NGOs' initiatives and grassroots approach for accessing to health care services for the slum people in Dhaka.

IF 1.6 Q3 HEALTH CARE SCIENCES & SERVICES
Frontiers in health services Pub Date : 2024-09-19 eCollection Date: 2024-01-01 DOI:10.3389/frhs.2024.1386698
Mohammad Ismail Bhuiyan, Md Aminul Haque
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引用次数: 0

Abstract

Objective: This study holds significant importance as it aims to delve into the impactful NGOs' initiatives and grassroots approaches instrumental in providing healthcare services to Dhaka's underserved slum people. It focuses on understanding how these factors influence the use and access to health services, which is a crucial aspect for researchers, policymakers, and healthcare professionals.

Study design: This study was meticulously designed, utilizing a comprehensive cross-sectional mixed-methods design. By incorporating qualitative and quantitative data collection methods, we ensured a thorough understanding of NGOs' initiatives and grassroots approaches to providing healthcare services to slum dwellers in Dhaka, thereby instilling confidence in the validity of our research for the audience.

Methods: A face-to-face interview was used to survey the participants (n = 722) using semi-structured questionnaires, following a systematic sampling technique. Four focus group discussions (FGDs) were also conducted with the slum people. Binary logistic regression was performed to know NGOs' initiatives, roles, and grassroots approach as predictors or independent variables and healthcare services as an outcome or dependent variable. The quantitative data were analyzed using SPSS version 23.0. At the same time, thematic analysis was conducted following Philip Adu's Qualitative data analysis process and Braun and Clarke's six steps of the thematic analysis system, integrating the 11 subthemes with the quantitative findings to highlight the interpretative findings of the qualitative data.

Findings: Major findings revealed that NGOs' initiative roles and grassroots approach had a significant impact on slum dwellers' use and access to healthcare services. The initiatives included affordable health services (OR = 22.86, 95% CI = 3.87, 35.00, P = 0.01), special health services (OR = 5.63, 95% CI = 3.36, 9.42, P = 0.00), engagement of responsible community leaders (OR = 1.72, 95% CI = 1.14, 2.59, P = 0.01), distribution of health and medicine items (OR = 1.92, 95% 2 CI = 1.40, 2.63, P = 0.01), provision of updated information to slum dwellers (OR = 1.37, 95% CI = .99, 1.90, P = 0.05), telehealth and telemedicine (OR = 1.82, 95% CI = 1.55, 2.13, P = 0.01), BCC strategy (OR = 1.26, 95% CI = 1.00, 1.57, P = 0.05), and doorstep services as NGOs' grassroots approach (OR = 1.84, 95% CI = 1.00, 3.38, P = 0.05). Qualitative findings supported the quantitative findings through 2 main themes and 11 sub-themes, which were integrated with quantitative findings to highlight the interpretative findings of qualitative data.

Conclusions: Health services and other facilities for urban slum people through NGOs' initiatives and grassroots approaches are highly affordable and practical, special health services with the involvement of special exceptional health professionals, community supportive services, BCC strategies, and doorstep health services may trigger the use and access to health services for slum dwellers. Results suggest and recommend capitalizing and investing in such initiatives and grassroots approaches from the government, policymakers, and donors with NGOs to find accessible, affordable health services for the unprivileged slum people.

非政府组织为达卡贫民窟居民提供医疗服务的举措和基层方法。
研究目的本研究旨在深入探讨非政府组织在为达卡服务不足的贫民窟居民提供医疗保健服务方面所采取的具有影响力的举措和基层方法,因此具有重要意义。研究重点在于了解这些因素如何影响医疗服务的使用和获取,这对于研究人员、政策制定者和医疗保健专业人员来说是至关重要的:本研究经过精心设计,采用了全面的横断面混合方法设计。通过结合定性和定量数据收集方法,我们确保了对非政府组织为达卡贫民窟居民提供医疗保健服务的举措和基层方法的全面了解,从而为受众树立了对我们研究有效性的信心:采用系统抽样技术,使用半结构化问卷对参与者(n = 722)进行了面对面访谈。此外,还与贫民窟居民进行了四次焦点小组讨论(FGD)。通过二元逻辑回归了解非政府组织的举措、作用和基层方法作为预测变量或自变量,医疗保健服务作为结果变量或因变量。定量数据使用 SPSS 23.0 版进行分析。同时,按照菲利普-阿杜的定性数据分析流程以及布劳恩和克拉克的六步主题分析系统进行了主题分析,将 11 个子主题与定量结果相结合,以突出定性数据的解释性结果:主要研究结果显示,非政府组织的倡议作用和基层方法对贫民窟居民使用和获得医疗保健服务产生了重大影响。这些举措包括负担得起的医疗服务(OR = 22.86,95% CI = 3.87,35.00,P = 0.01)、特殊医疗服务(OR = 5.63,95% CI = 3.36,9.42,P = 0.00)、负责任的社区领袖的参与(OR = 1.72,95% CI = 1.14,2.59,P = 0.01)、医疗和药品的分发(OR = 1.92,95% 2 CI = 1.40,2.63,P = 0.01)、向贫民窟居民提供最新信息(OR = 1.37,95% CI = .99,1.90,P = 0.05)、远程保健和远程医疗(OR = 1.82,95% CI = 1.55,2.13, P = 0.01)、BCC 策略(OR = 1.26, 95% CI = 1.00, 1.57, P = 0.05)和作为非政府组织基层方法的上门服务(OR = 1.84, 95% CI = 1.00, 3.38, P = 0.05)。定性研究结果通过 2 个主主题和 11 个次主题支持定量研究结果,这些主题与定量研究结果相结合,突出了定性数据的解释性结果:结论:通过非政府组织的倡议和基层方法为城市贫民窟居民提供的医疗服务和其他设施是非常实惠和实用的,有特殊医疗专业人员参与的特殊医疗服务、社区支持服务、BCC 战略和上门医疗服务可能会促使贫民窟居民使用和获得医疗服务。研究结果表明并建议政府、政策制定者、捐赠者和非政府组织对此类倡议和基层方法进行资本化和投资,以便为贫民窟的弱势群体提供方便、负担得起的医疗服务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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