scholarly journals 1535. Impact of Defunding Family Planning Health Centers on Gonorrhea and Chlamydia Cases in Iowa: A Spatiotemporal Analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S768-S768
Author(s):  
Megan L Srinivas ◽  
Eileen Yang ◽  
Weiming Tang ◽  
Joseph Tucker
Keyword(s):  
Family Planning ◽  
Low Income ◽  
Rural Areas ◽  
Spatiotemporal Analysis ◽  
Incidence Rates ◽  
Health Centers ◽  
Transmitted Infection ◽  
Missed Opportunities ◽  
Linear Regression Modeling ◽  
The Impact

Abstract Background Fifteen states have defunded family planning health centers (FPHCs), causing thousands to be left without health services. This has accelerated in the COVID-19 era. FPHCs provide low-income individuals in rural areas with essential primary care services, including sexually transmitted infection prevention, testing, and treatment. The purpose of this analysis is to use spatiotemporal methods to examine the impact of FPHC closures in Iowa on the reported number of gonorrhea and chlamydia cases at the county level. Methods This analysis investigates the association between FPHC closures and changes in the number of gonorrhea and chlamydia cases between 2016 and 2018. Iowa implemented defunding policies for family planning clinics, resulting in four FPHC closures in June 2017. 2016 pre-closure STI incidence rates were compared to 2018 post-closure rates. Gonorrhea and chlamydia rates in the four Iowa counties with clinic closures were compared to the 95 Iowa counties without closures. T tests were used to compare changes in reported gonorrhea and chlamydia rates in the two settings. Linear regression modeling was used to determine the relationship between clinic closures and changes in gonorrhea and chlamydia cases. Results The gonorrhea burden in Iowa increased from 83 cases per 100,000 people in 2016 to 153.8 cases per 100,000 people in 2018. The four counties with clinic closures experienced a significantly larger increase (absolute 217 cases per 100,000 population) in their gonorrhea rate compared to counties without FPHC closures (absolute 121 cases per 100,000 population). There was also a significant relationship between clinic closures and increasing gonorrhea rates (p = 0.0015). Over the three-year period, there was no change in chlamydia rates (p = 0.1182). However, there was a trend towards counties with more FPHC closures having a higher number of chlamydia cases (p = 0.057). Conclusion Despite the fact that many STI diagnoses are made and reported by FPHCs, our data suggest that clinic closures may have contributed to an increase in gonorrhea and chlamydia cases. This is consistent with delayed diagnoses and missed opportunities for providing essential STI services to vulnerable and under-served rural residents. Legislative action is urgently needed to curtail this trend. Disclosures All Authors: No reported disclosures

Intergroup Inequality in Wealth Ownership in Rural India: Caste, Tribe and Religion

2020 ◽  
Vol 6 (2) ◽  
pp. 117-132
Author(s):  
Nitin Tagade ◽  
Sukhadeo Thorat
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Agricultural Land ◽  
Wealth Inequality ◽  
Sample Survey ◽  
Rural India ◽  
Unequal Distribution ◽  
Majority Population ◽  
Intergroup Inequality ◽  
The Impact

In India, the rural economy still remains crucially important in the economic wellbeing of the majority population. The low income and high poverty in rural areas are closely associated with unequal distribution of income-earning assets, particularly agricultural land and non-land capital assets. In this article, therefore, we try to understand the intergroup inequality in wealth ownership across caste, ethnic and religious groups in rural India based on the 2013 data from the All India Debt and Investment survey carried out by National Sample Survey Office. The results indicate high interpersonal wealth inequality so also the intergroup wealth inequality at the aggregate level and by type of assets in rural India. The impact of caste on the ownership of wealth clearly indicates high ownership among Hindu high caste and Hindu other backward caste at the cost of low wealth share or ownership of the SC/ST indicating the existence of graded inequality.

