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C h a p t e r 1 2 Accessibility to Health Care in Urban Environments Francisca M. Mwangangi The World Health Organization (WHO) defines health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. The WHO has further elaborated that “the health of all the people is fundamental to the attainment of peace and security and is dependent upon the fullest co-operation of individuals and states” and that “the enjoyment of the highest attainable standards of health” is one of the fundamental rights of every human being (WHO 2000). A population’s health and productivity are directly linked. This relationship has been demonstrated in industrialized countries, which are now benefiting from years of investment in health services (Schultz and Tansel 1993). Provision of good health services satisfies a basic human need and contributes significantly toward maintaining and enhancing the productive potential of the people. Improving health services reduces production losses caused by worker illnesses, permits the use of national funds otherwise totally or nearly inaccessible because of disease, and increases children’s enrollment in school and their ability to learn (Mwabu et al. 2004). Therefore, increasing consumption of health-care services in the population should be a priority in all countries. Increasing access is the most effective way to increase the utilization of health-care services. In its simplest sense, access refers to entry into or use of the healthcare system. When health care is accessible, the health of every member of society improves because people are able to obtain care when necessary without facing obstacles. When health care is not accessible, mortality rates will be high and many people will be debilitated by disease . Access is one of the fundamental goals of every health-care system. 228 Francisca M. Mwangangi A major responsibility of every government is to provide effective and accessible health care to all of its citizens. For the majority, the term “access” refers to health-care services that are within reach. The term goes beyond the availability of health-care services to refer to the elimination of personal, organizational, and financial barriers to service utilization. Obrist and colleagues have identified three aspects of accessible health care: availability, acceptability , and affordability (Obrist et al. 2007). Lack of access to health care results when any one of these three aspects of accessibility is missing. “Availability” means that existing health services and goods meet clients ’ needs. Services and goods should be offered by an adequate number of skilled personnel. Supplies should cover demand. Health-care facilities should be within reach geographically. Health-care services should be organized in a manner that meets patients’ needs: For example , hours of operation should be based around clients’ schedules, taking into account, for instance, the daily work schedule of the small-scale business person or farmer. The health-care facilities should be clean and well kept. “Affordability” means that the price of health care fits clients’ income and ability to pay. Both direct and indirect costs of health care should be within a client’s ability to pay; for example, a client should be able to pay for the consultation fee, the cost of drugs, and transportation to the health facility. Last, “acceptability” of health care means that the information, explanations , and treatments provided take into account the clients’ cultural and social values. Patients should feel welcome and cared for and have trust in the competence and personality of their health-care providers. Differences in access to health care can have far-reaching consequences , with those denied access to basic health care living shorter and more constrained lives. Writing in 1990, Amartya Sen estimated that 100 million more women would have been alive, primarily in China, South Asia, and North Africa, if women and girls had equal access to health care and nutrition across the globe (Sen 1990). Equal access to health care is therefore a prerequisite for equality of opportunity in society. In developing countries, health care can be accessed from such facilities as the following: 1. Hospitals, health centers, and clinics run by the central government 2. Municipality or city council-controlled facilities Accessibility to Health Care in Urban Environments 229 3. Facilities run by faith-based organizations 4. Private sector facilities—both for-profit and nonprofit Access to Health Care in Urban Settings: Issues, Challenges, and Opportunities As earlier chapters have described, a lack of basic services—including safe water, sanitation, and good shelter—in rapidly expanding...

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Additional Information

ISBN
9780812205084
Related ISBN
9780812243536
MARC Record
OCLC
793012562
Pages
328
Launched on MUSE
2012-01-01
Language
English
Open Access
No
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