scholarly journals Improving access to healthcare for women in Tanzania by addressing socioeconomic determinants and health insurance: a population-based cross-sectional survey

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e023013 ◽  
Author(s):  
Deogratius Bintabara ◽  
Keiko Nakamura ◽  
Kaoruko Seino
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Formal Education ◽  
Wealth Index ◽  
Population Based ◽  
Reproductive Age ◽  
Low Income Countries ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Low Income Country

ObjectiveThis study was performed to explore the factors associated with accumulation of multiple problems in accessing healthcare among women in Tanzania as an example of a low-income country.DesignPopulation-based cross-sectional survey.SettingNationwide representative data for women of reproductive age obtained from the 2015–2016 Tanzania Demographic and Health Survey were analysed.Primary outcome measuresA composite variable, ‘problems in accessing healthcare’, with five (1-5) categories was created based on the number of problems reported: obtaining permission to go to the doctor, obtaining money to pay for advice or treatment, distance to a health facility and not wanting to go alone. Respondents who reported fewer or more problems placed in lower and higher categories, respectively.ResultsA total of 13 266 women aged 15–49 years, with a median age (IQR) of 27 (20–36) years were interviewed and included in the analysis. About two-thirds (65.53%) of the respondents reported at least one of the four major problems in accessing healthcare. Furthermore, after controlling for other variables included in the final model, women without any type of health insurance, those belonging to the poorest class according to the wealth index, those who had not attended any type of formal education, those who were not employed for cash, each year of increasing age and those who were divorced, separated or widowed were associated with greater problems in accessing healthcare.ConclusionThis study indicated the additive effects of barriers to healthcare in low-income countries such as Tanzania. Based on these results, improving uptake of health insurance and addressing social determinants of health are the first steps towards reducing women’s problems associated with accessing healthcare.

A Cross-sectional Study of the Clinical Profile of Children With Cerebral Palsy in Benin, a West African Low-Income Country

2019 ◽  
Vol 34 (13) ◽  
pp. 842-850
Author(s):  
Emmanuel Segnon Sogbossi ◽  
Damienne Houekpetodji ◽  
Toussaint G. Kpadonou ◽  
Yannick Bleyenheuft
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Low Income ◽  
Classification System ◽  
West African ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Common Cause ◽  
Low Income Country ◽  
Children With Cerebral Palsy

Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children’s mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school attendance. We recorded a high prevalence of intrapartum adverse events. Seventeen percent of children had postneonatal cerebral palsy, with cerebral malaria being the most common cause. Most children were severely affected (67.5% as bilateral spastic; 54.4% as GMFCS IV or V), but severity declined substantially with age. Only 23% of the children with cerebral palsy had attended school. Poor motor outcomes and comorbidities were associated with school nonattendance. These results suggest that intrapartum risk factors and postnatal cerebral malaria in infants are opportune targets for prevention of cerebral palsy in Sub-Saharan low-income countries.

scholarly journals Frequency of television viewing and association with overweight and obesity among women of the reproductive age group in Myanmar: results from a nationwide cross-sectional survey

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024680 ◽  
Author(s):  
Rajat Das Gupta ◽  
Ibrahim Hossain Sajal ◽  
Mehedi Hasan ◽  
Ipsita Sutradhar ◽  
Mohammad Rifat Haider ◽  
...  
Keyword(s):  
Rural Women ◽  
Television Viewing ◽  
Wealth Index ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Overweight And Obesity ◽  
Reproductive Age ◽  
Secondary Outcome ◽  
Cross Sectional Survey ◽  
Cross Sectional

