UNMET NEED FOR ADDITIONAL MEDICAL CARE FOR SICK CHILDREN IN MOTHER’S VIEW IN RURAL BANGLADESH: IMPLICATIONS FOR IMPROVING CHILD HEALTH SERVICES

2007 ◽  
Vol 39 (5) ◽  
pp. 769-778 ◽  
Author(s):  
NURUL ALAM
Keyword(s):  
Health Services ◽  
Medical Care ◽  
Unmet Needs ◽  
Unmet Need ◽  
Chronic Illnesses ◽  
Rural Bangladesh ◽  
Medical Needs ◽  
Poor Households ◽  
Sick Children ◽  
Unmet Medical Needs

SummaryWhile a country’s health policy aims to provide health services to all who need them, very little in known about unmet need for additional medical care from users’ perspectives in Bangladesh. This study examined unmet medical need (defined as whether a mother felt that, to manage sickness, her child had required medical care that was not available, regardless of reasons and medical care sought) of 2123 under-15 sick children by illness and child’s socioeconomic characteristics in rural Bangladesh. The 1996 Health and Socioeconomic Survey conducted in Matlab recorded children’s chronic (a disease or a condition lasting 3 months or more) and acute (a disease or a condition with a rapid onset and a short, severe course) morbidity, medical care sought to combat illness and unmet needs for additional medical services in mothers’ views to manage the illness. The survey also recorded household socioeconomic data. Logistic regression was used to examine the data. The results reveal that unmet needs for additional medical care were 5·4% for children with acute illnesses, and 30·2% for children with chronic illnesses. For chronic illnesses, seeking medical care to manage illness from any health provider outside the home reduced unmet medical needs. Economic inequalities existed for both acute and chronic illnesses: the odds ratio of unmet medical needs for sick children of the least poor households was 0·42 (95% CI: 0·28–0·64) times that for sick children of the very poor households. The critically high unmet needs for children’s chronic morbidity reveal that the chronic disease control programme in Bangladesh needs urgent revisiting and strengthening.

scholarly journals 1770. The Association of Unmet Needs With Subsequent Retention in Care and HIV Suppression Among Hospitalized Patients With HIV Who Are Out of Care

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S65-S66
Author(s):  
Dima Dandachi ◽  
Sarah May ◽  
Jessica Davila ◽  
Jeffrey Cully ◽  
K Rivet Amico ◽  
...  
Keyword(s):  
Viral Load ◽  
Dental Care ◽  
Unmet Needs ◽  
Unmet Need ◽  
Retention In Care ◽  
Hospitalized Patients ◽  
Hiv Care ◽  
Medical Needs ◽  
Retention In Hiv Care ◽  
Housing Needs

Abstract Background Unmet needs among hospitalized patients with HIV may prevent engagement in HIV care leading to worse clinical outcomes. Our aim was to examine the role of unmet subsistence needs (e.g., housing, transportation, food) and medical needs (e.g., mental health, substance abuse treatment) as barriers for retention in HIV care and viral load (VL) suppression. Methods We utilized data from the Mentor Approach for Promoting Patients’ Self-Care intervention study, the enrolled hospitalized HIV-patients at a large publicly funded hospital between 2010 and 2013, who were out-of-care. We examined the effect of unmet needs on retention in HIV care (attended HIV appointments within 0–30 days and 30–180 days) and viral load suppression, 6 months after discharge. Results A total of 417 participants were enrolled, 78% reported having ≥1 unmet need at baseline, most commonly dental care (55%), financial (43%), or housing needs (34%). Participants with unmet needs at baseline, compared with those with no needs, were more likely to be African American, have an existing HIV diagnosis, and be uninsured. Among participants who completed a baseline and 3-month survey (n = 320), 45% reported a need for dental care, 42% reported financial needs, and 32% reported housing needs that were unmet at either time point (Figure 1). Having a dental care need at baseline that was met was significantly associated with higher odds of VL improvements at 6-month follow-up (OR: 2.2; 95% CI: 1.04–4.50, P = 0.03) and higher odds for retention in care (OR: 2.06; 95% CI: 1.05–4.07, P = 0.04). An unmet need for transportation was associated with lower odds of retention in care (OR: 0.5; 95% CI: 0.34–0.94, P = 0.03), even after adjusting for other factors. Compared with participants with no need, those who reported ≥3 unmet subsistence needs were less likely to demonstrate viral load improvement (OR: 0.51; 95% CI: 0.28–0.92; P = 0.03) and to be retained in care (OR: 0.52; 95% CI: 0.28–0.95; P = 0.03). Conclusion An important and novel finding in our study is that the number of unmet subsistence needs had a significant effect on retention in care and VL suppression. Broader access to programs that can assist in meeting subsistence needs among hospitalized patients could have significant individual and public health benefits. Disclosures All authors: No reported disclosures.

scholarly journals Non-communicable diseases among refugees claimants in Greek refugee camps—are their care needs met?