Inequities in the allocation of medical resources in China’s Township Health Centers

2016 ◽  
Vol 8 (4) ◽  
pp. 637-646 ◽  
Author(s):  
Yue Ma ◽  
Linxiu Zhang ◽  
Matthew Boswell
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Rural China ◽  
Health Centers ◽  
Content Type ◽  
Representative Study ◽  
Use Of Data ◽  
Fixed Assets ◽  
Nationally Representative ◽  
Academy Of Sciences

Purpose The purpose of this paper is to produce a high-quality measure of the nature of healthcare resources available in China’s Township Health Centers (THCs), paying particular attention to equity between high- and low-income areas. Design/methodology/approach This study makes use of data from a nearly nationally representative survey in rural China conducted by the Center for Chinese Agricultural Policy at the Chinese Academy of Sciences in 2011. The samples of towns were selected randomly from 25 counties located in five provinces from different regions of China. Data were collected through questionnaires and direct observation. Findings The THCs located in rich areas have higher levels of human resources than poor areas. THCs in rich areas also have more fixed assets than those in poor areas. In fact, even though the Chinese Ministry of Health mandates that all THCs have certain basic levels of medical equipment and facilities, many THCs in poor areas do not have them. The allocation of mandated equipment is unequal. Practical implications These findings suggest that China’s government should pay more attention to THCs located in poor areas, especially in light of new initiatives to improve health care in poor rural areas. Originality/value This is the first nationally representative study to employ rigorous empirics to investigate the extent of inequality in allocation of resources within THCs across China.

scholarly journals Assessing women's satisfaction with family planning services in Mozambique

2016 ◽  
Vol 43 (3) ◽  
pp. 222-228 ◽  
Author(s):  
Leonardo Chavane ◽  
Martinho Dgedge ◽  
Patricia Bailey ◽  
Osvaldo Loquiha ◽  
Marc Aerts ◽  
...  
Keyword(s):  
Family Planning ◽  
Rural Areas ◽  
User Satisfaction ◽  
National Level ◽  
Quality Of Healthcare ◽  
Family Planning Services ◽  
Health Service Provision ◽  
Urban And Rural Areas ◽  
The Impact

BackgroundThe contraceptive prevalence rate in Mozambique was estimated as 11.3% in the last Demographic and Health Survey. The impact of family planning (FP) on women's health and on the reduction of maternal mortality is well known.MethodsAcknowledging the importance of user satisfaction in the utilisation of health services, exit interviews were used to assess women's satisfaction with FP services in Mozambique. The survey, conducted in 174 health facilities, was representative at the national level, covered all provinces, and both urban and rural areas.ResultsOverall, 86% of respondents were satisfied with FP services, but issues such as insufficient supplies of oral contraceptives and the low quality of healthcare provider/client interactions were given as reasons for women's dissatisfaction.ConclusionDefined actions at the level of health service provision are needed to tackle the identified issues and ensure improved satisfaction with, and better utilisation of, FP services in Mozambique.

scholarly journals THE INFLUENCE OF THE UNIVERSAL TWO-CHILD POLICY ON CHINA’S FUTURE AGING AND POPULATION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S706-S706
Author(s):  
Can Jia ◽  
Handong li
Keyword(s):  
Family Planning ◽  
Rural Areas ◽  
Leslie Matrix ◽  
Chinese Government ◽  
Growth Trend ◽  
Family Planning Policy ◽  
Registration System ◽  
Planning Policy ◽  
Child Policy ◽  
The Impact

Abstract China’s aging situation is becoming more and more prominent, and both the people and the government are facing unprecedented pressure of providing for the aged. For this reason, the Chinese government began implementing a new family planning policy for couples to have two children since 2016 (referred to as “universal two-child policy”). In order to explore the impact of the newly released policy, our research is based on the sixth census of China. And first, we use the cohort-component method and a Leslie matrix to construct the population prediction model. Considering some certain unique factors in China, such as the significant urban-rural dual structure and the household registration system and so on, we divide the total fertility rate into urban and rural areas which fully reflects the characteristics of China’s family planning policy. Then we predict and analyze the number and structure of China population between 2011 and 2050 based on the three scenarios of high, medium and low. And the results show that the Chinese population will present an inverted pyramid structure, and the population structure will continue to deteriorate. Besides, we adapt three indicators to analyze the aging trend in China, namely, the old-age coefficient, the population aging index, and the social dependency ratio. And the three indicators of China will continue to grow under the universal two-child policy with different changing rate, which means, the newly released policy will not change China’s aging population growth trend and the severity of China’s aging.

