Factors affecting health-care seeking behaviour
The Needs of Children from Abroad
Children arriving from abroad are usually members of ethnic minority communities. These communities, even when well established do not have equality of access to health services in this country. Access difficulties are compounded when families newly arriving have no knowledge or understanding of how health and welfare systems operate or what their entlitlements to services are. Given this, providers cannot wait for families to present with problems, but need to have systems designed to seek out those children who are in need. Without a system in place to identify newly arrived children, children in need of catch-up immunisation and surveillance will be missed, with consequences for the public health, their own health, welfare and education.
Webb E; Ryan A.D and O'Hare B.A.M (2005). The Needs of Children newly arrived from abroad. Current Paediatrics. 15. 339-346.
There is relative under-use of services for visual impairment among migrant and minority groups, especially amongst Asians and Afro-Caribbeans. There needs to be, therefore, better targetted information on conditions and the availability of relevant services. The low uptake of services by minorities may be associated with the current material having low cultural relevance or sensitivity. Low levels of literacy in ethnic minority languages reveal the importance of non-paper dissemination of information-there is some increased development in the use of talking books, newspapers and magazines in Asian languages such as Gujerati, Punjabi and Hindi.
Scase M.O and Johnson M.R.D (2005). Visual Impairment in Ethnic Minorities in the UK. International Congress Series. 1282. 438-442
Creating Consumer Satisfaction in Maternity Care amongst Migrants, Asylum-Seekers and Refugees
The UK government has enacted policies to reduce inequalities in its healthcare system by providing services which are sensitive to the needs of minority groups. The concept of patient-centred care has evolved. The approach involves a non-hierarchical type of communication between doctors and patients that explores the feelings, beliefs and expectations of the latter, with management of care being shaped by the resulting cognitions. Women in these particular groups are under-represented as consumers of health care because they lack knowledge of available services and of how to access them. A study which examined health visitors' provision of services to refugee families found that the providers had difficulties in meeting the emotional needs of women in unsettled circumstances, felt challenged by communication difficulties because of refugees' lack of English language skills and worked according to a hierarchy of needs, in which items such as shelter, warmth and food were placed before other needs e.g. relief from depression. Only a limited number of studies have concentrated on the health needs of women from free and forced migration groups or on maternity care provisions for them. It is likely that with improved communication between woman and provider, birth complications may be better anticipated or even prevented.
Jentsch B; Durham R; Hundley V and Hussein J (2007). Creating Consumer Satisfaction in Maternity Care: the Neglected Needs of Migrants, Asylum Seekers and Refugees. International Journal of Consumer Studies. 31. 128-134.
Improving Access and Quality for Ethnic Minority Women
A range of changes to service delivery have been made, but these have been patchy and dependent on individual health authorities and individuals. In addition, the acceptance of the existence of racism and racial discrimination has been slow and legislation often weak in this area. To understand issues of access to health care and quality of services for black and minority ethnic groups we need to understand the context: their environment, lifestyle and delivery of health services. People from minority ethnic groups are concentrated in the urban areas; over two thirds lived in London and the three metropolitan areas; in the West Midlands, Greater Manchester and West Yorkshire. Access and quality of ethnic minority women's health should be put into the context of the social and health disparities experienced by black and minority ethnic communities in Britain. The key issues are embedded in how the Department of Health, Health Services and Trusts have viewed black and minority ethnic health generally for a long time. The key obstacles to improving access to health care lie in lack of priority and recognition given to accessing health care for black and minority ethnic groups. This can lead to people not having proper treatment in the NHS and often can act as a barrier to people seeking help. Sometimes the whole encounter with the Health Service for people whose first language is not English is so full of anxiety that they tend not to discuss all of their health problems.
Bahl V (2001). Improving Access and Quality for Ethnic Minority Women. Women's Health Issues. 11.4.348-354