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S S Jervelund ◽  
O Nordheim ◽  
T Stathopoulou ◽  
T A Eikemo
Keyword(s):  
Medical Care ◽  
Communicable Diseases ◽  
Refugee Camps ◽  
Care Needs ◽  
Non Communicable Diseases ◽  
Medical Needs ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
Refugee Claimants ◽  
Unmet Medical Needs

Abstract Background Little is known about the prevalence of non-communicable diseases (NCDs) among newly arrived refugees in Europe and whether their medical needs are met. The objective of this study was to investigate patterns of NCDs as refugee claimants migrate, whether refugee claimants experience unmet healthcare needs before, during and after flight when living in Greek refugee camps and to elucidate sociodemographic determinants for unmet medical care needs in the Greek refugee camps. Methods Survey data collected in 2016 among 267 newly arrived adult asylum-seekers staying at six refugee camps in Greece was used. The survey was available in English, Arabic and Farsi. We inspected frequency distributions of NCDs and unmet medical care needs, and using multiple logistic regression analysis, we estimated determinants for unmet medical needs in Greece. Results The majority had a good or fair self-reported health; yet, 17.1% suffered from 1 NCD, while 42.1% suffered from 2 or more NCDs. The most prevalent reported NCDs in Greece were: back or neck pain (26.6%) and severe headache (24.7%). The prevalence of most NCDs in the migration phases followed a U- or J-shaped pattern: decreased during migration and increased after migration to Greece. Unmet medical care needs were reported by 41.3% with one NCD after arrival in Greece. Compared with young adults, adults aged 51+ years were in increased risk of reporting unmet medical needs in Greece [odds ratio = 7.59; p = 0.015]. Conclusions The high number of persons who report NCDs underscore the need for availability of diagnostic tools and agents to ensure that the refugee claimants receive the right healthcare assistance. Tools and guidelines to provide continuity of NCD care when people migrate are likewise important. Many European countries that receive this group of refugees should take the disease patterns, including multi-morbidity, into consideration when planning for health reception and the organization of healthcare. Key messages The prevalence of NCDs among refugee claimants decreased during migration and increased after migration to Greece. Unmet medical care needs were reported by 41.3% with one NCD after arrival in Greece.

Wishes and worries of haemophilia patients

2017 ◽  
Vol 37 (02) ◽  
pp. 117-126
Author(s):  
Herbert Lechner ◽  
Anja Schleiermacher ◽  
Karin Berger ◽  
Dorothee Schopohl ◽  
Wolfgang Schramm
Keyword(s):  
Medical Care ◽  
Psychosocial Support ◽  
Age Groups ◽  
Future Health ◽  
Medical Needs ◽  
Current State ◽  
Care And Support ◽  
High Level ◽  
Unmet Medical Needs ◽  
Improve Health

SummaryHaemophilia care in Germany has achieved a high level and enables the majority of patients to lead a largely normal life. The Bluter Betreuung Bayern e.V. (BBB) aims to improve health care and support for haemophilia patients. A questionnaire has been developed by BBB representatives to evaluate unmet medical needs from the patient perspective. It was sent to 290 haemophilia patients and/or their parents in Bavaria in November 2015. The response rate was 51.4 %: 66 children aged < 15 years (66.7 % severe), 30 patients 15–24 years (66.7 % severe), 26 patients 25–44 years (80.8 % severe), 24 patients > 44 years (95.8 % severe). Prophylactic therapy in patients with severe haemophilia aged < 25 and ≥ 25 years is given “always” in ≥ 80 % and > 60 %, respectively. Substitution therapy is mostly uncomplicated. Satisfaction with medical care is high. Chronic pain is a problem with increasing age. Patients aged 25–44 years worry least regarding future health, safety and availability of factor products, patients > 44 years most. Overall, 80–100 % of the patients from all age groups are interested in information on the current state of science. Offers of the BBB for psychosocial support in addition to the medical care seem to be helpful and needed in all age groups.

scholarly journals Integration of reproductive health services for men in health and family welfare centers in Bangladesh

2004 ◽  
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Medical Care ◽  
Care Delivery ◽  
Family Welfare ◽  
Modern Contraceptive ◽  
Reproductive Health Services ◽  
Contraceptive Methods ◽  
Medical Needs ◽  
District Hospitals

Since the mid-1970s, the Bangladesh national family planning program primarily focused on motivating women to use modern contraceptive methods and encouraging them to seek services from clinics. In addition, female field workers were recruited to deliver contraceptive methods at homes. The program design facilitated women’s access to information and medical care through clinics and home visits. In the process, however, the medical needs of males were marginalized. Men generally seek services from pharmacies, private practitioners, and district hospitals, and often ignore preventive steps and postpone seeking medical care for chronic health conditions. In cases of acute illness, they often resort to self-medication. As noted in this report, the study’s aim was to integrate male reproductive health services within the existing government female-focused health-care delivery system. The study concluded that reproductive health services for men could easily be integrated into the health and family welfare centers without affecting the clinics’ focus on serving women and children.

