scholarly journals The Effects of Housing on Health and Health Risks in an Aging Population: A Qualitative Study in Rural Thailand

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ratana Somrongthong ◽  
Saovalux Dullyaperadis ◽  
Anne Louise Wulff ◽  
Paul R. Ward
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Risks ◽  
Rural Areas ◽  
Aging Population ◽  
Direct Result ◽  
House Design ◽  
The Impact ◽  
Health Care Equipment ◽  
Rural Thailand

Background. Over the last decade, Thailand has experienced an aging population, especially in rural areas. Research finds a strong, positive relationship between good quality housing and health, and this paper assesses the impact and living experience of housing of older people in rural Thailand.Methods. This was a mixed-method study, using data from observations of the physical adequacy of housing, semistructured interviews with key informants, and archival information from health records for 13 households in rural Thailand.Results. There were four main themes, each of which led to health risks for the older people: “lighting and unsafe wires,” “house design and composition,” “maintenance of the house,” and “health care equipment.” The housing was not appropriately designed to accommodate health care equipment or to fully support individual daily activities of older people. Numerous accidents occurred as a direct result of inadequate housing and the majority of houses had insufficient and unsafe lighting, floor surfaces and furniture that created health risks, and toilets or beds that were at an unsuitable height for older people.Conclusion. This paper provides an improved and an important understanding of the housing situation among older people living in rural areas in Thailand.

scholarly journals The impact of living arrangements and intergenerational support on the health status of older people in China: are rural residents disadvantaged compared to urban residents?

2021 ◽  
pp. 1-26
Author(s):  
Yazhen Yang ◽  
Maria Evandrou ◽  
Athina Vlachantoni
Keyword(s):  
Life Satisfaction ◽  
Older People ◽  
Adult Children ◽  
Rural Areas ◽  
Living Arrangements ◽  
Psychological Wellbeing ◽  
Urban Residents ◽  
Intergenerational Support ◽  
Rural Residents ◽  
The Impact

Abstract Research to-date has examined the impact of intergenerational support in terms of isolated types of support, or at one point in time, failing to provide strong evidence of the complex effect of support on older persons’ wellbeing. Using the Harmonised China Health and Retirement Longitudinal Study (2011, 2013 and 2015), this paper investigates the impact of older people's living arrangements and intergenerational support provision/receipt on their physical and psychological wellbeing, focusing on rural–urban differences. The results show that receiving economic support from one's adult children was a stronger predictor for higher life satisfaction among rural residents compared to urban residents, while grandchild care provision was an important determinant for poor life satisfaction only for urban residents. Having weekly in-person and distant contact with one's adult children reduced the risk of depression in both rural and urban residents. Older women were more likely than men to receive support and to have contact with adult children, but also to report poor functional status and depression. The paper shows that it is important to improve the level of public economic transfers and public social care towards vulnerable older people in rural areas, and more emphasis should be placed on improving the psychological wellbeing of urban older residents, such as with the early diagnosis of depression.

scholarly journals The impact of COVID-19 on primary health care and antibiotic prescribing in rural China: qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tingting Zhang ◽  
Xingrong Shen ◽  
Rong Liu ◽  
Linhai Zhao ◽  
Debin Wang ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Rural Areas ◽  
Rural China ◽  
Antibiotic Prescribing ◽  
Epidemic Control ◽  
Primary Health ◽  
Tract Infections ◽  
The Impact

