Browsing by Author "Randhawa, Gurch"

Now showing 1 - 6 of 6
  • Thumbnail Image
    ItemOpen Access
    Engaging young people with sexual health services in general practice surgeries – A qualitative study of health care professionals
    (Wolters Kluwer, 2024-02-09) Adakpa, Itodo; Randhawa, Gurch; Ochieng, B.
    Evidence to date suggests that young people are becoming more sexually active and are forming relationships during the early stages of their lives, sometimes engaging in sexual risk-taking, which contributes to high rates of conception and sexually transmitted infections (STIs). Young people at risk of adverse sexual health outcomes are the least likely to engage with reproductive and sexual health promotion programmes and services (RSHPPs), especially in mainstream clinics such as general practice (GP) surgeries. The study aimed to explore the views and experiences of service providers. Materials and Methods: A qualitative approach to explore the views and experiences of designing and implementing RSHPPs for young people in GP surgeries was used. A total of seven participants were interviewed, including four general practitioners (GPs), two of whom were managers at the practice; one nurse; one healthcare and support worker; and one practice manager. Results: The context of RSHPPs such as local health priorities and partnerships to address STIs and unplanned pregnancies among young people contribute to the implementation and engagement of young people with RSHPPs. Training of GPs, nurses, and support workers helps develop confidence and overcome personal factors by promoting effective engagement of young people with RSHPPs. Conclusion: Addressing local health priorities such as reducing teenage pregnancies and STIs requires organisations to provide RSHPPs in both non-clinical and clinical settings to ensure that RSHPPs are accessible to young people. There is room for improvement in access to RSH for young people in GP surgeries by addressing organisational and structural barriers to access.
  • Thumbnail Image
    ItemOpen Access
    Improving support for breastfeeding mothers: a qualitative study on the experiences of breastfeeding among mothers who reside in a deprived and culturally diverse community
    (BioMed Central, 2021-04-06) Cook, Erica; Powell, Faye; Ali, Nasreen; Penn-Jones, Catrin; Ochieng, B.; Randhawa, Gurch
    Background: The United Kingdom has one of the lowest breastfeeding rates in Europe, with the initiation and continuation of breastfeeding shown to be closely related to the mothers’ age, ethnicity and social class. Whilst the barriers that influence a woman’s decision to breastfeed are well documented, less is known how these barriers vary by the UK’s diverse population. As such, this study aimed to explore mothers’ experiences of breastfeeding and accessing breastfeeding services offered locally amongst a deprived and culturally diverse community. Methods: A qualitative interpretive study comprising of 63 mothers (white British n = 8, Pakistani n = 13, Bangladeshi n = 10, black African n = 15 and Polish n = 17) who took part in single-sex focus groups, conducted in local community centres across the most deprived and ethnically diverse wards in Luton, UK. The focus groups were audio-recorded, transcribed and analysed thematically using Framework Analysis. Results: The most common barriers to breastfeeding irrespective of ethnicity were perceptions surrounding pain and lack of milk. Confidence and motivation were found to be crucial facilitators of breastfeeding; whereby mothers felt that interventions should seek to reassure and support mothers not only during the early stages but throughout the breastfeeding journey. Mothers particularly valued the practical support provided by health care professions particularly surrounding positioning and attachment techniques. However, many mothers felt that the support from health care professionals was not always followed through. Conclusions: The findings presented inform important recommendations for the design and implementation of future programs and interventions targeted at reducing breastfeeding inequalities. Interventions should focus on providing mothers practical support and reassurance not only during the early stages but throughout their breastfeeding journey. The findings also highlight the need for tailoring services to support diverse communities which acknowledge different traditional and familial practices.
  • Thumbnail Image
    ItemOpen Access
    Parents’ experiences of complementary feeding among a United Kingdom culturally diverse and deprived community
    (Wiley, 2020-11-09) Cook, Erica Jane; Powell, Faye Caroline; Ali, Nasreen; Penn-Jones, Catrin; Ochieng, B.; Randhawa, Gurch
    Complementary feeding practices and adherence to health recommendations are influenced by a range of different and often interrelating factors such as socio- economic and cultural factors. However, the factors underlying these associations are often complex with less awareness of how complementary feeding approaches vary across the UK’s diverse population. This paper describes a qualitative investiga- tion undertaken in a deprived and culturally diverse community in the UK which aimed to explore parents’ knowledge, beliefs and practices of complementary feed- ing. One hundred and ten mothers and fathers, self-identified as being White British, Pakistani, Bangladeshi, Black African/Caribbean or Polish took part in twenty-four focus group discussions, organised by age group, sex and ethnicity. The findings revealed that most parents initiated complementary feeding before the World Health Organisation (WHO) recommendation of 6 months. Early initiation was strongly influenced by breast feeding practices alongside the extent to which parents believed that their usual milk; that is, breastmilk or formula was fulfilling their infants' nutritional needs. The composition of diet and parents' approach to complementary feeding was closely aligned to traditional cultural practices; however, some contradic- tions were noted. The findings also acknowledge the pertinent role of the father in influencing the dietary practices of the wider household. Learning about both the common and unique cultural feeding attitudes and practices held by parents may help us to tailor healthy complementary feeding advice in the context of increasing diver- sity in the United Kingdom.
