dealt with mental health and/or substance use challenges. Design/methodology/approach: This qualitative study was comprised of 26 1:1 interviews (16 men and 10 women), conducted between February and May 2021 with people who experienced homelessness in North East England during the COVID-19 pandemic. An inductive reflexive thematic analysis was undertaken, with input from individuals with lived experience who were involved throughout the study. Findings: Four themes were developed. The first theme, lack of support and exacerbation of mental health and substance use difficulties, highlighted how the lack of in-person support and increased isolation and loneliness led to relapses or new challenges for many people's mental health and substance use. The second theme, uncertainty and fear during the pandemic, explored how the "surreal" experience of the pandemic led to many people feeling uncertain about the future and when things would return to normal. The third theme, isolation and impacts on social networks, discussed how isolation and changes to relationships also played a role in mental health and substance use. Finally, opportunity for reflection and self-improvement for mental health and substance use, explored how some people used the isolated time to re-evaluate their recovery journey and focus on self-improvement. Practical implications: The experiences shared within this study have important implications for planning the future delivery and commissioning of health and social care services for people facing homelessness, such as sharing information accessibly through clear, consistent and simple language. Originality/value: As one of the few papers to involve people with lived experience as part of the research, the findings reflect the unique narratives of this population with a focus on improving services. [ABSTRACT FROM AUTHOR]

Purpose: Refugees' access to psychotherapeutic care is insufficient in Germany. One factor particularly contributing to hindering their access to adequate therapeutic care is a lack of provision of language mediation. This paper aims to explore the institutional system in which the financing of language mediation in the context of the medical treatment of asylum seekers in Germany is located. It examines why the language barrier problem resulting from a lack of financing is not being solved, even though it has been well known for years as a structural problem of day-patient health care to refugees and migrants in Germany. Design/methodology/approach: The financing of language mediation is analysed against the background of theories of the so-called "shunting yard", in which public responsibilities for the assumption of costs are shifted from one level and actor to the other, thus preventing sustainable solutions being achieved. A mix of qualitative methods including the evaluation of official documents, reports and secondary literature, and of 23 expert interviews was used. Findings: The financing of language mediation is a perfect example of the "shunting yard" phenomenon, with responsibilities being shifted between federal government, health insurance bodies and the municipalities in Germany. This paper argues that the specific financing structure in the German federal system can be viewed as a reason for the non-solution of the language barrier that hinders refugees' access to health care. Originality/value: The problem of the financing of language mediation in the context of health care has been rarely treated from a social sciences perspective. This paper contributes to addressing this gap. [ABSTRACT FROM AUTHOR]