scholarly journals Factors associated with prenatal care and HIV and syphilis testing during pregnancy in primary health care

2019 ◽  
Vol 53 ◽  
pp. 76
Author(s):  
Cláudia Helena Soares de Morais Freitas ◽  
Franklin Delano Soares Forte ◽  
Angelo Giuseppe Roncalli ◽  
Maria Helena Rodrigues Galvão ◽  
Ardigleusa Alves Coelho ◽  
...  
Keyword(s):  
Health Care ◽  
Regression Analysis ◽  
Prenatal Care ◽  
Cash Transfer ◽  
Social Characteristics ◽  
Bivariate Analysis ◽  
Transfer Program ◽  
Factors Associated ◽  
Independent Variables ◽  
Syphilis Testing

OBJECTIVE: To evaluate the factors associated with HIV and syphilis testing during pregnancy in Brazil. METHODS: This was an ecological study covering all Brazilian municipalities evaluated by the second cycle of the National Program for Access and Quality Improvement in Primary Care, 2013-2014. The dependent variables were based on prenatal care access: prenatal care appointments, and HIV and syphilis tests during prenatal care. The independent variables were compared with demographic and social characteristics. Bivariate analysis was performed assessing the three outcomes with the independent variables. Variables with significant associations in this bivariate analysis were fit in a Poisson multiple regression analysis with robust variance to obtain adjusted estimates. RESULTS: Poisson regression analysis showed a statistically significant association with the variables “less than eight years of study” [prevalence ratio (PR) = 1.31; 95%CI 1.19–1.45; p < 0.001] and “participants of the cash transfer program” (PR = 0.80; 95%CI 0.72–0.88; p < 0.001) for the outcome of “having less than six prenatal care appointments” and individual variables. A statistically significant association was found for “participants of the cash transfer program” (PR = 1.43; 95%CI 1.19–1.72; p < 0.001) regarding the outcome from the comparison between HIV testing absence during prenatal care and demographic and social characteristics. The absence of syphilis testing during prenatal care, and demographic and social characteristics presented a statistically significant association for the education level variable “less than eight years of study” (PR =1.75; 95%CI 1.56–1.96; p < 0.001) and “participants of the cash transfer program” (PR = 1.21, 95%CI 1.07–1.36; p < 0.001). CONCLUSIONS: The individual factors were associated with prenatal care appointments and HIV and syphilis tests in Brazilian pregnant women. They show missed opportunities for diagnosing HIV and syphilis infection during prenatal care and indicate weaknesses in the quality of maternal health care services to eliminate mother-to-child transmission.

scholarly journals Prenatal evaluation in primary care in Northeast Brazil

2019 ◽  
Vol 53 ◽  
pp. 43 ◽  
Author(s):  
Esther Pereira da Silva ◽  
Antônio Flaudiano Bem Leite ◽  
Roberto Teixeira Lima ◽  
Mônica Maria Osório
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Prenatal Care ◽  
Health Care Professionals ◽  
Cross Sectional Study ◽  
Educational Strategies ◽  
Cross Sectional ◽  
Factors Associated ◽  
Primary Health ◽  
Logistic Regression Method

OBJECTIVE: To characterize prenatal care and verify possible factors associated with its adequacy. METHODS: This is a cross-sectional study based on interviews with health care professionals and consultations on official documents of women attending prenatal of the primary health care in the city of João Pessoa, capital of Paraíba, in the Northeast region of Brazil. Prenatal care was evaluated by an index with criteria referring to aspects of structure, process and outcome, denominated IPR/Prenatal. The multivariate logistic regression method revealed that demographic, socioeconomic, reproductive and maternal morbidity variables were possible determinants for prenatal adequacy. RESULTS: The survey involved 130 services and 1,625 primary health care patients. Prenatal care was adequate in approximately 23% of the cases. Low prevalence of referral to maternity, educational strategies and examinations were observed. The analysis showed that nonadolescent women (OR = 1,390), with a longer period of schooling (OR = 1.750), higher per capita income (OR = 1,870) and primiparous women (OR = 1,230) were more likely to have an adequate prenatal. CONCLUSIONS: Prenatal care, when evaluated by broader criteria, showed a low percentage of adequacy. Strategies should be developed to ensure the referral to the maternity where the birth will take place and health education activities and examinations to provide adequate prenatal care in the municipality under study. In addition, factors associated with adequacy must be considered by managers and health professionals.

scholarly journals What is the relative impact of primary health care quality and conditional cash transfer program in child mortality?