ObjectivesThis study aimed to discern the association between the frequency of television viewing and overweight and obesity among reproductive age women of Myanmar.DesignThis was a cross-sectional study.SettingThis study used Myanmar Demographic and Health Survey (2015–2016) data.ParticipantsTotal of 12 021 women both aged 15–49 years and also not pregnant or did not deliver a child within the 2 months prior to the survey were included.Primary and secondary outcome measuresThe primary outcome was overweight (23.0 kg/m2to <27.5 kg/m2) and obesity (≥27.5 kg/m2), which was measured using the Asian body mass index cut-off. Ordered logistic regression analysis was conducted to find the association between the explanatory and outcome variables. The potential confounders controlled in the multivariable analyses were age, place of residence, region of residence, highest educational status, current employment status, wealth index, parity and number of household members.ResultsThe prevalence of overweight was 26.5% and obesity was 12.2% among the study participants. The odds of being overweight and obese were 20% higher (adjusted OR (AOR) 1.16, 95% CI 1.02 to 1.32; p=0.023) among those who watched television at least once a week compared with those who did not watch television at all. Rural women who watched television at least once a week were 1.2 times more likely to be obese (AOR 1.16, 95% CI 1.01 to 1.34; p=0.040) compared with those who did not watch television at all.ConclusionsFrequent television watching was associated with obesity among rural women of reproductive age in Myanmar.

scholarly journals Availability of ENT Surgical Procedures and Medication in Low-Income Nation Hospitals: Cause for Concern in Zambia

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Lufunda Lukama ◽  
Chester Kalinda ◽  
Warren Kuhn ◽  
Colleen Aldous
Keyword(s):  
Surgical Procedures ◽  
Low Income ◽  
Care Delivery ◽  
National Policy ◽  
Low Income Countries ◽  
Health Concern ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Essential Drugs ◽  
High Prevalence

Background. Ear, nose, and throat (ENT) diseases are an oft overlooked global health concern. Despite their high prevalence and associated morbidity and mortality, ENT diseases have remained neglected in health care delivery. In Zambia and many other low-income countries, ENT services are characterized by poor funding, unavailable surgical procedures, and erratic supply of essential drugs. Objective. To investigate ENT service provision in Zambia with regard to availability of surgical procedures and supply of essential drugs. Methods. A descriptive cross-sectional survey was conducted using a piloted structured questionnaire between 17 January 2017 and 2 January 2018. Included in the study were the 109 hospitals registered with the Ministry of Health (MoH) across the 10 provinces of Zambia. Results. Of the participating hospitals, only 5.9% (n=1) and 40% (n=2) of Second-Level Hospitals (SLH) and Third-Level Hospitals (TLH), respectively, carried out tympanoplasty, myringotomy, and grommet insertion (M+G). Frontal trephination and external ethmoidectomy were offered in 11.7% (n=2) and 40% (n=2) of SLH and TLH, respectively. While tracheostomy (39.3%, n=24), tonsillectomy (27.9%, n=17), and adenoidectomy (27.9%, n=17) were the most widely performed head and neck procedures, laryngectomy was carried out by 1 hospital. Between 14.8% (n=9) and 36.1% (n=22) of hospitals lacked antibiotic and/or antiseptic ear drops. Despite 96.7% (n=59) of the respondents acknowledging ENT as an important branch of clinical practice, only 15.3% (n=4) of the hospitals had a budget for ENT. Also, 6.6% (n=4) of the respondents thought the discipline of ENT had received enough attention. Conclusion. ENT service delivery in Zambia is limited with regard to performed surgical procedures and availability of essential drugs, necessitating urgent intervention. The findings from this study may be used to direct national policy on the improvement of provision of ENT services in Zambia.

Social capital and related socio-demographic variation in women of reproductive age: A population-based study

2016 ◽  
Vol 61 (2) ◽  
pp. 247-259 ◽  
Author(s):  
Azam Baheiraei ◽  
Fatemeh Bakouei ◽  
Eesa Mohammadi ◽  
Reza Majdzadeh ◽  
Seyed Mostafa Hosseni
Keyword(s):  
Social Capital ◽  
Low Income ◽  
Family Income ◽  
Population Based ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Cross Sectional ◽  
The Social ◽  
Low Income Families

In this population-based cross-sectional study of women of reproductive age in Tehran, Iran, the social capital integrated questionnaire and socio-demographic questionnaire were used. The highest mean scores were related to social cohesion and inclusion dimension (55.72 ± 11.94) and the lowest mean scores to groups and networks dimension (31.78 ± 19.43). Stepwise multiple linear regressions showed the significant association between dimensions of social capital and certain socio-demographic variables, particularly family income. Policy makers should help low-income families by designing effective interventions for improving the status of social capital in this group, because it is considered one of the social determinants of health.