Abstract Background In China, the primary health care (PHC) system has been designated responsible for control and prevention of COVID-19, but not treatment. Suspected COVID-19 cases presenting to PHC facilities must be transferred to specialist fever clinics. This study aims to understand the impact of COVID-19 on PHC delivery and on antibiotic prescribing at a community level in rural areas of central China. Methods Qualitative semi-structured interviews were conducted with 18 PHC practitioners and seven patients recruited from two township health centres and nine village clinics in two rural residential areas of Anhui province. Interviews were transcribed verbatim and analysed thematically. Results PHC practitioners reported a major shift in their work away from seeing and treating patients (due to government-mandated referral to specialist Covid clinics) to focus on the key public health roles of tracing, screening and educating in rural areas. The additional work, risk, and financial pressure that PHC practitioners faced, placed considerable strain on them, particularly those working in village clinics. Face to face PHC provision was reduced and there was no substitution with consultations by phone or app, which practitioners attributed to the fact that most of their patients were elderly and not willing or able to switch. Practitioners saw COVID-19 as outside of their area of expertise and very different to the non-COVID-19 respiratory tract infections that they frequently treated pre-pandemic. They reported that antibiotic prescribing was reduced overall because far fewer patients were attending rural PHC facilities, but otherwise their antibiotic prescribing practices remained unchanged. Conclusions The COVID-19 pandemic had considerable impact on PHC in rural China. Practitioners took on substantial additional workload as part of epidemic control and fewer patients were seen in PHC. The reduction in patients seen and treated in PHC led to a reduction in antibiotic prescribing, although clinical practice remains unchanged. Since COVID-19 epidemic control work has been designated as a long-term task in China, rural PHC clinics now face the challenge of how to balance their principal clinical and increased public health roles and, in the case of the village clinics, remain financially viable.

The impact of Benin’s first public procurement code and its amendment on healthcare equipment acquisition prices

2018 ◽  
Vol 18 (4) ◽  
pp. 306-322 ◽  
Author(s):  
Pamphile Thierry Houngbo ◽  
Maikel Kishna ◽  
Marjolein Zweekhorst ◽  
Daton Medenou ◽  
Joske G.F. Bunder-Aelen
Keyword(s):  
Health Care ◽  
Time Series Data ◽  
Good Governance ◽  
Public Procurement ◽  
Linear Regression Analysis ◽  
Interrupted Time Series ◽  
Series Data ◽  
Content Type ◽  
The Impact ◽  
Health Care Equipment

PurposeTo satisfy donors and reduce public procurement acquisition prices, Benin has implemented and amended its first public procurement code guided by top-down principles of good governance.Design/methodology/approachThis study aims to measure the impact of the code and its amendment on public procurement acquisition prices of health-care equipment from 1995 to 2010.FindingsA segmented linear regression analysis was performed using interrupted time-series data. The analysis shows that the code and its amendment did not reduce acquisition prices, indicating the limited impact of the code. The authors recommend the implementation of bottom-up processes in establishing the public procurement system, and the development of a reference pricelist of the most widely used health-care equipment, as possible solutions for improving the effectiveness of the code.

scholarly journals Identifying and describing a model region to evaluate the impact of telemedicine

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Harst ◽  
S Oswald ◽  
P Timpel
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Focus Groups ◽  
Health Care Providers ◽  
Rural Areas ◽  
Demographic Data ◽  
Care Providers ◽  
Age Related ◽  
Model Region ◽  
The Impact

Abstract Background Telemedicine solutions providing patient-centered care over distance need to be integrated into the regional setting. The acceptance by both providers and patients hat to be continuously evaluated using methods of participatory implementation research. In controlled trials, often taking place in laboratory settings, these methods cannot be applied. In the following, research in progress is presented. Methods Based on socio-demographic data, epidemiology prevalence of age-related chronic diseases and data on the value of health care provision in Saxony, Germany a model region was chosen. Then, a focus group (n = 6) was conducted to differentiate the results and analyze the health networks of patients. For this, network maps putting the individual in the middle and his/her sources of information and support in case of illness in concentric circles around it, were used. The focus group was audiotaped, transcribed and analyzed by two researchers using MaxQDA. Results With a mean age of 47.8 years (n = 17,431), high prevalence of diabetes (>15.85 %) and hypertension (>39.1%) and an expected shortage of primary physicians in 2030, the town of Kamenz is a mirror image of the current health care challenges in rural areas of Saxony. Participants of the focus groups also stated problems in finding a primary physician or a dentist. Compensatory behavior, such as traveling large distances, relying on self-researched online diagnoses and immediately going to the emergency room for medical support was described. According to the network maps, primary sources of support in case of illness are partners and relatives, yet there is little connection between those and health care providers, as well as between different medical specialists. Conclusions The results will lead to potential use cases of telemedicine to be included into a standardized questionnaire for the assessment of telemedicine readiness in the model region. Key messages Telemedicine implementation in a rural area can be studied using a participatory approach. Focus groups and network maps are useful qualitative methods for participatory research and can inform the design of quantitative measurements.

