Service Utilization

Background Post-sexual violence service utilization is often poor in humanitarian settings. Little is known about the service uptake barriers facing male survivors specifically. Methods To gain insights into this knowledge gap, we undertook a qualitative exploratory study to better understand the barriers to service utilization among male survivors in three refugee-hosting countries. The study sites and populations included refugees who had travelled the central Mediterranean migration route through Libya living in Rome and Sicily, Italy; Rohingya refugees in Cox’s Bazar, Bangladesh; and refugees from eastern Democratic Republic of the Congo, Somalia, and South Sudan residing in urban areas of Kenya. Methods included document review, 55 semi-structured focus group discussions with 310 refugees, semi-structured key informant interviews with 148 aid workers and human rights experts, and observation of service delivery points. Data were thematically analyzed using NVivo 12. Results We ...

This study employs survey data from the Center for Community College Student Engagement to examine the similarities and differences that exist across student-level domains in terms of student engagement in community colleges. In total, the sample used in the analysis pools data from 663 community colleges and includes more than 320,000 students. Using data-mining techniques to discover a parsimonious number of natural clusters and, in turn, a k-means cluster analysis as a means of revealing a naturally occurring typology of engagement patterns, our findings reveal that support service utilization is the most distinguishing feature of the similarities and dissimilarities across student groups, suggesting areas for further theory development and testing.

The analysis uses data from the most recent Demographic and Health Surveys conducted in 31 countries for which data on all the 3Es are available. Separate logistic regression models are fitted for modern contraceptive use, antenatal care and skilled birth attendance in ...

To measure the 12-month utilization rates for mental health reasons in all types of services. A representative sample extracted from the National Population Register of non-institutionalized residents aged 21 or older were interviewed at their homes between May 2003 and April 2004. DSM-IV disorders were assessed using a revised version of the Composite International Diagnostic Interview (WMH-CIDI). About 10% of the adult population receives some type of treatment for emotional or mental health problems within a single year. More than half of service consumers were not classified as suffering from mood or anxiety disorders. Of those diagnosed with mood or anxiety disorders in the past 12 months only about 50% used any type of service for mental health problems. There is only a partial overlap between those who utilize the services and those who meet the criteria for a clinical diagnosis of mental disorder.

This article attempts to summarise the situation of sexual and reproductive health among young people in Nepal. Modernisation and social transformation are occurring rapidly in Nepalese society. Growing expansion of communication and transportation networks, urbanisation and in-migration of population to urban areas is creating a different socio-cultural environment, which is conducive to more social interactions between young girls and boys in Nepal. Rising age at marriage has now opened a window of opportunity for pre-marital and unsafe sexual activity among young people in Nepal which creates risks of unwanted pregnancy, STIs/HIV and AIDS. Several socio-economic, demographic and cultural factors have been identified as encouraging factors for risk taking behaviours among young people. Improving access to youth friendly services, implementing peer education programmes for school and out of school going adolescents, developing effective Information, Communication and Education (IEC...

As a means of establishing the characteristics of Medicaid beneficiaries with Alzheimer's disease during a time prior to the implementation of the new waiver program, two sets of investigations were conducted. The first looked at some general questions ...

A probability sample of 301 homeless adults from Buffalo, NY, was followed over 6 months to document the utilization of a variety of community services, examine services desired, and identify factors associated with service utilization, preference, and satisfaction. The following needs were all rated as at least equally important as the need for affordable housing: safety, education, transportation, medical/dental treatment, and job training/placement (most of these needs were also rated as difficult to obtain). Needs for formal mental health and substance abuse services were rated as relatively unimportant and easy to obtain, and for those who actually used them, respondents were often dissatisfied with them. Of 16 predictor variables examined in multivariate analyses, several showed consistent relationships with subsequent service use, preference, and satisfaction. Younger adults, persons of color, those with dependent children, and persons having fewer social supports reported le...

The use of outpatient psychiatric services has been shown to be a complex function of sociodemographic, clinical, and pathway variables. The relative contribution of each variable or groups of variables in explaining the variability in the use of outpatient psychiatric services, however, remains poorly documented. The subjects (N=382) were all patients admitted to an outpatient psychiatric clinic serving mostly a minority and low-income population. The charts of the patients were reviewed for sociodemographic, clinical, and pathway variables and the number of outpatient visits. The pathway variables studied were source of referral and most recent psychiatric treatment service used. Both bivariate and multivariate statistics were used to analyze the data. Pathway variables were better predictors of the number of outpatient visits than clinical variables after controlling for sociodemographic variables. Patients recently hospitalized may be sicker or have fewer social supports and therefore require more outpatient visits. Recent treatment history stands out as an important variable in the prediction of the number of outpatient mental health visits. More research is needed to examine the influence of pathway variables on treatment decisions.

To determine the impact of user fees on the utilization of health services in a community-based cost-sharing scheme in Kabarole District, western Uganda. Of the 38 government health units that had introduced user-fee financing schemes, 11 were included in the study. Outpatient utilization was assessed as the median number of visits per month before and after cost sharing began. After the introduction of cost sharing, overall utilization of general outpatient services, assessed by combining the data from all the participating units, dropped by 21.3%. Utilization increased, however, in facilities located in remote areas, while it decreased in those located in urban or semi-urban areas. The increased utilization in remote facilities was considered to be largely attributable to health workers' incentive payments derived from cost-sharing revenues. Incentive payments led the health workers to offer improved services. Other factors may also have been influential, such as an improved d...