scholarly journals Key bottlenecks to the provision of safe obstetric anaesthesia in low- income countries; a cross-sectional survey of 64 hospitals in Uganda

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Isabella Epiu ◽  
Agnes Wabule ◽  
Andrew Kambugu ◽  
Harriet Mayanja-Kizza ◽  
Jossy Verel Bahe Tindimwebwa ◽  
...  
Keyword(s):  
Low Income ◽  
Low Income Countries ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Obstetric Anaesthesia

scholarly journals Folic acid awareness and intake among women in areas with high prevalence of neural tube defects in China: a cross-sectional study

2011 ◽  
Vol 14 (7) ◽  
pp. 1142-1147 ◽  
Author(s):  
Ziqian Zeng ◽  
Ping Yuan ◽  
Yanping Wang ◽  
Xi Ma ◽  
Jun Zhu
Keyword(s):  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Low Income ◽  
Reproductive Age ◽  
Intake Rate ◽  
Childbearing Age ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
High Prevalence

AbstractObjectiveTo measure folic acid awareness and intake rates among women of childbearing age in certain areas of China with a high prevalence of neural tube defects (NTD).DesignA cross-sectional survey was carried out utilising a nineteen-item questionnaire enquiring into individual women's knowledge of, attitude towards and practice of folic acid supplementation.SettingA total of 293 low-income counties in six provinces of China.SubjectsWomen aged 19–44 years from six provinces with a high prevalence of NTD recruited from June to August 2008.ResultsAmong 33 025 participants, 57 % had heard of folic acid but only 15 % knew all of the core information. The intake rate was 12 %; only 8 % took the recommended dose and only 4 % of non-pregnant women took folic acid. Some women did not take folic acid because they did not know that they should take it (49 %) or they had misconceptions about it (24 %). According to logistic regression analysis, rural residence was a risk factor for folic acid awareness. Ethnicity, educational level, average annual income per person and pregnancy were the influencing factors of folic acid awareness and folic acid intake.ConclusionsAlthough more than half of the respondents had heard of folic acid, the intake rate was still very low in areas with a high prevalence of NTD. Thus, more efforts are needed to increase folic acid awareness and intake among women of reproductive age in these areas.

scholarly journals Geographical variations of early age sexual initiation among reproductive-age women in Ethiopia: Evidence from EDHS 2016

2019 ◽  
Author(s):  
Araya Mesfin Nigatu ◽  
Abraham Yeneneh Birhanu ◽  
Berhanu Fikadie Endehabtu
Keyword(s):  
Low Income ◽  
Wealth Index ◽  
Sexual Initiation ◽  
Reproductive Age ◽  
Low Income Countries ◽  
P Value ◽  
Early Age ◽  
Spatial Clusters ◽  
Geographical Variations ◽  
Early Sexual Initiation

Abstract Abstract Background : The early age of sexual initiation will contribute a lot for various risks such as mistimed pregnancy followed by insecure termination, developing fistula and contracting sexually transmitted infections which are currently the major public health concerns, particularly for low-income countries. Therefore, the purpose of this study was to detect spatial clusters and identify factors associated with an early age sexual initiation of women in the reproductive age group. Methods : We used a population-based nationwide representative Ethiopian demographic and health survey 2016 data for this analysis. A total of 12,033 respondents of reproductive age (15–49 years) who had at least one event of sexual initiation was retrieved and included for the analysis. Spatial cluster detection and autocorrelation analysis were also done to explore the patterns of early age sexual initiation. Results : The median age at first sexual intercourse among respondents was 16 (±3.3) years and more than half (66.2%), had their first intercourse before the age of 18 years. The spatial variations of the age of sexual initiation was nonrandom and clustered with a Moran's I = 0.413 (P-value < 0.001). In addition, five significant spatial clusters were also identified. Moreover, the probability of starting sex at an earlier age was associated with the respondent’s residence, marital status, educational attainment and wealth index. Conclusion : This study found a higher proportion of an early age sexual initiation of women. Socio-demographic variables were also significantly associated with early sexual initiation. The SaTScan analysis identified five statistical significant spatial clusters which indicate that there were geographical variations. Therefore, targeted and integrated interventions focusing on the identified high spot clustered areas are recommended to reduce early age sexual initiation. Keywords : Early sexual initiation, geographical variations, Ethiopia

scholarly journals Physical and Social Demographic Factors Affecting Utilization of Pit Latrine in Tigania East, Meru County, Kenya

