An Assessment of Health Care Needs and Barriers in a Rural Community of Haiti Justin Gerard 1 ; Dr....
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An Assessment of Health Care Needs and Barriers in a Rural Community of Haiti Justin Gerard 1 ; Dr. Jeffrey Van Laere 2 ; Nabil Othman 1 ; Terrie Ahn 1 ; John Dawdy 1 ; Priyanka Singh 1 ; Lea Monday 1 ; Amy Li 1 ; Dr. Diane Levine 3 1 Wayne State University School of Medicine; 2 Detroit Medical Center Department of Emergency Medicine; 3 Detroit Medical Center Department of Internal Medicine INTRODUCTION RESULTS DISCUSSION METHODS MATERIALS FUTURE STUDIES During a medical missions trip to Morne L’Hopital in Haiti, a needs assessment was conducted to obtain information regarding the healthcare needs of the local population. The goal was to determine obstacles to healthcare, as well as perceived healthcare needs. A qualitative survey was administered individually to clinic patients to determine the most prevalent healthcare needs, obstacles to obtaining healthcare, most frequent point-of-healthcare access, perceived best and worst aspects of Haitian healthcare, and finally needs for improvement. A need for more accessible healthcare clearly exists in this community. It is the hope of the WHSO that a more permanent and sustainable clinic be established to meet the needs of the Morne L’Hopital population. In order to accomplish this, a more thorough assessment regarding the strategic, legal, and financial barriers that exist must be conducted. The survey was conducted by a two person team, consisting of a medical student and a translator. Participants were selected at random from a group of patients whom were waiting to be triaged. All medical students involved in the study were required to complete CITI training. The survey was adjusted in response to difficulties that arose while conducting the survey. Question 1.a. was excluded from the survey. Participants had a difficult time discerning the meaning of the question, or providing a response. Participants were also providing similar responses to questions one and seven. A greater emphasis was placed on problems with the healthcare system when 213 patients were enrolled in the study. 56.8% stated that cost was the largest obstacle to obtaining healthcare. 41.7% expressed problems regarding healthcare access (not enough doctors and/or lack of transportation). A large majority accessed healthcare via large general hospitals; the exact reasons for this are unclear, although we hypothesize that this is because there are limited other options. These findings support the importance of maintaining a clinic in the area to circumvent the obstacles stated above. Our free clinic provides an opportunity for patients to access healthcare for primary care conditions that would likely go untreated otherwise. While our clinic is temporarily able to address many of the concerns brought up by this assessment, more must be done to provide sustainable and self-sufficient solutions. World Health Student Organization Needs Assessment Site/Clinic: Respondent’s Age: Respondent’s Gender: Relationship to patient: self____ parent_____ grandparent_____ spouse_____ other relative______ non-relative_______ 1. What are the 3 most pressing healthcare concerns you have about adults in your home? About children? a. What are different healthcare concerns you have at different times of the year, e.g., the rainy season? 2. Who in your household makes decisions about healthcare (e.g., where to go, when to go)? 3. Where do you normally go for healthcare for adults? For children? 4. What are the biggest obstacles to getting your healthcare needs met? 5. What is required to help you improve the health of adults in your household? Children in your household? 6. What are the best aspects of healthcare available in your community? 7. What are the problems with the healthcare available in your community? 