scholarly journals Distance as a barrier to obstetric care among indigenous women in Panama: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e034763
Author(s):  
Paloma Acevedo ◽  
Sebastian Martinez ◽  
Leonardo Pinzon ◽  
Emmanuelle Sanchez-Monin ◽  
Solis Winters
Keyword(s):  
Prenatal Care ◽  
Health Services ◽  
Health Centre ◽  
Obstetric Care ◽  
Cross Sectional Study ◽  
Indigenous Women ◽  
Sectional Study ◽  
Cross Sectional ◽  
Percentage Points ◽  
Care Utilisation

ObjectivesWe assess the relationship between distance to a woman’s assigned health clinic and obstetric care utilisation.DesignWe employ a cross-sectional study design using baseline data from the evaluation of a conditional cash transfer programme to promote greater utilisation of maternal and infant health services. Data were collected between December 2016 and January 2017.SettingThe study is conducted in Ngäbe Buglé, the largest of Panama’s three indigenous territories, where maternal mortality is three times the national average.ParticipantsWe analyse a representative sample of 1336 indigenous women with a birth in the 12 months prior to the survey.Primary and secondary outcome measuresPrimary outcomes include obstetric care utilisation measures for prenatal, childbirth and postpartum events. Secondary outcomes include reasons for not receiving prenatal care, alarming symptoms, child weight at birth and stillbirths or miscarriages.ResultsCompared with women in closest geographic proximity to a health centre (top quintile, Q1), women who lived farthest from a health centre (bottom quintile, Q5) had significantly lower obstetric care utilisation outcomes for critical prenatal, childbirth and postpartum events. Mothers in Q5 were 36 percentage points less likely to have had at least one prenatal care appointment in a hospital, health centre or clinic compared with mothers in Q1 (p<0.01), and 52 percentage points less likely to attend an institutional first appointment (p<0.01). The gap in institutional delivery and postnatal care between mothers in Q1 and Q5 was about 35 percentage points (p<0.01). All utilisation outcomes were negatively correlated with distance, and differences in obstetric care utilisation persisted even when controlling for household wealth, maternal age and maternal education.ConclusionDistance is an important barrier to obstetric care utilisation, with women in more distant locations suffering significantly lower use of prenatal, childbirth and postpartum care compared with women in closer vicinity to a health establishment. Expanding the supply of healthcare and implementing demand side incentives to promote the use of health services in remote communities are relevant policies to reduce disparities in obstetric care utilisation.Trial registration numberAEA Registry (RCT ID AEARCTR-0001751).

scholarly journals Cross sectional study of knowledge and awareness among MCH beneficiaries about antenatal and infant care in rural Tamil Nadu, India

2015 ◽  
Vol 7 (1) ◽  
pp. 59-65 ◽  
Author(s):  
Elayarani Elavarasan ◽  
Manasi S. Padhyegurjar ◽  
Shekhar B. Padhyegurjar
Keyword(s):  
Health Services ◽  
Antenatal Care ◽  
Rural Health ◽  
Health Centre ◽  
Infant Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Rural Health Centre ◽  
New Born

Aims and Objective: Mother and child together form the majority of the population in developing countries. Though they have maximum number of health services attributed to them, morbidity and mortality rates for antenatal women and children are very high. Lack of comprehensionof preventive services is one of the important reasons for this. This study was planned with the aim of assessing the knowledge and awareness levels among pregnant women about antenatal care and regarding various aspects of new born and infant care among mothers of under three.Materials and Methods:This is a community based cross- sectional study involving beneficiaries attending the Rural Health Centre of a teaching Medical College, in Tamil Nadu.Results: Awareness about routine antenatal care, danger signs of pregnancy and preparation for emergency labour were observed to be poor among antenatal women. Knowledge about new born care, infant feeding practices, immunization, newborn and childhood illnesses were all found inadequate among mothers of under three. All the aspects were better in antenatal women who were educated, could read Tamil, and belonged to joint family. But these factors had no effect of mothers of under three. Health workers and family members were the major source of information for both the groups.Conclusion: Knowledge is observed to be poor, inspite of all the participants being beneficiaries of Rural Health Centre and the majority of them being educated up to secondary standard. Efficient use of existing health services, giving health education sessions with precise messages will help to increase awareness.Asian Journal of Medical Sciences Vol.7(1) 2015 59-65

scholarly journals Trends and differences in sexual practices and sexually transmitted infections in men who have sex with men only (MSMO) and men who have sex with men and women (MSMW): a repeated cross-sectional study in Melbourne, Australia