2020 ◽  
pp. 122-132
Author(s):  
Sylvia M. Nkatha ◽  
Eric M. Muchiri ◽  
Patrick Kubai ◽  
Jane Rutto
Keyword(s):  
Low Income ◽  
Protective Factor ◽  
Demographic Factors ◽  
Water Sources ◽  
Low Income Countries ◽  
Cross Sectional Survey ◽  
Open Defecation ◽  
Cross Sectional ◽  
Pit Latrine ◽  
Social Demographic

Introduction: Globally, poor sanitation is the cause of childhood diseases. Annually, more than 19,500 people die from diarrhea of which 17,100 are children. Diarrhea, which accounts for 16% of deaths among the children below 5 years, is highly linked to open defecation (OD). Poor excreta disposal remains a major challenge to improved sanitation and hygiene in many communities of Kenya and therefore they continue to practice open defecation. Construction and utilization of a latrine at home is a protective factor for communicable diseases.  About 52% of the population practice proper utilization of latrine in low-income countries. Improper utilization of latrines leads to the contamination of the water sources. Availability of a pit latrine does not guarantee utilization because other factors like functionality and distance influence its use. Furthermore, the availability and use of the latrine depends on maintenance practices of the latrines and cleanliness as well as the quality of housing and household compound. Aims: To analyze the physical and social demographic factors influencing the utilization of pit latrines in Tigania East Sub-County, Meru County, Kenya. Study Design:  The study was a descriptive cross-sectional survey. Place and Duration of Study: The study was carried out in Tigania East Sub-County, Meru County, Kenya shown in Fig. 3. Household survey was carried out between June 2018 and December 2019. Methodology: This was a descriptive cross-sectional survey involving 369 respondents selected by systematic random sampling from different households across the sub-county was utilized. Data collection was done using a structured questionnaire administered in English and a spot observation checklist. All data generated was entered, validated and analyzed using SPSS using SPSS Software Version 23.  Descriptive analysis was done during the calculation of measures of central tendency and proportions. Regression analysis was used in the determination of any association between the socio-demographic factors and the utilization of latrines. Results: Ownership, location and functionality of the pit latrine were positively associated with utilization (OR=2.127, OR=1.53, OR=4.36, P=.00). Households that owned pit latrines were 2 times likely to utilize the pit latrines than those without a pit latrine. Moreover, household size, gender, and employment were positively related to utilization (R=0.502, P=.00). High construction costs challenges were 7 times linked to open defecation practices. Households with less than 6 members were 2.35 times more likely to utilize the pit latrine compared to those with 7-12 members (OR=2.35, X²=13.573, P=.00). Conclusion: Interventions should target households with more than 7 members. A call for partnerships between government and donors to improve household income, water sources, and sanitation practices in Tigania East Sub-County is necessary. A call for funding projects related to pour-flush pit latrines and wet technologies to enhance utilization.

scholarly journals Population-based estimates of post-acute sequelae of SARS-CoV-2 infection (PASC) prevalence and characteristics: A cross-sectional study

2021 ◽  
Author(s):  
Jana L. Hirschtick ◽  
Andrea R. Titus ◽  
Elizabeth Slocum ◽  
Laura E. Power ◽  
Robert E. Hirschtick ◽  
...  
Keyword(s):  
Low Income ◽  
Smoking Status ◽  
Prevalence Ratio ◽  
Population Based ◽  
Outcome Data ◽  
Cross Sectional Survey ◽  
Annual Household Income ◽  
Cross Sectional ◽  
Persistent Symptoms ◽  
Initial Symptoms

