%0 Journal Article
%T Access and Barriers to Healthcare Vary among Three Neighboring Communities in Northern Honduras
%A Catherine A. Pearson
%A Michael P. Stevens
%A Kakotan Sanogo
%A Gonzalo M. L. Bearman
%J International Journal of Family Medicine
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/298472
%X Objective. The aim of this study is to describe and compare access and barriers to health services in three proximal yet topographically distinct communities in northern Honduras served by the nonprofit organization the Honduras Outreach Medical Brigada Relief Effort (HOMBRE). Methods. Study personnel employed a 25-item questionnaire in Spanish at the point of care during HOMBRE clinics in Coyoles, Lomitas, and La Hicaca . We describe and compare the responses between sites, using Chi-squared and Fisher Exact tests. Results. Respondents in Lomitas demonstrated the greatest limitations in access and greatest barriers to care of all sites. Major limitations in access included ˇ°neverˇ± being able to obtain a blood test, obtain radiology services, and see a specialist. Major barriers were cost, distance, facility overcrowding, transportation, being too ill to go, inability to take time off work, and lack of alternate childcare. Conclusions. Despite being under the same local health authority, geographically remote Honduran communities experience greater burdens in healthcare access and barriers than neighboring communities of the same region. 1. Background Short-term medical missions are an increasingly popular method for delivery of healthcare to developing nations, including Honduras [1¨C4]. The medical literature sparsely details best practices and optimization of clinical services for short-term mission trips. A number of studies have identified the importance of needs assessments and provider knowledge of local infrastructure for the success of sustainable, mission-based healthcare [1, 4, 5]. It is documented that Honduras lacks adequate access to health services: 83% of Honduras is without health insurance and 30% is without health care as of 2007 [6]. Infant mortality, a standard measure of population health, is 25 per 1,000, 10 more than the regional average [7]. The reasons for healthcare limitations in Honduras are multiple, including inadequate numbers of physicians (0.8 per 1,000 persons), variable medication supplies, gaps in infrastructure, financial constraints, and sociopolitical factors [8, 9]. Rural Honduras, home to 51% of the population, is particularly limited in both access to basic health infrastructure such as improved drinking water and sanitation, as well as access to healthcare [6, 7], with services limited to small health posts staffed by auxiliary nurses [6, 8]. Leon reported healthcare users in Honduras feeling they are ˇ°passive recipients of services.ˇ± They must ˇ°walk long distances to catch a bus or get a rideˇ± only to find the
%U http://www.hindawi.com/journals/ijfm/2012/298472/