2019 ◽  
Vol 110 (6) ◽  
pp. 756-767
Author(s):  
Anya Pimentel Gomes Fernandes Vieira-Meyer ◽  
Maria Socorro de Araújo Dias ◽  
Maristela Ines Osawa Vasconcelos ◽  
Emilia Soares Chaves Rouberte ◽  
Ana Mattos Brito de Almeida ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Quality ◽  
Conditional Cash Transfer ◽  
Care Quality ◽  
Cash Transfer ◽  
Relative Impact ◽  
Transfer Program ◽  
Primary Health ◽  
Conditional Cash Transfer Program

scholarly journals Unmet dental health care needs among adults in Serbia, Survey on Income and Living Conditions 2017

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Z Terzic-Supic ◽  
J Todorovic ◽  
K Vojvodic ◽  
P Piperac ◽  
M Santric-Milicevic
Keyword(s):  
Health Care ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Dental Health ◽  
Multivariate Logistic Regression Analysis ◽  
Social Characteristics ◽  
Health Care Needs ◽  
Multivariate Logistic Regression ◽  
Care Needs ◽  
Dental Health Care

Abstract Background Changes in the health insurance law in 2005 led to the changes in the organization of the provision of dental health care in Serbia. Prior to this law, dental health care was available for every resident covered by mandatory health insurance without additional out-of-pocket payments. Now the dental health care is available only for children under the age of 18, students under the age of 26, pregnant women and for emergency dental care. The aim of this study was to assess the prevalence of unmet dental health care needs among adults and to assess the factors associated with unmet dental health care needs. Methods The study was the secondary analysis of the data from the Survey on income and Living conditions in Serbia, conducted during 2017. Multivariate logistic regression analysis was used to assess the association of unmet dental health care needs and socio-demographic and socio-economic factors. Results Total of 1718/12437 (12.1%) adults reported unmet dental health care needs. The main reason reported was not being able to afford it (1014/1718, 59.0%), along with the fear of doctors or hospitals (260/1718, 15.5%). Multivariate logistic regression analysis showed the association of unmet dental health care needs and being employed (OR: 1.50, 95% CI: 1.24-1.80), unemployed (OR: 1.96, 95% CI: 1.65-2.33), having primary (OR: 1.47, 95% CI: 1.16-1.86), or secondary education (OR: 1.43, 95% CI: 1.21-1.69), being divorced (OR: 1.47, 95% CI: 1.17-1.85), having good (OR:1.44, 95% CI: 1.20- 1.74), average (OR: 2.36, 95% CI: 1.91-2.92), poor (OR: 2.29, 95%CI: 1.77-2.97), or very poor general health (OR: 2.42, 95% CI: 1.68-3.48), having limitation in daily activities (OR: 0.66, 95% CI: 0.60-0.77) and being materially deprived (OR: 1.67, 95% CI: 1.46-1.90). Conclusions The prevalence of unmet dental health care needs in high among adults in Serbia. There is an association between social characteristics and health status with unmet dental health care needs in Serbia. Key messages There is a high prevalence of unmet dental health care needs in Serbia. Unmet dental health care needs are associated with social characteristics and health status.