8. How could we (US medical students) improve the healthcare we provide when we are Sym ptom s Total % ofResponses Pain 107 19.28 Headache 74 13.33 Abdom inal Pain 49 8.83 Fever 49 8.83 HTN 42 7.57 Vision/Eye Irritation 31 5.59 Infection 31 5.59 Vaginal Infection 23 4.14 Cold 22 3.96 Anem ia 16 2.88 Diarrhea/GI Com plaints 15 2.7 Rash 14 2.52 Dental Problem s 11 1.98 Cough 10 1.8 GERD 9 1.62 Palpitations/HeartProblem s 9 1.62 Asthm a 7 1.26 Dizziness 7 1.26 W eakness 5 0.9 ShortnessofBreath 5 0.9 Diabetes 4 0.72 Thyphoid 3 0.54 M alaria 3 0.54 Dyspnea 2 0.36 Gas 2 0.36 Hem orrhoid 2 0.36 Cholera 2 0.36 Cyst 1 0.18 TO TALResponse 555 99.98 N eeds/Im provem ents # ofR esponses % ofR esponses Perm anentClinic 87 30.21 M oreTrips 48 16.67 M oreM edications 38 13.19 Clean W ater 28 9.72 M oreD octors 27 9.38 Electricity 19 6.6 School 11 3.82 Betteraccess to healthcare 7 2.43 M oreClinics 6 2.08 Betterroads 5 1.74 Eye Specialist 3 1.04 M ore follow up 3 1.04 Soccerballs/toys forkids 3 1.04 M ore notification 2 0.69 Morecollaboration 1 0.35 Total 288 100 B estaspects ofH ealthcare # ofR esponses % ofR esponses Nothing 35 50 This clinic 18 25.71 Doctors(w hen available) 5 7.14 Seen during em ergency 3 4.29 Local Clinic/H ospital 3 4.29 A ccessto m edications/M edications 3 4.29 N urses 2 2.86 Transportation 1 1.43 Total 70 100.01 Access Point # ofResponses % ofResponses General Hospital 45 64.29 Community Health Center 18 25.71 Private 6 8.57 Pharmacy 1 1.43 Total 70 100 Obstacles Responses % ofResponses Finances 126 56.76 Access 65 29.28 None 10 4.5 Distance 9 4.05 Transportation 6 2.7 NotEnough Doctors 5 2.25 Sanitation 1 0.45 TOTALResponses 222 99.99 W orstAspectsofHealthcare Responses % ofResponses Cost 32 41.56 NotEnough Doctors 10 12.99 Distance 6 7.79 Inadequate Clinics 6 7.79 Accessto M edications 6 7.79 Transportation 5 6.49 No Clinic/Hospital 4 5.19 Accessto Clean W ater 4 5.19 Accessto Surgery 1 1.3 Hunger 1 1.3 CholeraTx 1 1.3 Leadership 1 1.3 TOTALResponses 77 99.99
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Transcript of An Assessment of Health Care Needs and Barriers in a Rural Community of Haiti Justin Gerard 1 ; Dr....
An Assessment of Health Care Needs and Barriers in a Rural Community of Haiti
Justin Gerard1; Dr. Jeffrey Van Laere2; Nabil Othman1; Terrie Ahn1; John Dawdy1; Priyanka Singh1; Lea Monday1; Amy Li1; Dr. Diane Levine3
1Wayne State University School of Medicine; 2Detroit Medical Center Department of Emergency Medicine; 3Detroit Medical Center Department of Internal Medicine
INTRODUCTION RESULTS DISCUSSION
METHODS
MATERIALS FUTURE STUDIES
During a medical missions trip to Morne L’Hopital in Haiti, a needs assessment was conducted to obtain information regarding the healthcare needs of the local population.
The goal was to determine obstacles to healthcare, as well as perceived healthcare needs.
A qualitative survey was administered individually to clinic patients to determine the most prevalent healthcare needs, obstacles to obtaining healthcare, most frequent point-of-healthcare access, perceived best and worst aspects of Haitian healthcare, and finally needs for improvement.
A need for more accessible healthcare clearly exists in this community. It is the hope of the WHSO that a more permanent and sustainable clinic be established to meet the needs of the Morne L’Hopital population.
In order to accomplish this, a more thorough assessment regarding the strategic, legal, and financial barriers that exist must be conducted.
The survey was conducted by a two person team, consisting of a medical student and a translator. Participants were selected at random from a group of patients whom were waiting to be triaged.
All medical students involved in the study were required to complete CITI training.
The survey was adjusted in response to difficulties that arose while conducting the survey. Question 1.a. was excluded from the survey. Participants had a difficult time discerning the meaning of the question, or providing a response. Participants were also providing similar responses to questions one and seven. A greater emphasis was placed on problems with the healthcare system when question seven was asked.