scholarly journals Climate shocks and human capital: The impact of the natural disasters of 2010 in Colombia on student achievement

2020 ◽  
Vol 39 (79) ◽  
pp. 303-328
Author(s):  
Mauricio Giovanni Valencia Amaya
Keyword(s):  
Human Capital ◽  
Low Income ◽  
Rural Areas ◽  
Test Scores ◽  
Standardized Test ◽  
Female Students ◽  
Capital Costs ◽  
Low Income Families ◽  
Climate Shocks ◽  
The Impact

This paper investigates the impact of the unprecedented climate shocks of the 2010 in Colombia on the results of the Saber 11 standardized test for the 2010- 2012 period. By using two unique datasets, this paper contributes to the literature by providing a better estimate of the human capital costs of climate shocks. The findings indicate that the climate shocks occurred on 2010 decreased Saber 11 test scores. The impact was stronger for female students, students from rural areas and students from low-income families. A possible channel of transmission is identified: the destruction of schools.

scholarly journals A qualitative exploration of the impact of COVID-19 on food decisions of economically disadvantaged families in Northern Ireland

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eleni Spyreli ◽  
Michelle C. McKinley ◽  
Jayne V. Woodside ◽  
Colette Kelly
Keyword(s):  
Northern Ireland ◽  
Low Income ◽  
Rural Areas ◽  
Meal Preparation ◽  
Fresh Food ◽  
Food Decisions ◽  
Low Income Families ◽  
Meal Planning ◽  
Urban And Rural Areas ◽  
The Impact

Abstract Background The first UK-wide lockdown to prevent the spread of COVID-19 had a serious financial impact on low-income households, a population already in higher risk of food insecurity and poor dietary choices. Qualitative data on the impact of COVID-19 lockdown on food decisions of UK families are scarce. This study aimed to explore how the measures to control the spread of COVID-19 influenced the food-related decisions of socioeconomically deprived families in Northern Ireland. Methods A qualitative study captured data from online individual interviews. Participation was open for parents of children 2–17 years old living on a tight budget in urban and rural areas of Northern Ireland. A sampling matrix enabled equal representation of single- and two-parent households, as well as parents of younger children (<12y) and adolescents (≥12y). Data were collected by using the methods of Photovoice and mapping exercise. Data were analysed through a thematic approach. Results Twelve online interviews were conducted and five distinct themes were identified reflecting families’ food-related decisions that were affected by the COVID-19 lockdown: 1) food planning; 2) food purchasing; 3) meal preparation; 4) eating and feeding behaviours and 5) eating food prepared outside the house. Conclusions The restrictions put in place to inhibit the spread of COVID-19 influenced all aspects of dietary decisions of low-income families. Changes observed during this period included frequent consumption of homemade meals, but also increased unhealthy snacking. Infrequent food shopping encouraged good meal planning, but was also a barrier to securing adequate fresh food. Food-related support including school meal assistance contributed to families’ food security, particularly those of single parents.

scholarly journals Food Decisions of Low-Income Families in the Era of COVID-19: A Qualitative Exploration

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 250-250
Author(s):  
Eleni Spyreli ◽  
Michelle McKinley ◽  
Jayne Woodside ◽  
Colette Kelly
Keyword(s):  
Northern Ireland ◽  
Low Income ◽  
Rural Areas ◽  
Economically Disadvantaged ◽  
Food Shopping ◽  
Food Planning ◽  
Low Income Families ◽  
The Government ◽  
The Impact ◽  
Disadvantaged Families

