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Besides the cultural obstacles, the clinic faces enormous logistical problems — maintaining a reliable supply of medications, for example, or trying to integrate its services, and psychiatry and counseling in general, with the larger Sierra Leonean health care system.
Pittman, a 58-year old Louisiana native who has worked at the center for 23 years, says the clinic faces the most acute crisis in its 36-year history.
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Following clinic face-to-face registration to collect self-reported demographic (including race/ethnicity) and behavioral information, clinicians performed physical examination of the genitalia among all male patients.
The results indicate that women demonstrated strongest positive preferences for a Breast Physician (followed by a Breast Cancer Nurse), 6-monthly visits, local breast cancer clinic, face-to-face attendance (followed by alternate face-to-face and telephone) and drop-in clinics for treatment side effects (followed by secondary prevention; all P<0.05).
Indeed, the efforts to open new clinics face considerable obstacles.
Patients at Charing Cross, and other NHS gender clinics, face more stringent criteria, including a two-year RLE.
When the District of Columbia decided to change to a managed care system for its Medicaid population in 1996, all the clinics faced a new way of doing business.
Africa's hospitals and clinics face a constant "brain drain" of doctors and nurses because Western aid agencies and countries elsewhere offer higher salaries.
The Espada clinics, faced with a loss of Medicaid financing earned through years of contempt by its management for audits, are being eroded.
Clinics face new inspection requirements, while employees who whistleblow on abortion clinics enjoy increased protections.
Kelli Jordan, a clinic escort in Charlotte, N.C., where abortion clinics face regular protests, said that "Across the Line" resonated deeply with her because of its portrayal of anti-abortion crisis pregnancy centers trying to lure patients away from the clinic.
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CEO of Professional Science Editing for Scientists @ prosciediting.com