Conflict, health care and professional perseverance: A qualitative study in the West Bank
School of Social Work, University of Washington, Seattle, WA, USA. Global Public Health
(Impact Factor: 0.92).
05/2011; 6(5):1-14. DOI: 10.1080/17441692.2011.574146
The past three decades have been a time of considerable global conflict, affecting over 50 countries and causing substantial impacts on civilian health. While many effects are direct results of violence, conflict also impinges on health through indirect means. The restricted mobility of health care staff and patients, targeting of health care workers, and stressful working conditions disrupt the ability of health care workers in conflict zones to function effectively. This paper explores the challenges experienced by health care workers in West Bank, Palestine, as well as their strategies of persistence. Research activities included participant observation and interviews with health care providers, which were then analysed for common themes. Results demonstrated that the Israeli military occupation of the West Bank considerably impacts civilians' access to both urgent and preventive care. While attempting to deliver care, providers encountered disruptions, harassment and violence, which interrupted care and contributed to job stress. Professional perseverance was evident, but its influence was limited by enduring constraints. This study thus underscores the importance of accountability to international law regarding the rights of civilians to health care in conflict zones. Health professionals may play a particular role in advocating for just and dignified resolutions to conflicts.
Available from: Guido Veronese
- "Finally, development may be defined as the scope for helpers to increase their skills, know-how, and socioeconomic status through training, supervision, and career opportunities (Ambrosino et al., 2008). Furthermore, in the case of helpers working and living in chronic and ongoing conflict contexts and constantly encountering disruption, harassment, and violence, with consequent interruptions to care and increased job stress, it is fundamental to take into account the full complexity of the dimensions affecting their well-being, which include not only safety and quality of working conditions but also QOL as a whole (Sousa and Hagopian, 2011). Williamson and Robinson (2006), apart from identifying safety, participation, and development as the main sources of well-being in waraffected populations, proposed that well-being is experienced in seven main domains, which they regard as being reasonably universal: biological , psychological (or mental), economic (or material), emotional, social (including political ), cultural, and spiritual. "
Available from: Massy Mutumba
- "The need for human resources in the health sectors of Africa (private or public), has appropriately garnered attention from international policy experts, as well as Ministries of Health throughout the region [1-4]. However, Ministries and donors alike remain uncertain about which, if any, targeted investments have the potential to measurably improve the number, retention and distribution of health personnel [5-8]. "
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ABSTRACT: The ability of many countries to achieve national health goals such as the Millennium Development Goals remains hindered by inadequate and poorly distributed health personnel, including doctors. The distribution of doctors in Ghana is highly skewed, with a majority serving in two major metropolitan areas (Accra and Kumasi), and inadequate numbers in remote and rural districts. Recent policies increasing health worker salaries have reduced migration of doctors out of Ghana, but made little difference to distribution within the country. This qualitative study was undertaken to understand how practicing doctors and medical leaders in Ghana describe the key factors reducing recruitment and retention of health professionals into remote areas, and to document their proposed policy solutions.
In-depth interviews were carried out with 84 doctors and medical leaders, including 17 regional medical directors and deputy directors from across Ghana, and 67 doctors currently practicing in 3 regions (Greater Accra, Brong Ahafo, and Upper West); these 3 regions were chosen to represent progressively more remote distances from the capital of Accra.
All participants felt that rural postings must have special career or monetary incentives given the loss of locum (i.e. moonlighting income), the higher workload, and professional isolation of remote assignments. Career 'death' and prolonged rural appointments were a common fear, and proposed policy solutions focused considerably on career incentives, such as guaranteed promotion or a study opportunity after some fixed term of service in a remote or hardship area. There was considerable stress placed on the need for rural doctors to have periodic contact with mentors through rural rotation of specialists, or remote learning centers, and reliable terms of appointment with fixed end-points. Also raised, but given less emphasis, were concerns about the adequacy of clinical equipment in remote facilities, and remote accommodations.
In-depth discussions with doctors suggest that while salary is important, it is career development priorities that are keeping doctors in urban centers. Short-term service in rural areas would be more appealing if it were linked to special mentoring and/or training, and led to career advancement.
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ABSTRACT: We carried out qualitative research with 61 health professionals and volunteer workers to explore their perceptions of their own and their clients' well-being in a context of political violence. We applied content analysis to identify the themes emerging from 8 focus group and 11 individual interviews. Participants were found to define the concept of well-being in terms of three key areas: security, participation, and development. Palestinian health providers see promotion of economic development and professional growth, involvement in political and social life, and resistance to the occupation as factors required to enhance well-being and quality of life for themselves and their clients.
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