Factors Associated With Severity of Cubital Tunnel Syndrome at Presentation

Hand ◽  
2021 ◽  
pp. 155894472110588
Author(s):  
Dafang Zhang ◽  
Brandon E. Earp ◽  
Scott H. Homer ◽  
Philip Blazar
Keyword(s):  
Diabetes Mellitus ◽  
Regression Analysis ◽  
Motor Nerve ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Bivariate Analysis ◽  
Factors Associated ◽  
Multivariable Regression Analysis ◽  
Multivariable Regression ◽  
Tunnel Syndrome

Background: The outcomes of cubital tunnel syndrome surgery are affected by preoperative disease severity. The aim of this study was to identify factors associated with clinical and electrodiagnostic severity of cubital tunnel syndrome at presentation. Methods: We retrospectively identified 213 patients with electrodiagnostically confirmed cubital tunnel syndrome who underwent cubital tunnel surgery from July 2008 to June 2013. Our primary response variable was clinical cubital tunnel syndrome severity assessed by the McGowan grade. Our secondary response variables were sensory nerve action potential (SNAP) recordability, presence of fibrillations, and motor nerve conduction velocities (CVs) in the abductor digiti minimi (ADM) and first dorsal interosseous (FDI). Bivariate analysis was used to screen for factors associated with disease severity; significant variables were selected for multivariable regression analysis. Results: Older age was associated with higher McGowan grade and diabetes mellitus was associated with unrecordable SNAPs on bivariate analysis. No other variables met inclusion criteria for multivariable regression analysis for McGowan grade or unrecordable SNAPs. Multivariable regression analysis showed older age and higher Distressed Communities Index (DCI) to be associated with decreased motor nerve CVs in ADM. Multivariable regression analysis showed higher body mass index (BMI) and higher DCI to be associated with decreased motor nerve CVs in FDI. No variable was associated with the presence of fibrillations. Conclusions: A subset of patients with cubital tunnel syndrome may benefit from earlier referral for hand surgery evaluation and earlier surgery. Older patients, with higher BMI, with diabetes mellitus, and with economic distress are at higher risk for presentation with more severe disease.

scholarly journals Exploring the Health Outcomes of Conditional Cash Transfer Program in Rural Philippines

2021 ◽  
Author(s):  
Ericson H. Peñalba
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Care Service ◽  
Health Care Service ◽  
Conditional Cash Transfer ◽  
Cash Transfer ◽  
Health Improvement ◽  
Transfer Program ◽  
Positive Health ◽  
Support Mechanism

The Pantawid Pamilya Pilipino Program (4Ps), the first conditional cash transfer (CCT) program of the Philippine government, has become a popular approach aimed at improving the health and educational status of disadvantaged households. Its implementation is expected to advance the government’s health agenda, particularly in terms of child mortality reduction and maternal health improvement. Despite the growing evidence on the positive health outcomes resulting from the implementation of CCT programs, evidence remains limited to the qualitative evaluation of health care service utilization among beneficiary households. In this regard, by employing key interviews and focus group discussion, this study aims to examine the impacts of 4Ps on health and nutrition as experienced and perceived by beneficiaries at a community-level implementation. After subjecting the interview transcripts to thematic network analysis, the results reveal six dominant themes: enhanced health practices, improved uptake of health care services, increased awareness on health issues, improved living conditions, responsive program implementation, and persisting implementation challenges. While it is evident that the positive impacts are reflective of the beneficiaries’ strict compliance to meet the program conditionalities, there is still much to be done to ensure the sustainability of the program. The provision for adequate health care should then be supplemented with reinforced delivery of the program’s learning component (family development session) and support mechanism to the implementers.

scholarly journals Factors associated to quality of life of orthodontists graduated from a public university (1993-2016): A mixed-methods approach

2020 ◽  
Vol 25 (5) ◽  
pp. 23e1-23e12 ◽  
Author(s):  
Natalia Muñoz-Pino ◽  
Anderson E. Tibaná-Guisao ◽  
Johnatan D. Cardona-Hincapié ◽  
Alejandro Hurtado-Aristizábal ◽  
Andrés A. Agudelo-Suárez
Keyword(s):  
Quality Of Life ◽  
Mixed Methods ◽  
Public University ◽  
Bivariate Analysis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Independent Variables ◽  
Research Activities

