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A mixed methods study of using wasta in healthcare services in Palestine: predictors, consequences and proposed solutions

BACKGROUND: Equity in access to quality healthcare is a fundamental human right. Yet studies demonstrate that some people receive preferential treatment while others are discriminated against. Wasta is a prevalent strategy whereby personal connections are used for influence and may result in gaining...

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Autores principales: Takruri, Adel, Nawajah, Inad, Jabari, Carol El
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10585732/
https://www.ncbi.nlm.nih.gov/pubmed/37858235
http://dx.doi.org/10.1186/s12913-023-10114-5
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author Takruri, Adel
Nawajah, Inad
Jabari, Carol El
author_facet Takruri, Adel
Nawajah, Inad
Jabari, Carol El
author_sort Takruri, Adel
collection PubMed
description BACKGROUND: Equity in access to quality healthcare is a fundamental human right. Yet studies demonstrate that some people receive preferential treatment while others are discriminated against. Wasta is a prevalent strategy whereby personal connections are used for influence and may result in gaining unfair advantages over others. This study aims to investigate wasta use in healthcare, the factors associated with its use, and the impact of wasta use on the equity and quality of healthcare services. METHODS: A mixed-methods study utilizing a quantitative survey and qualitative interviews was conducted in Palestine (West Bank and Gaza) between October 2021 and February 2022. Quantitative analysis was performed using Stata version 14. Bivariate and multivariate logistic regressions assessed the relationship between wasta use and individual-level variables such as gender, residence, age, employment status, and financial situation. Content analyses of qualitative transcripts were performed using Dedoose version 9. Textual quotes were grouped into major and minor themes. RESULTS: Multivariate regressions revealed that wasta use is more prevalent among refugee camp dwellers and more frequent in Gaza compared to the West Bank. Wasta was also employed to a greater degree among government employees. Qualitative interviews complemented the quantitative results and added further insights into the consequences of Wasta use in healthcare settings such as negatively impacting quality and equity in healthcare services. CONCLUSION: Wasta use in healthcare can have an adverse effect on equity and quality. Ensuring efficient processes, reduced financial burdens, stringent accountability measures, transparency, and training programs can contribute to diminishing the need for using wasta in healthcare. By addressing both systemic and cultural factors that perpetuate wasta, societies can move closer to healthcare systems characterized by fairness, accessibility, and ethical integrity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-023-10114-5.
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spelling pubmed-105857322023-10-20 A mixed methods study of using wasta in healthcare services in Palestine: predictors, consequences and proposed solutions Takruri, Adel Nawajah, Inad Jabari, Carol El BMC Health Serv Res Research BACKGROUND: Equity in access to quality healthcare is a fundamental human right. Yet studies demonstrate that some people receive preferential treatment while others are discriminated against. Wasta is a prevalent strategy whereby personal connections are used for influence and may result in gaining unfair advantages over others. This study aims to investigate wasta use in healthcare, the factors associated with its use, and the impact of wasta use on the equity and quality of healthcare services. METHODS: A mixed-methods study utilizing a quantitative survey and qualitative interviews was conducted in Palestine (West Bank and Gaza) between October 2021 and February 2022. Quantitative analysis was performed using Stata version 14. Bivariate and multivariate logistic regressions assessed the relationship between wasta use and individual-level variables such as gender, residence, age, employment status, and financial situation. Content analyses of qualitative transcripts were performed using Dedoose version 9. Textual quotes were grouped into major and minor themes. RESULTS: Multivariate regressions revealed that wasta use is more prevalent among refugee camp dwellers and more frequent in Gaza compared to the West Bank. Wasta was also employed to a greater degree among government employees. Qualitative interviews complemented the quantitative results and added further insights into the consequences of Wasta use in healthcare settings such as negatively impacting quality and equity in healthcare services. CONCLUSION: Wasta use in healthcare can have an adverse effect on equity and quality. Ensuring efficient processes, reduced financial burdens, stringent accountability measures, transparency, and training programs can contribute to diminishing the need for using wasta in healthcare. By addressing both systemic and cultural factors that perpetuate wasta, societies can move closer to healthcare systems characterized by fairness, accessibility, and ethical integrity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-023-10114-5. BioMed Central 2023-10-19 /pmc/articles/PMC10585732/ /pubmed/37858235 http://dx.doi.org/10.1186/s12913-023-10114-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Takruri, Adel
Nawajah, Inad
Jabari, Carol El
A mixed methods study of using wasta in healthcare services in Palestine: predictors, consequences and proposed solutions
title A mixed methods study of using wasta in healthcare services in Palestine: predictors, consequences and proposed solutions
title_full A mixed methods study of using wasta in healthcare services in Palestine: predictors, consequences and proposed solutions
title_fullStr A mixed methods study of using wasta in healthcare services in Palestine: predictors, consequences and proposed solutions
title_full_unstemmed A mixed methods study of using wasta in healthcare services in Palestine: predictors, consequences and proposed solutions
title_short A mixed methods study of using wasta in healthcare services in Palestine: predictors, consequences and proposed solutions
title_sort mixed methods study of using wasta in healthcare services in palestine: predictors, consequences and proposed solutions
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10585732/
https://www.ncbi.nlm.nih.gov/pubmed/37858235
http://dx.doi.org/10.1186/s12913-023-10114-5
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