Abstract Objectives The first lockdown enforced in the United Kingdom to limit the spread of COVID-19 had serious financial consequences for some lower-income households, which were already at risk of suboptimal food choices. Particularly in Northern Ireland, where 10% of the population live in food insecure households, the pandemic has potentially further exacerbated the nutritional challenges experienced by low-income families. This paper aimed to explore the impact of the COVID-19 lockdown on food-related decisions as experienced by economically disadvantaged families in Northern Ireland, UK. Methods A qualitative study collected data through online individual interviews. Participation was open to parents of children 2–17 years old who self-identified as living on a tight budget in urban and rural areas of Northern Ireland. A sampling matrix enabled equal representation of single- and two-parent households, as well as younger (&lt;12 y) and older children (&gt;12 y). Photovoice and participatory mapping techniques were employed to capture participant data. A thematic approach was utilised for data analysis. Results A total of 12 interviews were conducted. Five distinct themes were found, reflecting families’ food-related decisions that were affected by the COVID-19 lockdown: 1) food planning; 2) food purchasing; 3) meal preparation; 4) eating and feeding behaviours and 5) eating food prepared outside the house. Changes included an increase in home food preparation, but also in unhealthy snacking. Fear of being exposed to carriers of the virus led to infrequent food shopping and greater reliance on supermarket home deliveries. Long waiting times in-between food shops encouraged food planning but were also a barrier to providing daily fresh foods including fruit and vegetables to their families. Financial constraints were exacerbated during lockdown and led to a search for new ways to budget when food shopping. Food donations from the community and the government were important to maintain food security, particularly in single-parent families. Conclusions This study highlights that the COVID-19 lockdown influenced a broad range of dietary decisions of economically disadvantaged families and offers an insight into the nutritional challenges they experienced. Funding Sources The work was completed with financial support from internal funds of Queens University Belfast.

scholarly journals Does Energy Poverty Reduce Rural Labor Wages? Evidence From China’s Rural Household Survey

2021 ◽  
Vol 9 ◽  
Author(s):  
Wei-ping Wu ◽  
Wei-kang Zeng ◽  
Si-wen Gong ◽  
Zi-gui Chen
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Health Effect ◽  
Marginal Effect ◽  
Skilled Workers ◽  
Regional Heterogeneity ◽  
Energy Poverty ◽  
Rural Labor ◽  
Rural Workers ◽  
The Impact

Eliminating energy poverty is helpful to get rid of the vicious circle between the lack of adequate and affordable energy services and low income in rural areas. We deconstruct energy poverty into extensive energy poverty and intensive energy poverty and analyze the net effect and its heterogeneity of energy poverty on rural labor wages with micrometric methods, as well as further investigate the impact mechanism from education effect and health effect. The results show that both extensive energy poverty and intensive energy poverty have a significant negative effect on the wages of rural workers, and the marginal effect of extensive energy poverty on the wages of rural workers is lower than that of intensive energy poverty. In addition, the net effect of energy poverty on the wages of rural workers shows labor heterogeneity and regional heterogeneity, and the inhibition effect to low skilled workers and workers with middle wage and in the Western region is the most obvious. Furthermore, energy poverty will limit the access of rural workers to education and damage their health, and then inhibit their productivity and wage. Our results suggest that enhancing the accessibility of energy consumption in rural areas and reducing the incidence of energy poverty are critically essential, and the implementation and optimization of energy poverty alleviation policy should give full consideration to labor force heterogeneity and regional heterogeneity.

scholarly journals Implementation of Adolescent and Youth Friendly Health Services in a Rural Region of Tigray, Ethiopia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Cigliano ◽  
H Gebremichael ◽  
K Teklay ◽  
B Ayele ◽  
D Negash ◽  
...  
Keyword(s):  
Family Planning ◽  
Young People ◽  
Health Services ◽  
Sex Education ◽  
Low Income ◽  
Public Health Problem ◽  
Health Centers ◽  
Low Income Countries ◽  
Sexual Life ◽  
Youth Friendly