  • Thumbnail Image
    ItemOpen Access
    A qualitative study of health care providers’ perceptions and experiences of patients bypassing primary healthcare facilities: a focus from Nigeria
    (Journal of Global Health Reports, 2020-07-27) Koce, Francis; Randhawa, Gurch; Ochieng, B.
    Background The healthcare referral system is designed to ensure that patients receive the best care at the appropriate level, as well as improving access to different levels of care. However, approximately 60-90% of patients in Nigeria bypass their local primary level of care to seek healthcare outside of the community. This study is part of a larger mixed methods study that explored the patients’ and healthcare providers’ perceptions and experiences in order to understand the factors that influence a patient’s decision to bypass the primary level of care to go to secondary and tertiary level facilities. In this study we present the perspectives of the healthcare providers and the factors that influence a patient’s decision to self-refer, as well as their suggestions for how primary healthcare facilities can retain patients locally. Methods In-depth semi-structured interviews were conducted with eighteen healthcare providers comprising doctors, nurses, and community healthcare workers from primary and secondary healthcare facilities in Niger State, Nigeria. The interviews were tape recorded and subsequently transcribed. The analysis was carried out using the principles of framework analysis. Results The shortage of healthcare providers at local facilities was described as a key reason for patients to self-refer to secondary and tertiary care. Lack of basic equipment, inequitable distributions, and the inconsistent opening hours of the primary healthcare facilities were also considered to be influencing factors for bypassing the primary health facilities. In order to encourage the use of the primary healthcare facilities, some of the healthcare providers suggested ensuring that medical doctors were stationed within those facilities, and also suggested the need for collaboration between the different levels of care, as current services appeared fragmented. Conclusions Interventions such as employing the services of doctors (family physicians) and standardising the primary healthcare facilities in terms of distribution and availability of the basic facilities are needed to reduce the barriers associated with the bypass of the primary level of care in low cost economies. In addition, tangible policies that ensure the primary health facilities are well resourced should be enacted. The findings have implications for planning, practice, and policy in service delivery aimed at curtailing the bypass of the primary health care facilities.
  • Thumbnail Image
    ItemOpen Access
    ‘They are kids, let them eat’: A qualitative investigation into the parental beliefs and practices of providing a healthy diet for young children among a culturally diverse and deprived population in the UK
    (MDPI, 2021-12-11) Cook, Erica Jane; Powell, Faye; Ali, Nasreen; Penn-Jones, Catrin; Ochieng, B.; Constantinou, Georgina; Randhawa, Gurch
    In the UK ethnic minority children are at greater risk of obesity and weight-related ill health compared to the wider national population with the factors that influence the provision of a healthy diet among these populations less understood. An interpretive qualitative study com-prised of 24 single sex semi-structured focus groups was conducted with 110 parents (63 mothers and 47 fathers) of young children (aged 0-5). Participants were recruited from deprived and ethnically diverse wards in Luton, UK and self-identified as being white British, Pakistani, Bangladeshi, black African and Caribbean or Polish. The findings highlighted a wide range of inter-relating psychological and socio-cultural factors that inform and underpin parental beliefs and practices relating to providing children a healthy diet. Parents whilst aware of the im-portance of providing children a healthy diet; challenges, particularly among mothers surround-ing lack of time and balancing competing responsibilities were clear barriers to providing a healthy diet to children. Access, affordability of healthy food alongside the over exposure of cheap convenient and unhealthy processed foods made it increasingly difficult for parents to pro-vide a healthy diet to their growing families. Household food practices were also found to be situated within the wider context of socio-cultural and religious norms around cooking and eat-ing with cultural identity and upbringing.
  • Thumbnail Image
    ItemOpen Access
    Understanding healthcare self-referral in Nigeria from the service users’ perspective: a qualitative study of Niger State
    (Emap, 2019-05-02) Koce, Francis; Randhawa, Gurch; Ochieng, B.
    Background: The distortion of the pyramidal structure of the healthcare delivery system due to by-passing the primary level of care to the referral facilities has continued to raise concerns for the healthcare delivery system. About 60-90% of patients in Nigeria are reported to self-refer to a referral level of care. Thus, this study sought to identify the factors that influence service-users’ decision to self-refer to the secondary healthcare facilities in Nigeria by exploring the perceptions and experiences of the service-users. Methods: Twenty-four self-referred service-users were interviewed from three selected secondary healthcare facilities (general hospitals) in Niger state, Nigeria. The interviews were tape-recorded, each lasting 20 minutes on average. This was subsequently transcribed verbatim and framework analysis was employed for the analysis. Results: Various reasons were identified to have resulted in the bypass of the primary healthcare facilities in favour of the secondary level of care. The identified themes were organised based on the predisposing, enabling and need component of Andersen’s model. These themes included: patients understanding of the healthcare delivery system; perceptions about the healthcare providers; perceptions about healthcare equipment/ facilities; advice from relatives and friends; service-users’ expectations; access to healthcare facilities; regulations/ policies; medical symptoms; perceptions of severity of medical symptoms. Conclusions: The findings from this study call for an evaluation of the current healthcare referral system, particularly in developing settings like Nigeria and consequently the need for developing a contextual model as applicable to individual settings. Therefore, a multifaceted approach is needed to address the current concerns to ensure patients utilise the appropriate level of care. This will ensure the primary healthcare facilities are not undermined and allow the referral levels of care to live up to their mandate.