Social Work & Society

Advancing Health Equity for the Disadvantaged: The Transformative Role of Social Work in Bridging the Gap

Anoop C Choolayil — 2024-12-13

The constitution of the World Health Organisation (1946) endorses the highest attainable standard of health as a fundamental right. The commitment to the right to health has always been a global priority. The Alma Ata declaration affirmed the global commitment to “the right to health” and the need for all people to attain an acceptable level of health (World Health Organization, 1978) and the Sustainable Development Goals (SDG) target 3.8 emphasises the need to extend accessible and affordable healthcare in the form of Universal Health Coverage (United Nations, 2015). However, despite continued efforts, globally, the violation of the right to health is rampant in the forms of 'violation of commission', 'violation of the obligation to protect', 'failure to fulfil minimum core obligations' and 'violations related to gender discrimination' (Chapman, 1998). The right to health envisioned as health equity is an ambitious goal rooted in the idea of social justice that seeks to attain the highest standard of health possible for all, particularly vulnerable sections of society, as persistent health inequalities can entrap marginalised populations in a vicious cycle of poverty and ill health (Wagstaff, 2002). The social factors that influence and shape health outcomes, commonly known as social determinants of health (SDOH) constitute an important aspect in this regard. SDOH are those conditions “in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life,” including income, education, occupation, housing conditions and food security, among others, (World Health Organization, n.d.). Addressing SDOH is essential in ensuring the right to health for all, and social work, as a public health profession, advances health equity by addressing the problem of SDOH (Kerson & Lee, 2016).

Obstacles Faced by Palestinian Refugees in Accessing Health Services

Abdulaziz Albrithen — 2024-12-13

Health equity is a right stipulated by United Nations charters and is a basic topic of interest in humanitarian assistance professions, including social work. The principles of health equity are based on achieving parity in the delivery and provision of human services and satisfying the health needs of disadvantaged individuals, groups, and communities. This study aims to understand the obstacles Palestinian refugees face in availing the health services provided by international relief agencies (e.g., UNRWA). Palestinian society is classified as a disadvantaged community by virtue of its political nature and humanitarian situation. This study conducts a social survey to assess the obstacles preventing the achievement of health equity among Palestinian refugee families living in Palestinian territories. The sample consisted of 600 Palestinian refugee families in Nablus, covering different geographical distributions. Furthermore, 121 social workers in a relief and social work program affiliated with UNRWA in the West Bank were surveyed. The findings suggest that Palestinian refugees face multiple disadvantages that curtail them from availing of healthcare facilities. The findings pertaining to the role of social work show that social workers have an important role in improving healthcare access.

Health Financing and Equity in Healthcare for Disadvantaged Groups in Vietnam

Thi Xuan Huong Le — 2024-12-13

Equity in health means that all people in general and disadvantaged groups in particular receive the same healthcare services, according to their needs, regardless of each person's financial ability and social status. In Vietnam, equity in healthcare for the disadvantaged is expressed in the Party's guiding viewpoints, guidelines, and legal policies. This study has employed a combination of quantitative and qualitative research methods to understand the impact of health financing in advancing health equity for disadvantaged people. Quantitative and qualitative research methods have helped us evaluate the current health financing and equity in healthcare for disadvantaged people in Vietnam. The study assessed the health financing activities, including the distribution of free health insurance cards to disadvantaged groups, medical examination and treatment available, and the services of social workers at hospitals and localities. Based on the results of this analysis, we identify existing gaps and their causes. Based on the findings we build and propose solutions for government agencies, training activities, medical facilities, and social work organizations. The significance of the proposed solutions is to improve fairness and efficiency in financial use and healthcare for disadvantaged groups in Vietnam.

Social Work at Hamad Medical Corporation: Historical Perspective

Nada Eltaiba — 2024-12-17

Understanding the historical context of social work is critical for providing insights into aspects that influenced the profession. The knowledge obtained will give valuable lessons in navigating the complex systems within which social workers practice. Despite the growing interest among researchers in recording the history of social work, there is still a gap in many societies and agencies. In this paper, we present a brief introduction concerning social service in the Hamad Medical Corporation (HMC), one of the leading institutions in Qatar. To explore historical social work issues, we spoke with a group of pioneering social workers in the field of social work‏, who have witnessed and even contributed to the beginnings of the development of social work. The participants talked about establishing social work in HMC and some of the narratives relevant to health, mental health, and cultural contexts.