scholarly journals Impact of COVID-19 Pandemic on Mental Health of the General Population, Students, and Health Care Workers: A Review

2020 ◽  
Author(s):  
Sabina Sankhi ◽  
Nirmal Raj Marasine
Keyword(s):  
Mental Health ◽  
Health Care ◽  
General Population ◽  
Health Care Workers ◽  
Rural Areas ◽  
Psychological Reactions ◽  
Policy Makers ◽  
Lower Socioeconomic ◽  
Care Workers ◽  
The Impact

Background: The COVID-19 among humans is spreading heavily and is largely impacting the mental health of the general population, students, and health care workers worldwide. Hence, this review aims to summarize the literatures addressing the impact of the COVID-19 pandemic on the mental health of the general population, students, and health care workers. Methods: Published articles concerning mental health of the general population, students, and health care workers related to the COVID-19 outbreak have been considered and reviewed. Results and Discussion: Mental health symptoms of stress, anxiety, and depression are common psychological reactions to the COVID-19 pandemic in the general population, students, and health care workers. This collectively influences daily behavior, economy, prevention strategies and decision making from policy makers and health organizations, weakening the strategies of COVID-19 control leading to more morbidity and mental health needs at the global level. Conclusion: There is a need for more evidence-based research from other affected countries, particularly in vulnerable populations such as children and adolescents, people of lower socioeconomic status, and those residing in rural areas, so that valid strategies can be developed and COVID-19 and outbreaks of similar types in the near future can be prevented.

Changing Service Provision in Rural Areas and the Possible Impact on Older People: A Case Example of Compulsory Post Office Closures and Outreach Services in England

2015 ◽  
Vol 15 (3) ◽  
pp. 387-401 ◽  
Author(s):  
Charlotte Hamilton
Keyword(s):  
Older People ◽  
Rural Areas ◽  
Post Office ◽  
Customer Group ◽  
Network Change ◽  
Outreach Services ◽  
The Impact ◽  
Alternative Delivery ◽  
Delivery Models

Rural post office provision is becoming increasingly reliant on alternative delivery models. The effect of change could fall disproportionately on older people as a key customer group of the Post Office, overrepresented in rural areas. There are only very limited polices in this area. The existing literature has not yet examined where compulsory changes have taken place alongside the impact on older people living in the community. This research uses a mixed methods approach, exploring the example of the 2007–9 Post Office Network Change Programme in England and a case study of older people in a community affected by this change. Very rural areas were vulnerable to post office changes; 70 per cent of changes to post office delivery models occurred in these areas. It is important to consider the impacts of changes more broadly, including both direct and indirect outcomes.

scholarly journals The Impact of Living Arrangements and Intergenerational Support on the Health Status of Older People in China

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 796-796
Author(s):  
Yazhen Yang ◽  
Maria Evandrou ◽  
Athina Vlachantoni
Keyword(s):  
Life Satisfaction ◽  
Older People ◽  
Adult Children ◽  
Rural Areas ◽  
Living Arrangements ◽  
Urban Areas ◽  
Well Being ◽  
Intergenerational Support ◽  
Rural And Urban Areas ◽  
The Impact

Abstract Research to-date has examined the impact of intergenerational support in terms of isolated types of support, or at one point in time, failing to provide strong evidence of the complex effect of support on older persons’ wellbeing. Using the Harmonised China Health and Retirement Longitudinal Study (2011, 2013 and 2015), this paper investigates the impact of older people’s living arrangements and intergenerational support provision/ receipt on their physical and psychological wellbeing, focusing on rural/ urban differences. The results show that receiving economic support from one’s adult children was a stronger predictor for higher life satisfaction among older rural residents compared to those in urban areas, while grandchild care provision was an important determinant for poor life satisfaction only for older urban residents. Receiving informal care from one’s adult children was associated with a poor (I)ADL functional status and with depressive symptoms among older rural people. Meanwhile, having weekly in-person and distant contact reduced the risk of depression among older people in both rural and urban areas. The paper shows that it is important to improve the level of public economic transfers and public social care towards vulnerable older people in rural areas, and more emphasis should be placed on improving the psychological well-being of urban older residents, such as with the early diagnosis of depression.