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037608
Author(s):  
Mario Martín-Sánchez ◽  
Richard Case ◽  
Christopher Fairley ◽  
Jane S Hocking ◽  
Catriona Bradshaw ◽  
...  
Keyword(s):  
Health Centre ◽  
Cross Sectional Study ◽  
Sexual Practices ◽  
Sectional Study ◽  
Anal Sex ◽  
Cross Sectional ◽  
Men And Women ◽  
Sexually Transmitted ◽  
Receptive Anal Sex ◽  
Sex With Men

ObjectivesIn the 2010s, there has been an increase in sexually transmitted infections (STI) in men who have sex with men (MSM) in Australia, and since 2015 also in urban heterosexuals. Men who have sex with both men and women (MSMW) have characteristics that may differ from both men who have sex with men only (MSMO) and heterosexual men. We aimed to compare the sexual practices and the trends in HIV/STI positivity between MSMO and MSMW.DesignRepeated cross-sectional study.SettingA sexual health centre in Melbourne, Australia.ParticipantsMSM aged 18 years and above who attended the Melbourne Sexual Health Centre for the first time between 2011 and 2018. This includes 12 795 MSMO and 1979 MSMW.Primary outcome measuresDemographic characterics, sexual practices and HIV/STI positivity.ResultsCompared with MSMW, MSMO were more likely to practice anal sex and to have condomless receptive anal sex with casual male partners, and less likely to have a current regular relationship. Over the 8-year period, there was an increase in condomless receptive anal sex with casual male partners for both groups (MSMO: from 46.2% to 63.3%, ptrend <0.001; MSMW: from 41.3% to 57.9%, ptrend=0.011). Syphilis positivity increased in MSMO (from 5.5% to 7.9%, ptrend=0.012) and MSMW (from 0.9% to 6.4%, ptrend=0.004) and HIV remained stable. Gonorrhoea increased among MSMO from 2011 to 2014 (from 6.7% to 9.6%, ptrend=0.002), and remained stable from 2015 to 2018. MSMO had higher odds of testing positive for gonorrhoea (adjusted OR (aOR) 1.36, 95% CI 1.13 to 1.64), chlamydia (aOR 1.39, 95% CI 1.16 to 1.67), syphilis (aOR 1.74, 95% CI 1.37 to 2.22) and HIV (aOR 4.60, 95% CI 2.43 to 8.70) than MSMW.ConclusionsMSMW have overall lower condomless sex and lower HIV/STI positivity. In the last years, changes in sexual practices in MSM have affected both MSMW and MSMO leading to an increased STI risk.

scholarly journals Evaluation of e-health (Seha) application: a cross-sectional study in Saudi Arabia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abeer Alharbi ◽  
Joharah Alzuwaed ◽  
Hind Qasem
Keyword(s):  
Saudi Arabia ◽  
Health Services ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Advanced Technology ◽  
Sectional Study ◽  
Cross Sectional ◽  
Technical Problems ◽  
Significant Difference ◽  
Ease Of Access

Abstract Background The Ministry of Health in Saudi Arabia is expanding the country’s telemedicine services by using advanced technology in health services. In doing so, an e-health application (app), Seha, was introduced in 2018 that allows individuals to have face-to-face visual medical consultations with their doctors on their smartphones. Objective This study evaluated the effectiveness of the app in improving healthcare delivery by ensuring patient satisfaction with the care given, increasing access to care, and improving efficiency in the healthcare system. Methods A cross-sectional study design was used to assess the perceptions of users of the Seha app and non-users who continued with traditional health services. The data were collected using an online survey via Google Forms between June 2020 and September 2020. Independent t tests and chi-square (χ2) tests were conducted to answer the research questions. Results There was a significant difference between users and non-users in terms of ease of access to health services (t =  − 9.38, p < 0.05), with app users having a higher mean score (4.19 ± 0.91) than non-users (3.41 ± 1.00); satisfaction with health services (t =  − 6.33, p < 0.05), with users having a higher mean score (3.96 ± 0.91) than non-users (3.45 ± 0.94); and efficiency (only one visit needed for treatment) (t =  − 3.20, p < 0.05), with users having a higher mean score (3.71 ± 0.93) than non-users (3.45 ± 0.93). There were significant associations between the use of the Seha app and age (χ2 = 8.79, p < 0.05), gender (χ2 = 22.19, p < 0.05), region (χ2 = 19.74, p < 0.05), and occupation (χ2 = 22.05, p < 0.05). There were significant relationships between the three items (on access, satisfaction, and efficiency) and experiencing technical issues (t = 4.47, t = 8.11, and t = 3.24, respectively, p < 0.05), with users who faced technical problems having significantly lower mean scores for all three items. Conclusion This study provided evidence that the Seha app improved the delivery of healthcare in Saudi Arabia. Users of the app had a better health experience in terms of their perceived ease of access to healthcare services; their satisfaction with healthcare services; and the efficiency of the system, measured by the number of required doctor visits. Other factors that appeared to influence the use of the app included age, gender, usual source of care, and technical difficulties.