Poly-Victimisation and Health Risk Behaviors amongst Street Children in Zimbabwe

Constance Gunhidzirai — 2024-12-13

This paper explores how poly-victimisation affects health and influences street children's behavior in Harare Metropolitan Province in Zimbabwe. There are many studies on street children in Zimbabwe, but little is known about how multiple forms of violence affect their physical and mental health. The study has problematized poly-victimisation from the theoretical lens of psychoanalytic theory, as the traumatic events experienced by street children can have a negative impact on their physical and mental health. A survey in the form of a questionnaire was used to gather data from 202 street children between the ages of 6-18 years who were purposively selected for this study. The findings indicated that most street children are experiencing physical, sexual, emotional and psychological abuse. This drives them to indulge in substance use, alcohol consumption, suicide idealism, and risky sexual activities. Recommendations for this study have been derived from the findings that seek to improve social work policy in Zimbabwe.

Ensuring Equity in Health Services in Hospital Settings through Social Work Interventions: A Mixed Method Study

Golam Azam — 2024-12-13

The study aimed to explore the status of equity in health service provisions and the process of ensuring equity in health services in the Social Welfare Department (SWD) of a tertiary care hospital with the application and effectiveness of social work interventions at micro and macro levels. Under pragmatism, the study employed a mixed-method approach within the explorative research framework that applied social surveys, case studies, and observations. A total of 120 poor diabetic patients for a survey, 10 patients for case studies, and 10 key informants were chosen for the study. The key findings reveal that SWD equitably distributes healthcare services through the identification of patients, assessment of psychophysical conditions, economic and social conditions, and distribution of services to the patients. The need-based and rehabilitation-based social work interventions at micro and macro levels contributed to the patients getting satisfied with the healthcare services in the hospital. In conclusion, the tertiary care services for poor diabetic patients need to be upgraded to meet their healthcare needs.

Re-Examining Intimate Partner Violence: Feminist Social Work Reflections

Meenu Anand — 2024-12-13

Intimate partner violence has been one of the foremost public health problems and a violation of women's human rights impacting one in three women worldwide (UN Women, 2020). Offering an insight into and questioning the concomitant edifices of violence inherent within the intimate marital relationships, the authors put forth arguments to interrogate the unique factors that impact women’s experiences and understandings of the abuse and demonstrate how gendered discourses function to polarize women’s sexuality.

The authors argue that violence both stems from and perpetuates gender differences and disparities and embodies lived experience where one can see the ubiquity and reproduction of male dominated gender relations (Wendt & Zannettino, 2015). Backed by research evidence from the post pandemic global and national intelligences, they unfold the multifarious impact of violence by intimate partners on women and how these pose a greater risk gross vandalism of human rights while magnifying the gendered perils of the public health crisis. The paper also contours domestic violence and its trepidation effect on women’s reproductive and sexual health while reaffirming the impact of gender-based power imbalances within sexual relationships on sexual, reproductive, physical and mental health of women.

As feminist social work academic/ researchers, the authors attempt to link their pragmatic reflections through social work practice and the feminist perspective ‘at work’. They focus on valuing the local experiences and understandings of marital violence and the gendered relations and identities that inhere in such experiences while accelerating the vigour to identify, realize and take actions paving pathways to sustainable development. They contend the pertinent role of social workers from a feminist lens in addressing the critical issues surrounding intimate partner violence and delineate holistic social work interventions relevant to the global dynamic environment advocating human rights-based perspective. The paper concludes with few suggestive eclectic mechanisms to address the issue of violence within marriage from a feminist social work perspective.

Domestic Violence, Mental Health, and COVID-19: A Community-based Study of Women in Delhi

Ajit Kumar Lenka — 2024-12-13

Domestic violence is a product of unequal gender power relations in the household. During the COVID-19 pandemic, due to restricted physical movement there was an increased risk of violence which further exacerbated the vulnerability of those already in abusive relationships. Several factors led to an increase in the number of domestic violence cases including loss of livelihoods, restriction of social contact within informal and informal networks, and limited access to services and community support. During the COVID-19 in many countries, data indicates an increase in reports of domestic violence, sexual harassment, and other forms of violence against women. The current paper is based on an empirical study using qualitative methods of data collection, conducted in Munirka urban village, Delhi. The paper focuses on the factors affecting the rate of increase in domestic violence cases during the COVID-19 pandemic, and subsequent effects on the mental health of women. Main finding of the study indicates that cases of domestic violence during COVID-19 increased due to alcoholism, loss of livelihood, financial insecurity, and limited access to services. Hence, authors suggest that to reduce the prevalence of violence against women, there should be an improvement in female education, raising awareness about their rights, and providing better social support.