scholarly journals 532 CARING FOR AND CARING ABOUT OLDER PEOPLE LIVING WITH SEVERE FRAILTY DURING COVID-19

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii8-ii13
Author(s):  
R Green ◽  
H King ◽  
C Nicholson
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Services ◽  
Social Care ◽  
Social Contact ◽  
Care Services ◽  
Poor Access ◽  
Health And Social Care ◽  
Video And Audio ◽  
The Impact

Abstract Introduction An ongoing study collected survey and interview data from older people with frailty living in the community near end-of-life during the Covid-19 pandemic. Methods Unstructured interviews with older people with frailty living in the community (N = 10), which included accounts from unpaid carers (N = 5), were video and audio recorded between October–November 2021. Six of these older people have died since fieldwork completion. A face-to-face survey collected data from a further 10 older people. Participants ages ranged from 70–99, 11, men, and 9 women, living in owned, rented, or sheltered accommodation, with Clinical Frailty Scores of 6 (N = 8), 7 (N = 9), and 8 (N = 3). Results Topics raised in relation to the pandemic included loss of social contact and increased loneliness, concern about not physically getting out, and losing physical function. Older people struggled to gain access to health and social care for support and previously received services were withdrawn. Most participants did not have access to internet and relied heavily on families to facilitate virtual contact with health professionals. Families and friends were the main anchor in facilitating social and health care including chasing up medications, liaising with social care to ensure quality and consistency of care provided, and monitoring older people’s health. Where older people’s conditions worsened family provided intense support, though family carers described the strain and unsustainability of this provision. Older people and their families felt they had been forgotten. Conclusions These are insights from hard-to-reach population that are frequently invisible. Greater examination of the impact of using communication technologies in care provision on those with poor access to and capabilities with using these technologies is required. Unpaid carers need more information and resources to support the care they provide and to facilitate access to appropriate social and health care services for those they care for.

scholarly journals The impact of COVID-19 on primary health care and antibiotic prescribing in rural China: qualitative study

2021 ◽  
Author(s):  
Tingting Zhang ◽  
Xingrong Shen ◽  
Rong Liu ◽  
Linhai Zhao ◽  
Debin Wang ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Rural Areas ◽  
Central China ◽  
Antibiotic Prescribing ◽  
Epidemic Control ◽  
Primary Health ◽  
Tract Infections ◽  
The Impact

ABSTRACTIntroductionPrimary health care (PHC) system is designated to be responsible for epidemic control and prevention during the outbreak of COVID-19 in China, while COVID-19 suspected cases in PHC are required to be transferred to specialist fever clinics at higher level hospitals. This study aims to understand to impact of COVID-19 on PHC delivery and antibiotic prescribing at community level in the rural areas of central China.MethodsQualitative semi-structured interviews were conducted with 18 PHC practitioners and seven patients recruited from two township health centres (THCs) and nine village clinics (VCs) in two rural residential areas of Anhui province. Interviews were transcribed verbatim and thematically analysed.ResultsPractitioners’ and patients’ views and perspectives on COVID-19 impacts on PHC services and antibiotic prescribing are organised into four broad themes: switch from PHC to epidemic prevention and control, concerns and challenges faced by those delivering PHC, diminished PHC, and COVID-19 as a different class of illness.ConclusionThe COVID-19 epidemic has had a considerable impact on the roles of rural PHC clinics in China that shifted to public health from principal medical, and highlighted the difficulties in rural PHC including inadequately trained practitioners, additional work and financial pressure, particularly in VCs. Antibiotic prescribing practices for non-COVID-19 respiratory tract infections remained unchanged since the knowledge of COVID-19 was not seen as relevant to practitioners’ antibiotic treatment practices, although overall rates were reduced because fewer patients were attending rural PHC clinics. Since COVID-19 epidemic control work has been designated as a long-term task in China, rural PHC clinics now face the challenge of how to balance their principal clinical and public health roles and, in the case of the VCs, remain financially viable.

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