Trends in access to health services and financial protection in China between 2003 and 2011: a cross-sectional study

The Lancet ◽  
2012 ◽  
Vol 379 (9818) ◽  
pp. 805-814 ◽  
Author(s):  
Qun Meng ◽  
Ling Xu ◽  
Yaoguang Zhang ◽  
Juncheng Qian ◽  
Min Cai ◽  
...  
Keyword(s):  
Health Services ◽  
Cross Sectional Study ◽  
Financial Protection ◽  
Sectional Study ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Access To Health

Distress and impaired functioning, coping mechanisms and barriers to access mental health services among Syrian refugees and Jordanian adults after eight years of Syrian crisis: a cross-sectional study (Preprint)

2021 ◽  
Author(s):  
Yousef Khader ◽  
Ahmad Bawaneh ◽  
Zaid Al-Hamdan
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
Coping Mechanisms ◽  
Syrian Refugees ◽  
Sectional Study ◽  
Cross Sectional ◽  
Barriers To Access

BACKGROUND The Syrian conflict started in 2011 and resulted ever since in a large displacement of Syrians. Conflict-related violence coupled with displacement related stressors such as poverty, poor access to health services, loss of family support and discrimination had a significant impact on the mental health and psychosocial wellbeing of Syrian refugee OBJECTIVE This study aimed to identify the perceived symptoms of severe distress and impaired functioning, identify coping mechanisms and identify the barriers to access mental health services among Syrian refugees and Jordanian adults. METHODS This cross-sectional study study took place in 14 randomly selected sites in Jordan where Syrian refugees are concentered and from Za’tari refugee camp. A toolkit for humanitarian settings was used for data collection. RESULTS Of the 1424 participants, 43.4% had distress; 38.9% among host population, 57.0% among refugees in urban communities, and 23.0% among refugees in camp (p <0.005). Overall, finding comfort in faith and spiritual beliefs was the most common coping mechanism reported by those who perceived to be experiencing distress. CONCLUSIONS A significant proportion of Syrian refugees had distress symptoms. It is recommended to incorporate mental health services into broad-based community settings, such as schools, primary prevention or case management programs.

scholarly journals A cross-sectional study to assess the health profile of street sweepers and sanitary workers in a zone of Greater Chennai Corporation, Tamil Nadu, India

2018 ◽  
Vol 5 (10) ◽  
pp. 4357 ◽  
Author(s):  
Joy Patricia Pushparani ◽  
Chitra A. ◽  
Kalpana J.
Keyword(s):  
Health Services ◽  
Mental Health Problems ◽  
Cross Sectional Study ◽  
Health Problems ◽  
Health Profile ◽  
Sectional Study ◽  
Cross Sectional ◽  
Respiratory Problems ◽  
Utilization Of Health Services ◽  
Musculoskeletal Problems

Background: Sweepers and sanitary workers are getting exposed to hazardous dust during their work. The health profile of the sanitary workers and utilization of health services are not clearly known. This study aimed to assess the health profile and associated risk factors among street sweepers and sanitary workers.Methods: A community based cross sectional study was conducted among 73 street sweepers and sanitary workers in a zone of Greater Chennai Corporation by multistage sampling method, during November 2016 to December 2016 using a semi structured questionnaire.Results: Among the respondents 67.1% were females, 2/3rd of them belonged to the age group of 30-40 years. Majority of them (82.2%) had reported to have musculoskeletal problems followed by respiratory problems (61.6%), ophthalmic problems (53.4%), skin problems (38.4%), mental health problems (39.7%). Most of the respondents had multiple problems. Musculoskeletal problems were more common among the female workers (p=0.002). Health problems like headache, fatigue, giddiness were more common among the workers who worked for >5 years (p=0.006). The utilization of health services was better among those workers who had formal school education (p=0.042).Conclusions: This study concludes majority of them have musculoskeletal problems followed by respiratory problems and ophthalmic problems. Usage of personal protective equipments and utilization of health services by the sweepers and sanitary workers were poor. Hence steps have to be taken to improve the health status by subjecting them to periodic screening and sensitization programs on usage of PPE.

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