ABSTRACT Introduction: For dental professionals, including orthodontists, Quality of life (QOL) is a topic of growing concern and could be determined by objective and subjective complex factors. Objective: This study analyzed the factors that influence the QOL of orthodontists graduated between 1993 and 2016 of a public university (Medellín, Colombia). Methods: A mixed-methods study was conducted (cross-sectional survey; 88 participants; 3 focus groups, 21 participants). Quantitative analysis: the research included sociodemographic, labor and health characteristics as independent variables and the WHOQOL-BREF questionnaire as main outcome for QOL. Frequencies were calculated and the association between QOL and independent variables was estimated by bivariate analysis (Chi square tests) and a linear multivariate regression. Qualitative analysis: Narrative content analysis according to thematic categories. Mixed methods: a conceptual framework for QOL using the triangulation was developed. Results: All the scores surpassed 55 points on the 4 domains of WHOQOL-BREF. A lower value was found in the physical dimension (57.1±10.7) and a greater value in the psychological dimension (70.8±8.3). The variables associated positively to QOL were permanent contract, teaching/research activities, monthly income, resting days per week and sex. Factors associated negatively were low social support, mental health and rent housing. Discourses of participants allowed to identify the concept of QOL and the contextual and social determinants and satisfiers. Conclusion: QOL of orthodontists is influenced by sociodemographic, employment, working and health factors. Therefore, QOL is a multidimensional concept that recognizes the political and socio-economic context and personal and professional experiences.

Influences on the Receipt of Well-child Visits in the First Two Years of Life

PEDIATRICS ◽  
1999 ◽  
Vol 103 (Supplement_1) ◽  
pp. 864-869 ◽  
Author(s):  
Gary L. Freed ◽  
Sarah J. Clark ◽  
Donald E. Pathman ◽  
Robin Schectman
Keyword(s):  
Health Care ◽  
Prenatal Care ◽  
Outpatient Care ◽  
Odds Ratio ◽  
Chart Review ◽  
Birth Certificates ◽  
Targeted Interventions ◽  
Factors Associated ◽  
Private Physician ◽  
Adequate Number

Objective. To determine demographic and health care system factors associated with children receiving an adequate number of well-child visits (WCVs). Methods. Information on 4385 children and their families was obtained via birth certificates, parent interviews, chart review of outpatient sites of care, and insurance records. Results. Only 77% of children received at least five WCVs by age 2. In regression analysis, the factors most strongly associated with children's total number of WCVs were delay in the initiation of prenatal care (odds ratio = 0.6) and receipt of all outpatient care in private physician offices (odds ratio = 4.2 to 5.6). Having an adequate number of WCVs was associated with being up to date for immunizations. Conclusions. Children of mothers who delay prenatal care are at high risk for not receiving adequate numbers of WCVs. Recognition of this marker can allow for targeted interventions that aim to ensure that children receive appropriate preventive care.

scholarly journals Inequalities in access to HIV and syphilis tests in prenatal care in Brazil

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Claudia Helena Soares de Morais Freitas ◽  
Franklin Delano Soares Forte ◽  
Maria Helena Rodrigues Galvão ◽  
Ardigleusa Alves Coelho ◽  
Angelo Giuseppe Roncalli ◽  
...  
Keyword(s):  
Prenatal Care ◽  
Gini Index ◽  
Family Income ◽  
Conditional Cash Transfer ◽  
Education Level ◽  
Cash Transfer ◽  
Transfer Program ◽  
The Family ◽  
Conditional Cash Transfer Program ◽  
The City

