Factors influencing the decision to drop out of health insurance enrolment among urban slum dwellers in Ghana

Background: : Slum dwellers are likely to be among the most deprived people in urban areas. Poor hygiene practices and inadequate sanitary conditions play major roles in the increased burden of communicable diseases within developing countries like ours.Objective: To assess the knowledge and practice about personal hygiene and environmental sanitation in selected slums of Dhaka city.Materials and method: This cross sectional study was conducted in purposively selected urban slum areas of Moghbazar slum, Bashabo slum and T&T slum of Dhaka city during February 2014 to April 2014. Convenient sampling technique was applied. Semi-structured pre-tested questionnaire was used and face to face interview was conducted. Total 475 subjects, irrespective of age and sex, were included in this study.Results: Out of 475 respondents, more than fifty percent slum dwellers resided in tin shaded room while 21.7% in kacha houses. Sixty six percent of the respondents used to drink water from tube-well and 24% used supplied water provided by the city corporation. The study revealed that near 59% of the respondents used sanitary latrine. About 67% slum dwellers regularly practiced hand washing before taking meal and 59.2% respondents used soap after defecation. About fifty percent respondents brushed their teeth regularly with tooth paste. Regarding personal cleanliness, 81% subjects took bath regularly while 78% washed clothes irregularly. A statistically significant relation was found between washing of hands before meal (p=0.001), washing of hands after defecation (p=0.02), tooth brushing (p=0.001), bathing (p=0.009), washing of cloths (p=0.001), use of footwear (p=0.63) with knowledge of personal hygiene of the slum dwellers.Conclusion: Continuous community hygiene education along with adequate access to water supply and sanitation improves hygiene behaviour and policy makers and health care providers should have definite strategy and implementation.Delta Med Col J. Jul 2015; 3(2): 68-73

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Studies on some factors involved in the organization of a health insurance scheme-especially the factors influencing the financial balance-

Okayama Igakkai Zasshi (Journal of Okayama Medical Association) ◽

10.4044/joma1947.96.5-6_651 ◽

1984 ◽

Vol 96 (5-6) ◽

pp. 651-663

Author(s):

Takashi TANIGUCHI

Keyword(s):

Health Insurance ◽

Health Insurance Scheme ◽

Insurance Scheme ◽

Factors Influencing ◽

Financial Balance

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Household Food Security of Urban Slum Dwellers: A Case Study in Colombo Municipality, Sri Lanka

Journal of Food Chemistry and Nanotechnology ◽

10.17756/jfcn.2021-0110 ◽

2021 ◽

Vol 7 (2) ◽

pp. 34-40

Author(s):

N.L. Gunawardhana ◽

GAS Ginigaddara

Keyword(s):

Food Security ◽

Sri Lanka ◽

Urban Slum ◽

Household Food Security ◽

Household Food ◽

Slum Dwellers

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School Environmental Factors Influencing Female Pupils Academic Performance in Public Primary Schools in Iringa Municipality

Asian Journal of Education and Social Studies ◽

10.9734/ajess/2021/v23i130546 ◽

2021 ◽

pp. 40-48

Author(s):

Chesco Aloyce Motto

Keyword(s):

Academic Performance ◽

Environmental Factors ◽

Primary Schools ◽

Teaching And Learning ◽

Cross Sectional Study ◽

Drop Out ◽

Long Distance ◽

Cross Sectional ◽

Factors Influencing ◽

The Government

This study intended to explore the school environmental factors influencing female pupils’ academic performance in public primary schools at Iringa Municipality. A cross-sectional study design was used where structured questionnaire using open and closed ended questionnaire as well as interviews to participants were used to collect primary information from 123 girls’ pupils and 36 key informants from seven selected public primary schools. Data analysis was done through descriptive statistics (SPSS). The study findings revealed that harsh environmental factors contributing to poor academic performance through sexual harassment by pest teachers, longer distance of a female pupils form schools that affect pupils attendance and drop out, Shortage of teaching and learning resources as well as facilities i.e. text books, library and shortage of latrines while teaching and learning it is difficult for them to deriver pedagogical principal of teaching following large class size 68-80, and the bias attitude of the teacher towards subject matter that girls are always do performs poor in science subjects than boys. Finally, the study recommends that the government should build hostels for standard six and seven female pupils for solving the issue of long distance and drop out. Good and enough latrines should be built for girls and boys. Teachers should be well trained in order to handle girls well and also government should organize regular workshops for teachers. Either girls pupils should all the time helped by both male and female teachers in their problems and academic matters openly to avoid bias and mistrust among male teachers.

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Prevalence and factors associated with catastrophic health expenditure among slum and non-slum dwellers undergoing emergency surgery in a metropolitan area of South Western Nigeria

PLoS ONE ◽

10.1371/journal.pone.0255354 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0255354

Author(s):

Taiwo A. Obembe ◽

Jonathan Levin ◽

Sharon Fonn

Keyword(s):

Health Insurance ◽

Marital Status ◽

Emergency Surgery ◽

Health Expenditure ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Catastrophic Health Expenditure ◽

Catastrophic Expenditure ◽

Slum Dwellers ◽

Multistage Sampling

Background Out of Pocket (OOP) payment continues to persist as the major mode of payment for healthcare in Nigeria despite the introduction of the National Health Insurance Scheme (NHIS). Although the burden of health expenditure has been examined in some populations, the impact of OOP among slum dwellers in Nigeria when undergoing emergencies, is under-researched. This study sought to examine the prevalence, factors and predictors of catastrophic health expenditure amongst selected slum and non-slum communities undergoing emergency surgery in Southwestern Nigeria. Methods The study utilised a descriptive cross-sectional survey design to recruit 450 households through a multistage sampling technique. Data were collected using pre-tested semi-structured questionnaires in 2017. Factors considered for analysis relating to the payer were age, sex, relationship of payer to patient, educational status, marital status, ethnicity, occupation, income and health insurance coverage. Variables factored into analysis for the patient were indication for surgery, grade of hospital, and type of hospital. Households were classified as incurring catastrophic health expenditure (CHE), if their OOP expenditure exceeded 5% of payers’ household budget. Analysis of the data took into account the multistage sampling design. Results Overall, 65.6% (95% CI: 55.6–74.5) of the total population that were admitted for emergency surgery, experienced catastrophic expenditure. The prevalence of catastrophic expenditure at 5% threshold, among the population scheduled for emergency surgeries, was significantly higher for slum dwellers (74.1%) than for non-slum dwellers (47.7%) (F = 8.59; p = 0.019). Multiple logistic regression models revealed the significant independent factors of catastrophic expenditure at the 5% CHE threshold to include setting of the payer (whether slum or non-slum dweller) (p = 0.019), and health insurance coverage of the payer (p = 0.012). Other variables were nonetheless significant in the bivariate analysis were age of the payer (p = 0.017), income (p<0.001) and marital status of the payer (p = 0.022). Conclusion Although catastrophic health expenditure was higher among the slum dwellers, substantial proportions of respondents incurred catastrophic health expenditure irrespective of whether they were slum or non-slum dwellers. Concerted efforts are required to implement protective measures against catastrophic health expenditure in Nigeria that also cater to slum dwellers.

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