Social science & medicine
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Social science & medicine · Jan 2011
Food security and humanitarian assistance among displaced Iraqi populations in Jordan and Syria.
The Iraq conflict resulted in the largest displacement in the Middle East in recent history, and provision of health services to the displaced population presents a critical challenge. With an increase in the number of people affected by complex emergencies and the number of people displaced in urban settings, the international community must adapt intervention strategies to meet the specific demands and contexts of this population. The study aimed to provide information on food security and livelihoods for Iraqi refugees in Syria and Jordan to inform humanitarian assistance planning. ⋯ In Syria, female headed households, Damascus residents, families with children, and those registered with UNHCR were more likely to receive cash assistance. Food insecurity remains a concern among displaced Iraqi households in both Jordan and Syria. Improved targeting of both food and cash assistance and the expansion of cash-based programs could lead to a more effective use of funds and facilitate the implementation of assistance programs that are sustainable in the context of declining funding availability.
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Social science & medicine · Jan 2011
Measuring and decomposing socioeconomic inequality in healthcare delivery: A microsimulation approach with application to the Palestinian conflict-affected fragile setting.
Socioeconomic-related inequalities in healthcare delivery have been extensively studied in developed countries, using standard linear models of decomposition. This paper seeks to assess equity in healthcare delivery in the particular context of the occupied Palestinian territory: the West Bank and the Gaza Strip, using a new method of decomposition based on microsimulations. Besides avoiding the 'unavoidable price' of linearity restriction that is imposed by the standard methods of decomposition, the microsimulation-based decomposition enables to circumvent the potentially contentious role of heterogeneity in behaviours and to better disentangle the various sources driving inequality in healthcare utilisation. ⋯ The microsimulation method has made it possible to identify the contributions of factors driving such pro-rich patterns. While much of the inequality in utilisation appears to be caused by the prevailing socioeconomic inequalities, detailed analysis attributes a non-trivial part (circa 30% of inequalities) to heterogeneity in healthcare-seeking behaviours across socioeconomic groups of the population. Several policy recommendations for improving equity in healthcare delivery in the occupied Palestinian territory are proposed.
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Social science & medicine · Jan 2011
The role of leader behaviors in hospital-based emergency departments' unit performance and employee work satisfaction.
The role of the leader of a medical unit has evolved over time to expand from simply a medical role to a more managerial one. This study aimed to explore how the behavior of a hospital-based emergency department's (ED's) leader might be related to ED unit performance and ED employees' work satisfaction. One hundred and twelve hospital-based EDs in Taiwan were studied: 10 in medical centers, 32 in regional hospitals, and 70 in district hospitals. ⋯ Both task- and employee-oriented leader behaviors were found to be positively related to ED nurses' work satisfaction. However, leader behaviors were not shown to be related to ED physicians' work satisfaction at a statistically significant level. Some ED organizational characteristics, however, namely departmentalization and hospital accreditation level, were found to be related to ED physicians' work satisfaction.
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Social science & medicine · Jan 2011
Utilization of HIV-related services from the private health sector: A multi-country analysis.
Increasing the participation of the private health sector in the AIDS response could help to achieve universal access to comprehensive HIV prevention, treatment, care and support. Yet little is known about the extent to which the private health sector is delivering HIV-related services. This study uses data from the Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS) from 12 countries in Africa, Asia and Latin America and the Caribbean to explore use of HIV testing and STI care from the private for-profit sector, and its association with household wealth status. ⋯ From 3 to 45 percent of women and 6 to 42 percent of men reported the private for-profit sector as their source of the most recent HIV testing. While in some countries, use of the private for-profit health sector for HIV testing and STI care increases with wealth, in others the relationship is not clear, as there are no significant differences in using private for-profit HIV-related services between the rich and the poor. We conclude that as the global AIDS response evolves from emergency relief to sustained country programs, broader consideration of the role of the private for-profit health sector may be warranted.