scholarly journals Unmet Medical Needs in Ulcerative Colitis: An Expert Group Consensus

2019 ◽  
Vol 37 (4) ◽  
pp. 266-283 ◽  
Author(s):  
Silvio Danese ◽  
Matthieu Allez ◽  
Ad A. van Bodegraven ◽  
Iris Dotan ◽  
Javier P. Gisbert ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Unmet Needs ◽  
Unmet Need ◽  
Incidence Rates ◽  
Cochrane Library ◽  
Future Research ◽  
Extensive Literature ◽  
Expert Group ◽  
Medical Needs ◽  
Modified Delphi

Background: The authors aimed to conduct an extensive literature review and consensus meeting to identify unmet needs in ulcerative colitis (UC) and ways to overcome them. UC is a relapsing and remitting inflammatory bowel disease with varied, and changing, incidence rates worldwide. UC has an unpredictable disease course and is associated with a high health economic burden. During 2016 and 2017, a panel of experts was convened to identify, discuss and address areas of unmet need in UC. Methods: PubMed and Cochrane Library databases were searched for relevant articles describing studies performed in patients with UC. These findings were used to generate a set of statements relating to unmet needs in UC. Consensus on these statements was then sought from a panel of 9 expert gastroenterologists using a modified Delphi review process that consisted of anonymous surveys followed by live meetings. Results: In 2 literature reviews, over 5,000 unique records were identified and a total of 138 articles were fully reviewed. These were used to consider 26 areas of unmet need, which were explored in 2 face-to-face meetings, in which the statements were debated and amended, resulting in consensus on 30 final statements. The unmet needs identified were categorised into 7 areas: impact of UC on patients’ daily life; importance of early diagnosis and treatment; drawbacks of existing treatments; urgent need for new treatments; and disease-, practice- or patient-focused unmet needs. Conclusions: These expert group meetings found a number of areas of unmet needs in UC, which is an important first step in tackling them in the future. Future research and development should be focused in these areas for the management of patients with UC.

scholarly journals Multi-criteria decision analysis as a tool for evaluation of unmet needs in health care

2018 ◽  
Vol 51 ◽  
pp. 02001
Author(s):  
Diana Araja
Keyword(s):  
Health Care ◽  
Decision Analysis ◽  
Universal Health Coverage ◽  
Health Care Services ◽  
Unmet Needs ◽  
Health Coverage ◽  
Medical Needs ◽  
Care Services ◽  
Unmet Medical Needs ◽  
Universal Health

The United Nations Sustainable Development Goals appoint that all Member States have agreed to try to achieve Universal Health Coverage by 2030. This includes financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines for all. The World Health Organisation has defined the Universal Health Coverage as a priority, which means that all people can use the preventive, curative, rehabilitative and palliative health care services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship. The classic approach of the unmet medical needs is defined as the total self-reported unmet needs for medical care for the following three reasons: financial barriers, waiting times, too far to travel. According to the Eurostat data, overall range of unmet medical needs in Latvia is the highest of the European Union countries, however, the accessibility of health services depends on a multitude of factors that relate to the health system and also to the patients themselves. Therefore the Multi-criteria decision analysis approach could be acceptable for assessment of the unmet medical needs. The data on unmet medical needs for Latvia should be additionally evaluated, taking into account the “therapeutic need”, which refers to the need for a better treatment than the treatment currently reimbursed, from the perspective of the patient. Apart from therapeutic need, the concept of societal need should be investigated, which refers to the need for a better treatment than the currently available treatment for societal reasons.

The Special Perils of Being Old and Sick in Prison

2020 ◽  
Vol 32 (5) ◽  
pp. 276-284
Author(s):  
William J. Jefferson
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Health Care Providers ◽  
The United States ◽  
United States Constitution ◽  
Care Providers ◽  
Medical Practitioners ◽  
Medical Needs ◽  
Access To Medical Care

The United States Supreme Court declared in 1976 that deliberate indifference to the serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain…proscribed by the Eighth Amendment. It matters not whether the indifference is manifested by prison doctors in their response to the prisoner’s needs or by prison guards intentionally denying or delaying access to medical care or intentionally interfering with treatment once prescribed—adequate prisoner medical care is required by the United States Constitution. My incarceration for four years at the Oakdale Satellite Prison Camp, a chronic health care level camp, gives me the perspective to challenge the generally promoted claim of the Bureau of Federal Prisons that it provides decent medical care by competent and caring medical practitioners to chronically unhealthy elderly prisoners. The same observation, to a slightly lesser extent, could be made with respect to deficiencies in the delivery of health care to prisoners of all ages, as it is all significantly deficient in access, competencies, courtesies and treatments extended by prison health care providers at every level of care, without regard to age. However, the frailer the prisoner, the more dangerous these health care deficiencies are to his health and, therefore, I believe, warrant separate attention. This paper uses first-hand experiences of elderly prisoners to dismantle the tale that prisoner healthcare meets constitutional standards.

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