Abstract Background The Eastern Zone of the Tigray (Ethiopia) is inhabited by 900,000 people, 34% of whom are adolescents and young people between 10-24 years of age, who are easily influenced by the social and family context and are exposed to significant health risks associated with the earliness of their approach to sexual life. Nonetheless, even if a complete health service is available, the quality is often undermined by the lack of the so-called Youth-Friendly Corners (high confidentiality spaces reserved for young people), promoted internationally by WHO. The aim of the study is to evaluate the effectiveness of the program established in this zone by the Medical Collaboration Committee regarding the creation of friendly health services for adolescent and youth people (AYFHS), especially built for sex education, family planning, abortion, and sexual transmitted infection (STI) prevention. Methods The program “#Youths at the centre!” was implemented in 20 rural health centers in the North-East Tigray on April 2018. Data from these AYFHS were collected monthly in aggregated indicators, separated for gender and age class. Use of AYFHS during 2018 and 2019 was assessed using percentage and 95% confidence interval and the period of implementation of the project and centers' characteristics were analyzed to investigate differences in AYFHS utilization. Results A monthly mean of 6.04% (6.01% - 6.08%) of adolescents and young people utilized an AYHFS for any of its service; 0.03% accessed for counseling, diagnosis, and treatment of STI, 1.31% for family planning, 1.09% for delivery, and 0.05% for legal abortion. Lower level of utilization was observed in more remote health centers, despite a general increase across the study period. Conclusions This project shows the importance of providing friendly facilities dedicated to adolescents and youth in low-income countries, in order to increment the utilization of health services from this population, especially in rural contexts. Key messages In rural areas of Africa the risks associated with poor health information of young people and the earliness of the beginning of sexual life remain a Public Health problem. In low income countries the presence of high confidentially spaces for young people in the Health Services could increase their utilization, especially for sex education and family planning.

scholarly journals Assessing clinical quality performance and staffing capacity differences between urban and rural Health Resources and Services Administration-funded health centers in the United States: A cross sectional study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242844
Author(s):  
Nadereh Pourat ◽  
Xiao Chen ◽  
Connie Lu ◽  
Weihao Zhou ◽  
Hank Hoang ◽  
...  
Keyword(s):  
United States ◽  
Low Income ◽  
Rural Areas ◽  
Health Resources ◽  
Quality Measures ◽  
The United States ◽  
Health Centers ◽  
Quality Performance ◽  
Clinical Quality

Background In the United States, there are nearly 1,400 Health Resources and Services Administration-funded health centers (HCs) serving low-income and underserved populations and more than 600 of these HCs are located in rural areas. Disparities in quality of medical care in urban vs. rural areas exist but data on such differences between urban and rural HCs is limited in the literature. We examined whether urban and rural HCs differed in their performance on clinical quality measures before and after controlling for patient, organizational, and contextual characteristics. Methods and findings We used the 2017 Uniform Data System to examine performance on clinical quality measures between urban and rural HCs (n = 1,373). We used generalized linear regression models with the logit link function and binomial distribution, controlling for confounding factors. After adjusting for potential confounders, we found on par performance between urban and rural HCs in all but one clinical quality measure. Rural HCs had lower rates of linking patients newly diagnosed with HIV to care (74% [95% CI: 69%, 80%] vs. 83% [95% CI: 80%, 86%]). We identified control variables that systematically accounted for eliminating urban vs. rural differences in performance on clinical quality measures. We also found that both urban and rural HCs had some clinical quality performance measures that were lower than available national benchmarks. Main limitations included potential discrepancy of urban or rural designation across all HC sites within a HC organization. Conclusions Findings highlight HCs’ contributions in addressing rural disparities in quality of care and identify opportunities for improvement. Performance in both rural and urban HCs may be improved by supporting programs that increase the availability of providers, training, and provision of technical resources.

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