Social Work Education and Health Equity in India: A Critical Review

Ngaopunii Trichao Thomas — 2024-12-13

Considering the persistence of significant health inequities in India, exploring the interface between health equity and social work education is a critical research priority. This article attempts to present a systematic analysis of the present status of health equity and social work training in India, elaborating on healthcare discrepancies among various populations in India, examining reasons for elevated morbidity and mortality rates among marginalized communities, and approaches to social work education at present. Consequently, curriculum revision should be all-inclusive and focus on highlighting fairness in health provision as well as cultural competency with an emphasis on social justice. It also calls for a paradigm shift towards contextualized knowledge, critical pedagogy and community engagement to prioritize health equity by suggesting that future training should focus on a holistic approach to dealing with preventable illnesses emanating from these determinants. In conclusion, this article points out the significance of giving more attention towards health equity within Indian schools of social work while providing some directions for possible research lines.

Prevalence, Patterns and Implications of Gender-Based Violence against Women: Challenges and the Way Forward

Sigamani Panneer — 2024-12-13

The alarming incidence of Gender-Based Violence (GBV) highlights a critical humanitarian crisis that necessitates urgent consideration and collaborative endeavours to alleviate human suffering and advance principles of equity and security for every person. Women and teen girls are primarily affected by GBV. Patterns of GBV against women and teens are sexual, emotional, and physical. Nearly one in three women, or 736 million women and teen girls, have experienced intimate partner abuse, non-partner sexual violence, or both. A systematic review was conducted to understand the forms of GBV, and Women's knowledge of protective legislation. Studies were selected in a systematic manner to understand the interrelated forms of violence (such as physical, sexual, economic, and psychological abuse) that women and teen girls experience. The review prioritizes the best practices by highlighting the feasible approaches and priorities for addressing GBV effectively.

Preventing and Controlling Tuberculosis through Village Adoption Model in Koppal District of Karnataka: A Case Study

D. Srinivasa — 2024-12-13

The Indian government aims to eliminate tuberculosis (TB) by 2025 due to its high morbidity and mortality. India has much to do to lower TB rates. This research examined Koppal district of Karnataka, South India’s village adoption model for tuberculosis detection, treatment, and prevention. The authors used an exploratory research design. After a screening process, the participants comprised 8 TB patients and 13 healthcare workers were recruited from the Koppal district through purposive sampling technique. A total of 21 semi-structured interviews were conducted among these selected beneficiaries and health professionals. Conventional content analysis was used to analyse the data obtained from the interviews. From the analysis, seven themes emerged from the health care workers and eight themes emerged from the beneficiaries. The major themes from the beneficiaries included critical roles in project management, private practitioners' reactions, healthcare workers' implementation experiences, initiatives beyond project staff, execution challenges, strategies to overcome them, and reasons for non-use. From the health care professionals, main themes were their experiences, process insights, patient emotions, programme services, beneficiaries' dislikes, suggestions, satisfaction, and thoughts on expanding the initiative to other regions. The Koppal District village adoption model was helpful in understanding private-sector dynamics and patient preferences. The project helped health professionals and communities promote TB knowledge, treatment adherence, and the TB agenda. Finally, this technique made Koppal district in Karnataka, India, TB-free.

Nutritional Status among the Women and Children in Bangladesh: Implications for Health Social Work Practice

Hanumant Waghmare — 2024-12-13

Undernutrition is a serious public health concern in several Asian countries, especially in Bangladesh. This paper presents the findings of a study conducted to identify the factors influencing the nutritional status of women and children under the age of five, using data from the Demographic Health Survey. The study also explores potential social work interventions to address these issues through civil society and advocacy efforts. Despite government initiatives, the nutritional status of women and children remains a major concern in Bangladesh. The study assesses the nutritional status of women based on their Body Mass Index (BMI) and reports a decrease in the prevalence of anemia by 15.4% among women and 32.2% among children. Furthermore, the study indicates that nutritional policies and programs have had a positive impact on the nutritional status of women and children. The findings highlight the necessity of a robust support system that prioritizes a multi-sectoral approach to address undernutrition. The study emphasizes the importance of collective and coordinated efforts for the successful implementation of nutritional policies. Additionally, the study stresses the significance of understanding and perspectives about nutrition for social work researchers and practitioners to effectively address health-centered social work practices. Ultimately, the study underscores the direct link between health and nutrition and the broader goals of human well-being, inclusive, and sustainable development.

