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- Costa, D, et al.
(författare)
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Factors associated with quality of services for marginalized groups with mental health problems in 14 European countries
- 2014
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; , s. Art. no. 49-
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Tidskriftsartikel (refereegranskat)abstract
- Background:Different service characteristics are known to influence mental health care delivery. Much less isknown about the impact of contextual factors, such as the socioeconomic circumstances, on the provision of careto socially marginalized groups.The objectives of this work were to assess the organisational characteristics of services providing mental health carefor marginalized groups in 14 European capital cities and to explore the associations between organisationalquality, service features and country-level characteristics.Methods:617 services were assessed in two highly deprived areas in 14 European capital cities. A Quality Index ofService Organisation (QISO) was developed and applied across all sites. Service characteristics and country levelsocioeconomic indicators were tested and related with the Index using linear regressions and random interceptlinear models.Results:The mean (standard deviation) of the QISO score (minimum = 0; maximum = 15) varied from 8.63 (2.23) inIreland to 12.40 (2.07) in Hungary. The number of different programmes provided was the only service characteristicsignificantly correlated with the QISO (p < 0.05). The national Gross Domestic Product (GDP) was inverselyassociated with the QISO. Nearly 15% of the variance of the QISO was attributed to country-level variables, withGDP explaining 12% of this variance.Conclusions:Socioeconomic contextual factors, in particular the national GDP are likely to influence theorganisational quality of services providing mental health care for marginalized groups. Such factors should beconsidered in international comparative studies. Their significance for different types of services should be exploredin further research.Keywords:Mental health services, Quality index of service organization, Socially marginalized groups,Multi-level analysis
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- Strassmayr, C, et al.
(författare)
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Mental health care for irregular migrants in Europe : Barriers and how they are overcome
- 2012
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 12:367, s. Art. no. 367-
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIrregular migrants (IMs) are exposed to a wide range of risk factors for developing mental health problems. However, little is known about whether and how they receive mental health care across European countries. The aims of this study were (1) to identify barriers to mental health care for IMs, and (2) to explore ways by which these barriers are overcome in practice.MethodsData from semi-structured interviews with 25 experts in the field of mental health care for IMs in the capital cities of 14 European countries were analysed using thematic analysis.ResultsExperts reported a range of barriers to mental health care for IMs. These include the absence of legal entitlements to health care in some countries or a lack of awareness of such entitlements, administrative obstacles, a shortage of culturally sensitive care, the complexity of the social needs of IMs, and their fear of being reported and deported. These barriers can be partly overcome by networks of committed professionals and supportive services. NGOs have become important initial points of contact for IMs, providing mental health care themselves or referring IMs to other suitable services. However, these services are often confronted with the ethical dilemma of either acting according to the legislation and institutional rules or providing care for humanitarian reasons, which involves the risk of acting illegally and providing care without authorisation.ConclusionsEven in countries where access to health care is legally possible for IMs, various other barriers remain. Some of these are common to all migrants, whilst others are specific for IMs. Attempts at improving mental health care for IMs should consider barriers beyond legal entitlement, including communicating information about entitlement to mental health care professionals and patients, providing culturally sensitive care and ensuring sufficient resources.
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- Elimian, K, et al.
(författare)
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COVID-19 mortality rate and its associated factors during the first and second waves in Nigeria
- 2022
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Ingår i: PLOS global public health. - : Public Library of Science (PLoS). - 2767-3375. ; 2:6, s. e0000169-
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Tidskriftsartikel (refereegranskat)abstract
- COVID-19 mortality rate has not been formally assessed in Nigeria. Thus, we aimed to address this gap and identify associated mortality risk factors during the first and second waves in Nigeria. This was a retrospective analysis of national surveillance data from all 37 States in Nigeria between February 27, 2020, and April 3, 2021. The outcome variable was mortality amongst persons who tested positive for SARS-CoV-2 by Reverse-Transcriptase Polymerase Chain Reaction. Incidence rates of COVID-19 mortality was calculated by dividing the number of deaths by total person-time (in days) contributed by the entire study population and presented per 100,000 person-days with 95% Confidence Intervals (95% CI). Adjusted negative binomial regression was used to identify factors associated with COVID-19 mortality. Findings are presented as adjusted Incidence Rate Ratios (aIRR) with 95% CI. The first wave included 65,790 COVID-19 patients, of whom 994 (1∙51%) died; the second wave included 91,089 patients, of whom 513 (0∙56%) died. The incidence rate of COVID-19 mortality was higher in the first wave [54∙25 (95% CI: 50∙98–57∙73)] than in the second wave [19∙19 (17∙60–20∙93)]. Factors independently associated with increased risk of COVID-19 mortality in both waves were: age ≥45 years, male gender [first wave aIRR 1∙65 (1∙35–2∙02) and second wave 1∙52 (1∙11–2∙06)], being symptomatic [aIRR 3∙17 (2∙59–3∙89) and 3∙04 (2∙20–4∙21)], and being hospitalised [aIRR 4∙19 (3∙26–5∙39) and 7∙84 (4∙90–12∙54)]. Relative to South-West, residency in the South-South and North-West was associated with an increased risk of COVID-19 mortality in both waves. In conclusion, the rate of COVID-19 mortality in Nigeria was higher in the first wave than in the second wave, suggesting an improvement in public health response and clinical care in the second wave. However, this needs to be interpreted with caution given the inherent limitations of the country’s surveillance system during the study.
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