213 patients were enrolled in the study.
56.8% stated that cost was the largest obstacle to obtaining healthcare.
41.7% expressed problems regarding healthcare access (not enough doctors and/or lack of transportation). A large majority accessed healthcare via large general hospitals; the exact reasons for this are unclear, although we hypothesize that this is because there are limited other options.
These findings support the importance of maintaining a clinic in the area to circumvent the obstacles stated above.
Our free clinic provides an opportunity for patients to access healthcare for primary care conditions that would likely go untreated otherwise. While our clinic is temporarily able to address many of the concerns brought up by this assessment, more must be done to provide sustainable and self-sufficient solutions.
World Health Student Organization
Needs Assessment Site/Clinic: Respondent’s Age: Respondent’s Gender: Relationship to patient: self____ parent_____ grandparent_____ spouse_____ other relative______ non-relative_______
1. What are the 3 most pressing healthcare concerns you have about adults in your home? About children? a. What are different healthcare concerns you have at different times of the year, e.g., the rainy season? 2. Who in your household makes decisions about healthcare (e.g., where to go, when to go)? 3. Where do you normally go for healthcare for adults? For children? 4. What are the biggest obstacles to getting your healthcare needs met? 5. What is required to help you improve the health of adults in your household? Children in your household? 6. What are the best aspects of healthcare available in your community? 7. What are the problems with the healthcare available in your community? 8. How could we (US medical students) improve the healthcare we provide when we are in country?
Symptoms Total % of ResponsesPain 107 19.28Headache 74 13.33Abdominal Pain 49 8.83Fever 49 8.83HTN 42 7.57Vision/Eye Irritation 31 5.59Infection 31 5.59Vaginal Infection 23 4.14Cold 22 3.96Anemia 16 2.88Diarrhea/GI Complaints 15 2.7Rash 14 2.52Dental Problems 11 1.98Cough 10 1.8GERD 9 1.62Palpitations/Heart Problems 9 1.62Asthma 7 1.26Dizziness 7 1.26Weakness 5 0.9Shortness of Breath 5 0.9Diabetes 4 0.72Thyphoid 3 0.54Malaria 3 0.54Dyspnea 2 0.36Gas 2 0.36Hemorrhoid 2 0.36Cholera 2 0.36Cyst 1 0.18TOTAL Response 555 99.98
Needs/Improvements # of Responses % of Responses
Permanent Clinic 87 30.21
More Trips 48 16.67
More Medications 38 13.19
Clean Water 28 9.72
More Doctors 27 9.38
Electricity 19 6.6
School 11 3.82
Better access to healthcare 7 2.43
More Clinics 6 2.08Better roads 5 1.74
Eye Specialist 3 1.04
More follow up 3 1.04
Soccer balls/toys for kids 3 1.04
More notification 2 0.69
More collaboration 1 0.35
Total 288 100
Best aspects of Healthcare # of Responses % of Responses
Nothing 35 50
This clinic 18 25.71
Doctors (when available) 5 7.14
Seen during emergency 3 4.29
Local Clinic/Hospital 3 4.29
Access to medications/Medications 3 4.29
Nurses 2 2.86
Transportation 1 1.43
Total 70 100.01
Access Point # of Responses % of Responses
General Hospital 45 64.29
Community Health Center 18 25.71
Private 6 8.57
Pharmacy 1 1.43
Total 70 100
Obstacles Responses % of ResponsesFinances 126 56.76Access 65 29.28None 10 4.5Distance 9 4.05Transportation 6 2.7Not Enough Doctors 5 2.25Sanitation 1 0.45TOTAL Responses 222 99.99
Worst Aspects of Healthcare Responses % of ResponsesCost 32 41.56Not Enough Doctors 10 12.99Distance 6 7.79Inadequate Clinics 6 7.79Access to Medications 6 7.79Transportation 5 6.49No Clinic/Hospital 4 5.19Access to Clean Water 4 5.19Access to Surgery 1 1.3Hunger 1 1.3Cholera Tx 1 1.3Leadership 1 1.3TOTAL Responses 77 99.99