Inter-State Migration, Footloose Labour and Accessibility to Health Care: An Exploration among Metro Workers of a Camp in Bengaluru

Venkatanarayanan Sethuraman — 2024-12-13

The neoliberal political economy that India adopted in 1991 has brought in huge Foreign Direct Investments, which has led to a perceptible increase in the number of migrants in the major cities of India due to various structural reasons in their place of origin and rapid developmental activities in the cities. Bengaluru has the second largest migrant population after Mumbai, and as per the labour department of the government of Karnataka; there are more than 65 lakh migrant workers in Karnataka, who are involved in various developmental projects, including the metro railway project in Bangalore. Even though the Karnataka Building and Other Construction Workers Welfare Board (KBOCWWB) offers certain social security, including health care for registered migrants, they must wait more than a year to get these benefits. With privatisation and increased out-of-pocket expenditure for health related issues, the migrants face a major hurdle in surviving at the migrated workplaces. Many of them are unaware of welfare boards, and the number of migrants who are registered with them is very small. This paper aims to understand the accessibility of health facilities for migrant workers working in the Bengaluru Metro Project. This research will understand the legal, economic and psychological aspects related to the health status of migrant workers through qualitative study. The study used in-depth interviews to elicit responses from selected inter-state migrant workers to understand their access towards health facilities. The thematic analysis of the interview transcripts revealed a substantive gap in workers' access to health facilities. The unregulated working conditions have added more stress to the workers, and due to poverty and unemployment back home, these hurdles are not forcing them to go back. More awareness creating interventions from the government can transform their lives.

Health Social Workers in Promoting Mental Health Equity: Voice and Agency for the Marginalized

Chandramathi Ramaswamy — 2024-12-13

Globally, 1 in 4 persons have mental health issues at some point in life. However, the mental health services are not easily available, accessible and affordable to all strata of the society with varying socio-economic and cultural backgrounds. In healthcare settings, social workers work in a context where a greater number of other professionals often have medical expertise rather than social science background which makes their job unique. Thus, health social workers have a crucial role in attaining health equity at mental health settings. This article primarily investigates the contemporary role of health social workers in pioneer mental health institutions of India. The study has two phases, the first phase adopts in-depth interview method with mental health social work practitioners using self-structured interview guide that highlights the role of health social workers, especially in establishing mental health equity by de-stigmatization, reducing the disparities, equal access, etc. Totally eight Health Social Workers participated in the study from, NIMHANS, JIPMER, Vazhikatti, and National Health Mission (Coimbatore), two from each institute respectively. Thematic analysis was performed and themes were generated from the qualitative data gathered. In the second phase, literatures were identified from SCOPUS, Google Scholar and Web of Science databases for mapping pertinent literatures on international health social workers in mental health settings. The results of the thematic analysis and the literatures from various sources were compiled to understand the aspects of health social workers in addressing marginalized identity, structural inequalities, cultural sensitivity, intersectionality and providing voice and agency to the marginalized in shaping the mental health policy and programs. Therefore, the article aims to identify and bridge the gaps in the roles of health social workers in attaining health equity within this context.

Understanding Experiences of Medical Social Workers Managing Older Adults with Chronic Illnesses: Insights from Nigeria

Oluwagbemiga Oyinlola — 2024-12-13

This qualitative research study explored how social workers in Nigerian hospital managed the complex needs of older adults living with chronic illnesses among individuals residing in rural communities of Nigeria. As the global population continues to age, the burden of chronic illnesses among older adults is growing, however, there is limited knowledge on how social workers in hospital are addressing these numerous challenges in Nigerian healthcare systems. Keeping with the principle of a descriptive phenomenological approach, this study conducted in-depth interviews with 16 medical social workers from six geo-political zones in Nigeria. Data analysis revealed three themes on the multifaceted nature of their work. These themes encompassed: 1) emotional toll of witnessing the suffering of older adults, 2) navigating a resource-constrained healthcare system, and 3) the importance of collaboration element of/with community leaders/ faith-based healers in Nigeria for effective care. The study highlights the need for improved training, support, and recognition of social workers within the Nigerian healthcare system. Additionally, it emphasizes the significance of a holistic and collaborative approach involving social workers, healthcare providers, policymakers, and communities to improve the well-being of this vulnerable population in Nigeria and similar settings around the world.

Structural Violations of Mental Health Equity among Divorced Women: Challenges and Policy Implications

Fathima Sherin Ottakkam Thodukayil — 2024-12-13

The mental health equity of divorced women is a critical concern, as divorce can have significant emotional and psychological implications. Mental health equity refers to ensuring all individuals have equal access to mental health resources, support, and care regardless of their circumstances. Even though there are disparities in mental health care affecting mental health equity especially among divorced women, there is a noticeable gap in studies that delve into this issue. In this context, employing a mixed-method approach, this study explored the prevalence of mental health issues in divorced women and identified structural violations contributing to disparities in mental health care. The sample encompassed of divorced women in Kerala, representing diverse socio economic backgrounds, who were selected through purposive sampling. The data for the quantitative analysis was collected from 60 respondents in Kerala using the Depression, Anxiety, and Stress Scale (DASS21) to assess the mental health status of the women and a demographic questionnaire. In-depth face-to-face interviews with seven women were conducted for qualitative analysis. The findings of the study showed that the women experience significant mental health impairments in their post-divorce phase, and highlighted the impact of pre-existing structural violations and intersections of gender, class, and marital status of women in hindering their access to mental health care. Urgent policy interventions are needed to address these issues and cater to the specific needs of marginalized groups, especially, divorced women.

