THE ASSOCIATION BETWEEN FAMILY STRUCTURE, REPORTS OF ILLNESS AND HEALTH CARE DEMAND FOR CHILDREN: EVIDENCE FROM RURAL BANGLADESH

2009 ◽  
Vol 41 (5) ◽  
pp. 645-659 ◽  
Author(s):  
ATONU RABBANI ◽  
G. CALEB ALEXANDER

SummaryAccess to health care in lesser-developed countries is often quite limited, especially in rural areas. However, less is known about how different factors, such as household structure, parental income and parental education, modify such access to care. This study uses individual-level data from rural Bangladesh during and following a period of major flooding to examine factors associated with reports of illness and demand for doctors in households with children less than 10 years of age. Using information about the number of children who were reported sick and also those who were taken to a doctor, a model was estimated for such reports and decisions to visit a doctor. Overall, 74% of households reported an illness in a child during the study period. The likelihood of reports was significantly greater for boys (36%) than girls (31%). In most analyses, there was no association between parental education and reports of child illness after adjusting for village- and household-level heterogeneity. However, in analyses limited to female children, greater education of the household head was associated with lower odds of such a report (odds ratio [OR] 0.95, 95% confidence interval [CI] 0.91–1.00). Parental education and income were also related to household decisions to seek medical care, though results once again differed based on the sex of the child. There was a particularly strong effect between maternal education level and demand for medical care for boys (OR 1.13; CI 1.01–1.27), though not for girls (OR 0.96; CI 0.84–1.09). Overall, the likelihood of a doctor's visit for a sick child was positively related to household income and at the highest levels of income was a virtual certainty.

2020 ◽  
Vol 15 (3) ◽  
pp. 88-93
Author(s):  
Sergey Budarin ◽  
Yuliya El'bek

The potential for improving the efficiency of medical organizations that provide medical care to the population in conditions of limited resources largely depends on an objective and comprehensive assessment of their use. In this regard, the research of methodological and practical approaches to assessing the efficiency and rational use of resource potential, which are important for different levels of the organization of the health system, including the provision of medical care to citizens living in rural areas, is of particular relevance. The purpose of the study was to determine the relationship between indicators for assessing the quality of resource management and indicators of access to medical care of medical organizations of the state health system in Moscow that provide primary health care to adults in 2019. The quality of resource management was assessed using 27 indicators selected for the purpose of the study in 4 areas of resource management (financial management, procurement management, property management, personnel management), provided by the methodology of the resource management quality standard (RMQS). For each indicator, the calculated score based on the importance value (weight value) a normative criterion of evaluation and the degree of difficulty, and by summing up of scores obtained a composite score. The assessment of the availability of medical care is also calculated using the method of point estimates based on 7 indicators developed through the use of the methodology of performance audit. The article presents the results of a study based on data from 9 Moscow city polyclinics, which confirmed the existence of a correlation between the selected indicators of the quality of resource management and the availability of medical care. The total score for 2019 for the selected indicators of resource management quality varies from 9.62 points to 13.92 points, availability-from 5.54 to 11.63 points, and the correlation coefficient was 0.612


2019 ◽  
Author(s):  
Lunic Base Khoza ◽  
Wilfred Njabulo Nunu ◽  
Bumani Solomon Manganye ◽  
Pfungwa Mambanga ◽  
Shonisani Tshivhase ◽  
...  

Abstract Background Despite government efforts to improve access to health care services through the re-engineered Primary Health Care and National Health insurance platform, access still remain a challenge particularly in rural areas. The aim of this study was to analyse secondary data on cataract patients who were attended to in selected hospitals in rural Limpopo of South Africa. Methodology A cross section survey was conducted on 411 patient records from five selected hospitals in Vhembe district. A pre tested structured checklist was used to guide retrieval of variables from patient records. The collected data was entered into excel spreadsheet, cleaned and imported into Statistical Package for Social Sciences version 26 for analysis. Proportions of demographic characteristics were presented and these were cross tabulated with the outcome variable “success of operation” using Chi Squared tests. Results Findings point out that majority of patients who attended hospital for eye services were aged 65 years above and females (63%). There was no association between the tested demographic characteristics and the outcome variable. Most patients were diagnosed in the period 2015-2018 (60%). Over 90% of those that were operated had successful operations. Of the remaining 10% that had unsuccessful operations, 30% cited complications as being the reason why these operations were unsuccessful. Conclusions It is evident from the findings that cataract services offered in rural areas have low impact as they are not accessible to the patient. It is critical to have a worker retention strategy to retain experts.


Author(s):  
Douglas C. Haldeman

Sexual minority and gender-diverse (SM/GD) persons experience depression, anxiety, suicidality, and substance use issues at a disproportionate rate when compared with heterosexuals. Stigma, minority stress, and prejudicial social attitudes and institutional policies are viewed as the reason for this. The disparities in access to health care for SM/GD persons is significant and is perceived as due to lack of access to competent care as well as mistrust of health care professionals on the part of SM/GD persons. SM/GD teens and elders, as well as individuals with low socioeconomic status, those living in rural areas, and those with disabilities, are particularly vulnerable. Recommendations for changes in health care policy, as well as strategies for improving the cultural competence of health care providers and evidence-based treatments, are discussed. Additionally, further research, standardizing health care training to include SM/GD persons, prevention, and inter-organizational advocacy are recommended.