AbstractImportanceEmerging evidence suggests many people have persistent symptoms after acute COVID-19 illness.ObjectiveTo estimate the prevalence and correlates of persistent COVID-19 symptoms 30 and 60 days post onset using a population-based sample.Design & SettingThe Michigan COVID-19 Recovery Surveillance Study is a population-based cross-sectional survey of a probability sample of adults with confirmed COVID-19 in the Michigan Disease Surveillance System (MDSS). Respondents completed a survey online or via telephone in English, Spanish, or Arabic between June - December 2020.ParticipantsLiving non-institutionalized adults (aged 18+) in MDSS with COVID-19 onset through mid-April 2020 were eligible for selection (n=28,000). Among 2,000 adults selected, 629 completed the survey. We excluded 79 cases during data collection due to ineligibility, 6 asymptomatic cases, 7 proxy reports, and 24 cases missing outcome data, resulting in a sample size of 593. The sample was predominantly female (56.1%), aged 45 and older (68.2%), and Non-Hispanic White (46.3%) or Black (34.8%).ExposuresDemographic (age, sex, race/ethnicity, and annual household income) and clinical factors (smoking status, body mass index, diagnosed comorbidities, and illness severity).Main outcomes and MeasuresWe defined post-acute sequelae of SARS-CoV-2 infection (PASC) as persistent symptoms 30+ days (30-day COVID-19) or 60+ days (60-day COVID-19) post COVID-19 onset.Results30- and 60-day COVID-19 were highly prevalent (52.5% and 35.0%), even among respondents reporting mild symptoms (29.2% and 24.5%) and non-hospitalized respondents (43.7% and 26.9%, respectively). Low income was statistically significantly associated with 30-day COVID-19 in adjusted models. Respondents reporting very severe (vs. mild) symptoms had 2.25 times higher prevalence of 30-day COVID-19 (Adjusted Prevalence Ratio [aPR] 2.25, 95% CI 1.46-3.46) and 1.71 times higher prevalence of 60-day COVID-19 (aPR 1.71, 95% 1.02-2.88). Hospitalized (vs. non-hospitalized) respondents had about 40% higher prevalence of both 30-day (aPR 1.37, 95% CI 1.12-1.69) and 60-day COVID-19 (aPR 1.40, 95% CI 1.02-1.93).Conclusions and RelevancePASC is highly prevalent among cases with severe initial symptoms, and, to a lesser extent, cases with mild and moderate symptoms.

scholarly journals Tobacco Use and Associated Risk Factors in Burkina Faso: Results from a Population-Based Cross-Sectional Survey.

2019 ◽  
Author(s):  
Bruno Bonnechère ◽  
Cissé Kadari ◽  
Millogo Tiéba ◽  
Ouédraogo H. Gautier ◽  
Garanet Franck ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alcohol Consumption ◽  
Burkina Faso ◽  
Tobacco Use ◽  
Low Income ◽  
Associated Factors ◽  
World Health ◽  
Low Income Countries ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Tobacco is a leading preventable cause of non-communicable diseases (NCDs). Studies characterizing the prevalence of tobacco use in low-income countries are lacking. This study describes the prevalence of tobacco use in Burkina Faso and its associated factors. Methods : Data from the 2013 Burkina Faso World Health Organization (WHO) Stepwise approach to Surveillance (STEPS) were analyzed. The prevalence of any tobacco product use, cigarette smoking, and other tobacco use was calculated. Logistic regression analyses identified factors associated with tobacco use. Overall, 4,691 people were included in this analysis. Results: The prevalence of any tobacco use was 19.8% (95% CI: 18.4–21.2). Tobacco use was higher for men (29.2% [27.0–31.5]) than women (11.8% [10.3–13.4]). The prevalence of smoked tobacco was 11.3% (10.3–12.4), with a significantly higher prevalence among men (24.5% [22.1–27.0]) than women (0.1% [0.01–0.3]). The overall prevalence of other tobacco use was 8.9% (7.4–10.7), with lower values for men (5.6% [4.1–7.2]) compared to women (11.7% [9.4–14.1]). Tobacco smoking among men was significantly associated with an increased age and alcohol consumption. The analysis of risk factors for other tobacco use stratified by gender showed that age, education, residence, and alcohol consumption were significantly associated with consumption for women, and age and alcohol consumption for men. Conclusion: Tobacco use is common in Burkina Faso. To effectively reduce tobacco use in Burkina Faso, a comprehensive tobacco control program should consider associated factors, such as gender, age, and alcohol consumption.

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