Prepared for the future? Social work students, ontological insecurity and the turning point in Swedish refugee policies

Norma Montesino — 2024-12-13

The year 2015 marked a rupture in the post-war development of refugee reception and integration policies in Sweden. This rupture involved both a radical change in refugee policy and practice, and a rupture in the long-held collective self-image of Sweden as a country with generous reception and integration policies (Scarpa & Schierup 2018). This article responds to the question of how social work students in Sweden understand and conceptualise these changing conditions. It draws on the concept of ontological insecurity and on two qualitative studies conducted in 2015 involving individual- and group interviews with social work students at different Swedish universities. The article discusses how the students' responses reflect this moment of rupture. On a personal level, they express confusion and uncertainty as they experience the consequences of changing narratives in the public and private spheres. The analysis shows that although the students are engaged with the current political and social refugee situation, the social work education does not provide them with tools to unpack the situation. This reveals the limitations of a conceptual apparatus learned in social work education that is not up to date in responding to contemporary challenges.

Ageing after the Loss of Partner: Exploring the Lives of Widowed Older Adults in Kerala

Laxmi Putran — 2024-12-13

The loss of a life partner often exerts psychological distress on older adults, which often compounds with other factors, adversely affecting their lives. Living arrangements and social connections can impact the ageing experience of older adults after the loss of a spouse. This descriptive cross-sectional study was conducted among 200 randomly selected older adults from the Kasaragod district of Kerala, India, who had lost their spouses to understand the sense of community and psychosocial profile of the respondents. Data was collected using a questionnaire comprising questions on demographic details and standardised scales for measuring the sense of community, life satisfaction, loneliness and depression. The findings showed that the sense of community had a significant positive correlation with life satisfaction (r = 0.531) and significant negative correlations with loneliness (r = -0.304) and depression (r = -0.603). Loneliness and depression had a significant positive correlation (r=0.447) with each other. Satisfaction with life had significant negative correlations with loneliness (r = -0.529) and depression (r = -0.689). Also, there were significant differences in the psychosocial profile of the respondents based on gender. Female respondents had significantly higher loneliness and depression and significantly lower life satisfaction and sense of community than their male counterparts. The findings suggest that widowed older adults experience significant psychosocial distress, and this distress is disproportionately affecting women. Hence, gender-informed interventions that target improving the social connectedness of older adults can contribute to better mental health outcomes.

The implementation of social policies in a pandemic context: an analysis of anger

Andrea Dettano — 2024-12-10

The pandemic context put into operation social policies that sought to accompany the difficulties in earning an income. Against this background, social policies acquired a visible centrality in state agendas, dedicated to dealing with the health emergency caused by COVID-19. In the Argentine case, a policy called Emergency Family Income (EFI) was implemented, consisting of a cash transfer intended to mitigate the loss of income generated by Social, Preventive, and Compulsory Isolation (SPCI). The EFI’s management, implementation, access, and collection method underwent a digitalisation process, enabling access through official and nonofficial channels. Among nonofficial channels there are Facebook Groups, where the beneficiaries of social policies exchange information, doubts, and advice. Its application and actual access encountered several obstacles and engendered different emotions. As part of a virtual ethnography in a Facebook group, this paper develops -from the social studies of emotions-, how anger unfolds in the collection of a social policy. The analysis of emotions in state interventions allows us to reformulate the study of the implementation processes. The main findings are 1) anger appears as a product of the mismatch between expectation and experience in the face of irregular operations in its implementation; 2) anger presents a binding and supportive character that is shared in the search for empathy and is reinforced by sharing it; 3) it is driven by the evaluations of deserving/not deserving subsidies 4) politicians and different leaders are regarded as legitimate recipients. The conclusions highlight the central place that anger holds in the implementation of social policies. Studying anger allows us to shed light on the obstacles and the practices involved in state interventions and thus improve the implementation processes of social policies based on the experiences of the recipient population. It also makes it possible to identify some guidelines for improving government interventions, such as help with digitalisation processes; provide clear and uniform information; comply with regular payments; assist recipients; and promote government transparency.