2011 ◽  
pp. 1574-1580
Author(s):  
Michele Masucci

E-health has rapidly gained attention as a framework for understanding the relationship between using information and communication technologies (ICTs) to promote individual and community health, and using ICTs for improving the management of health care delivery systems. The use of e-collaborative tools is implicit to the delivery and access of e-health. Development of the capacity to transmit and receive digital diagnostic images, use video telecommunications for supporting the remote delivery of specialized care and surgical procedures, and the use of e-communication technologies to support logistical elements of medical care (such as scheduling appointments, filling prescriptions, and responding to patient questions) are just a few ways in which e-communications are transforming how medical care is embedded within institutional, organizational, family, and community settings. The emerging field of e-collaboration focuses attention on the need for society to critically examine how electronic communication technologies facilitate, shape, and transform the ways in which organizations, groups, and communities interact. There are many works that explain how to (a) develop e-health systems, (b) assess the use of such systems, and (c) analyze the health outcomes that can be achieved with effective e-health applications (Brodie et al., 2000; Eder, 2000; Spil & Schuring, 2006). Less attention has been paid to how advances in e-collaboration research might inform e-health applications development and scholarly discourse. Because of this gap in the literature, few discussions pertain to understanding patient perspectives about the advantages and disadvantages that may result from rapidly emerging interconnections among access to health care, health information, health support systems, and ICTs (Berland et al., 2001; Hesse et al., 2005; Gibbons, 2005; Gilbert & Masucci, 2006).


2019 ◽  
Vol 25 (12) ◽  
pp. 1-9
Author(s):  
Nenavath Sreenu

At present, the development of healthcare infrastructure in India is poor and needs fundamental reforms in order to deal with emerging challenges. This study surveys the growth of the healthcare infrastructure. The development of infrastructure and health care facilities, the position of the workforce, and the quality of service delivery are important challenges that are confronting healthcare centres in rural India. This article critically analyses the future challenges of Indian healthcare infrastructure development in rural areas, discussing the burden of disease, widespread financial deficiency, the vaccination policy and poor access to health care as some of the main issues. Life expectancy, literacy and per capita income are further considerations.


2020 ◽  
pp. 205141582090319
Author(s):  
Kerri Keet ◽  
Brandon Michael Henry ◽  
R Shane Tubbs

Background: Prune-belly syndrome is a rare congenital disorder characterized by a spectrum of three anomalies: bilateral undescended testes, dilated urinary tract, and anterior abdominal muscle deficiency. Objectives: In developing countries, inadequate access to health care may affect treatment and outcomes of prune-belly syndrome. This study’s goal was to review the anatomical features, etiology, genetics, management, and outcomes of cases in Africa. Methods: PubMed was searched to identify case reports and case studies describing prune-belly syndrome in Africa. Data collected from each study included the number of cases, age at diagnosis, sex, description of the abdominal muscles, testes, and urinary tract, as well as associated anomalies, management, and long-term outcomes. Results: A total of 16 publications that reported 58 cases in African countries were included. The prevalence of female patients (15.5%) was higher than in developed countries (3%). The abdominal muscles were deficient in all cases, and bilateral cryptorchidism was present in nearly all males (96%). Distension of the bladder was common, with normal anatomy reported in only one case. Bilateral hydroureters and hydronephrosis also were present in the majority of cases. Only six cases (10.3%) had no associated anomalies, such as musculoskeletal or cardiovascular. Karyotyping was performed in only three cases (5.2%) because of limited hospital facilities. Six parents (10.3%) declined treatment for their children, 12 cases (20.7%) were managed conservatively, and 25 (43.1%) received surgical intervention. Patients’ mortality rate was higher than in developed countries. Conclusion: Diagnosis and treatment of prune-belly syndrome remains a challenge in Africa, in which multiple factors, such as access to health care and cultural beliefs, affect mortality rates and outcomes. Patient education and support groups may improve compliance with treatment. Level of evidence: Not applicable for this multicenter audit.


2017 ◽  
Vol 43 ◽  
pp. 104-112 ◽  
Author(s):  
Julia T. Caldwell ◽  
Chandra L. Ford ◽  
Steven P. Wallace ◽  
May C. Wang ◽  
Lois M. Takahashi

1994 ◽  
Vol 51 (3) ◽  
pp. 337-377 ◽  
Author(s):  
Robert A. Connor ◽  
John E. Kralewski ◽  
Steven D. Hillson

2016 ◽  
Vol 23 (1) ◽  
pp. 188-194 ◽  
Author(s):  
Sylvain Bussières ◽  
Alain Tanguay ◽  
Denise Hébert ◽  
Richard Fleet

Access to health care in Canada’s rural areas is a challenge. The Unité de Coordination Clinique des Services Préhospitaliers d’Urgence (UCCSPU) is a telemedicine program designed to improve health care in the Chaudiere-Appalaches and Quebec City regions of Canada. Remote medical services are provided by nurses and by an emergency physician based in a clinical unit at the Alphonse-Desjardins Community Health and Social Services Center. The interventions were developed to meet two objectives. The first is to enhance access to quality health care. To this end, Basic Life Support paramedics and nurses were taught interventions outside of their field of expertise. Prehospital electrocardiograms were used to remotely diagnose ST segment elevation myocardial infarction and to monitor patients who were en route by ambulance to the nearest catheterization facility or emergency department. Basic Life Support paramedics received extended medical authorization that allowed them to provide opioid analgesia via telemedicine physician orders. Nurses from community health centres without physician coverage were able to request medical assistance via a video telemedicine system. The second objective is to optimize medical resources. To this end, remote death certifications were implemented to avoid unnecessary transport of deceased persons to hospitals. This paper presents the telemedicine program and some results.


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