This study aims to evaluate the social determinants of access to HIV and VDRL tests during pregnancy in Brazil. The dependent variables were based on prenatal care access: prenatal care appointments, no HIV and syphilis tests. The independent variables at the first level were formal education level, age, race, work and participation in the Family Income program conditional cash transfer program. The city-level variables were the human development index (HDI), Gini index, and indicators related to health services. An exploratory analysis was performed assessing the effect of each level through prevalence ratios (PR) calculation. A multilevel mixed-effect Poisson regression model was constructed for all outcomes to verify the effect of individual level and with both the individual and contextual levels. Regarding prenatal appointments, the main implicated factors were related to individual socioeconomic position (education level and participation in the Family Income Program conditional cash transfer program), however only HDI maintained significance for the city-level context. The city-level variance dropped from 0.049 to 0.042, indicating an important between-city effect. Regarding the outcomes performing tests in prenatal care, the worst conditions such as contextual (HDI > 0.694, p < 0.001; Gini index ≥ 0.521, p < 0.001) and individual (> 8 years of schooling, p < 0.001) showed a risk effect in the final model. Variables related to health services did not show significant effects. They were associated with individual socioeconomic position and a city-level contextual effect. These findings indicate the importance of strengthening HIV and syphilis infection control programs during pregnancy.

scholarly journals Factors associated with TB in an indigenous population in Brazil: the effect of a cash transfer program

2018 ◽  
Vol 60 (0) ◽  
Author(s):  
Jocieli Malacarne ◽  
Ida Viktoria Kolte ◽  
Lais Picinini Freitas ◽  
Jesem Douglas Yamall Orellana ◽  
Maximiliano Loiola Ponte de Souza ◽  
...  
Keyword(s):  
Indigenous Population ◽  
Cash Transfer ◽  
Transfer Program ◽  
Factors Associated

scholarly journals Women and health professionals’ perspectives on a conditional cash transfer program to improve pregnancy follow-up: a qualitative analysis of the NAITRE randomized controlled study

2020 ◽  
Author(s):  
AURELIE GODARD MARCEAU ◽  
Nicolas Meunier Beillard ◽  
Philippe Deruelle ◽  
Mathieu Morin ◽  
Claude Virtos ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Prenatal Care ◽  
Health Professionals ◽  
Medical Condition ◽  
Conditional Cash Transfer ◽  
Cash Transfer ◽  
Controlled Study ◽  
Transfer Program ◽  
Cross Sectional

Abstract Objectives. Many types of conditional cash transfer (CCTs) programs have been developed and their effects demonstrated, including programs to improve prenatal care, but ethical critiques have included paternalism and lack of informed choice. These criticisms were levelled at the French NAITRE randomized clinical trial, which is assessing a CCT program that promotes prenatal care among women of low socioeconomic backgrounds. We conducted qualitative research to determine if women in the study and health professionals (HP) shared these concerns.Study design. We conducted a multicenter, cross-sectional, qualitative study of 26 participating post-delivery women and 8 HP (physicians and midwives, participants and non-participants) to assess their perspectives on CCT, purposively selecting a sample of women with diverse experiences. We excluded women who had miscarried or whose babies had died, or whose new-born suffered from a severe medical condition. We invited health professionals to participate even if they or their center had not participated in the trial. Participants agreed to semi-structured face-to-face or phone interviews, which we recorded as audio and transcribed. Our approach to identifying patterns was inductive; we highlighted topics that repeatedly emerged, characterized them, and organized them into themes.Results. Women expressed surprise that the CCT was offered, but did not perceived it negatively. They never mentioning feeling stigmatized. They described CCT as a significant source of aid for women with limited financial resources. HP described the CCT in less positive terms, e.g., expressing concern about discussing cash transfer at their first medical encounter with women. Though they emphasized ethical concerns about the basis of the trial, they recognized that CCT needed to be evaluated.Conclusion. In France, a high-income country where prenatal follow-up is free, health professionals were concerned that the CCT program would change their relationship with patients and wondered if it was the best use of funding, but women who received a cash incentive said they did not feel stigmatized and indicated that these payments helped them prepare for their baby’s birth. Trial registration: NCT02402855- Clinical Trial – first registration 30 march 2015 -

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