scholarly journals Inequitable Utilization of Neonatal Health Services in Southwest Ethiopia: The Effects of Socioeconomic Disparities

2021 ◽  
Vol 58 ◽  
pp. 004695802110182
Author(s):  
Kiddus Yitbarek ◽  
Sarah Hurlburt ◽  
Terje P. Hagen ◽  
Melkamu Berhane ◽  
Gelila Abraham ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Concentration Index ◽  
Binary Logistic Regression ◽  
Rural Setting ◽  
Neonatal Health ◽  
Southwest Ethiopia ◽  
Index Value

Low levels of neonatal health services utilization and high neonatal deaths are often concentrated among socially and economically disadvantaged groups, especially in low-income countries. Therefore the aim of this study was to assess inequity in the use of neonatal health services in Southwest Ethiopia. A community-based cross-sectional study was conducted in 8 districts located in Jimma Zone, Southwest Ethiopia from 19 March to 28 April 2018. A total of 835 mothers were included in the study with systematic random sampling. Principal component analysis was conducted to develop wealth quintiles of the households. Equity in neonatal health services was measured using rate-ratio, concentration curve, concentration index, and analyzed by binary logistic regression. Neonates from richer families were 1.25 times more likely to use neonatal health services than the poorer households with a concentration index value of 0.07. Neonates from highly educated mothers have better used the services and the corresponding concentration index value of 0.03. Neonatal service utilization was 1.32 times higher in the highest wealth quintile in rural settings. Similarly, services delivered at health posts and hospitals were used 2.4 and 2 times more by the wealthy, whereas services given at health centers are more utilized by the poorest. Outputs of binary logistic regression analysis indicated that neonates from middle quintile wealth households were found to be better neonatal health service users [AOR_1.72, 95% CI: 1.04, 2.82]. Neonate born from a secondary school attended mother [AOR_3.56, 95% CI: 1.90, 6.69] were more likely to use neonatal health services. Neonatal health service utilization in Southwest Ethiopia is more common among neonates from richer households and more educated mothers. There is a big difference among the wealthy and poorer in a rural setting and among those who used health posts. Working on the social-determinants of health will facilitate eliminating inequity.

scholarly journals Uptake of Sexual And Reproductive Health Services and Associated Factors Among Rural Adolescents in Southern Ethiopia, 2020

2021 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Logistic Regression ◽  
Reproductive Health ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Sexual And Reproductive Health ◽  
Burden Of Illness ◽  
Reproductive Health Service ◽  
Southern Ethiopia ◽  
Reproductive Health Services

Introduction: Although 25% of Ethiopia’s population is an adolescent cohort of age 15-19 yrs, the Adolescent Sexual and Reproductive Health Service (ASRH) service utilization has not been adequately researched and addressed, and, therefore, they have had to deal with multiple reproductive health problems. Therefore, assessing the determinants of sexual and reproductive health service uptake in this age group is critical to boosting service use and, in doing so, reducing the burden of illness and disability among adolescents. And so, the motivation at the rear of this research was to look into the level of sexual and reproductive health services utilization and to find out determinants among adolescents who reside in rural districts of Guraghe zone, southern Ethiopia. Methods: A community-based cross-sectional study was undertaken from May 1-30, 2020. A multi-stage method of sampling was employed. A total of 1028 adolescents have been randomly chosen and participated in the study. Pre-tested structured questionnaires were used for data collection. The data was encoded and entered into Epi-Data version 3.1 and exported for analysis to SPSS version 23. A bivariable logistic regression analysis was conducted, and variables with a p-value less than 0.25 were considered candidates for a multivariable logistic regression model. In multivariate logistic regression, variables with p-values <0.05 were declared as statistically significant. Results: of the sampled 1028 participants, 1009 took part in the study and yielded a response rate of 98.1%. The study found that 281 (27.8%) of adolescents received sexual and reproductive health services. Accordingly, among these SRH service users (n = 281), provision of SRH information and education was the most common item received by 171(60.8%) of adolescents whereas relatively few respondents 32(11.4%) got safe and /or postabortion care. Variables that became important determinants of SRH service utilization were; taking part in peer education (AOR:2.07; 95%CI:1.46-2.94), parental discussion (AOR:3.94; 95%CI:2.77-5.60), availability of youth clubs (AOR:3.15; 95%CI:2.22-4.49), and being knowledgeable on SRH issues (AOR:3.48; 95%CI: 2.44-4.96). Conclusion: In the study area, sexual and reproductive health service utilization was low. Since most adolescents are enrolled in school, schools can be an excellent way to increase adolescents’ awareness of SRH services through behavioral change communication (BCC). Furthermore, special attention should be given to promoting discussion between parents and adolescents and the creation and strengthening of youth clubs as important steps to improving the use of Sexual and reproductive services for adolescents by the relevant stakeholders.

scholarly journals Determinants of Health Service Utilization Among Users of Dokolo Health Centre IV, Dokolo District: A Community Perspective

2021 ◽  
Vol 8 (1) ◽  
pp. 17
Author(s):  
Francis Ojok ◽  
Samuel Samuel Mukasa ◽  
Kizito Omona [PhD]
Keyword(s):  
Health Service ◽  
Health Services ◽  
Health Facility ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Health Centre ◽  
Determinants Of Health ◽  
Rural Setting ◽  
Fundamental Aspect ◽  
Qualitative Approaches

Introduction: Health services utilization (HSU) is an important health outcome indicator, a surrogate measure of access to healthcare that influences the outcomes of health status and consumer satisfaction. Healthcare is central to community well-being as well as a fundamental aspect of life. Objective: The study sought to assess determinants of health service utilization among users of Dokolo Health Centre IV, Dokolo district. Methods: A cross sectional analytical design, which employed both quantitative and qualitative approaches, was used between January and July, 2020. A total of 396 respondents participated. Data was collected using Semi-structured questionnaires and Focus Group Discussion guide. Analysis was done using SPSS and qualitative data was analyzed verbatim.Results: Only 26.8% of the users were satisfied with services provided in the health facility. Living environments of respondents was the only socio-demographic factor that determined HSU (p = 0.046). Living in urban area was 1.6 times more likely to be a determinant of HSU than living in rural setting [COR=1.571, 95% CI (0.986-2.504)]. The study found that being a female was 1.14 times more likely to utilize health services (COR=1.135, 95% CI (0.741-1.739)). Similarly, majority of the respondents who were peasants, 174(43.9%), utilized health services from the facility as opposed to their formally employed counterparts. Thus, being formally employed was 0.7 times less likely to utilize health services (COR= 0.655, 95% CI (0.29-1.476)). Satisfaction with services (p=0.000), level of satisfaction (p=0.000) and distance to health facility (p=0.033) were enablers of HSU. Being very satisfied was 16 times more likely for one to utilize health services [COR=16, 95% CI (0.000- 0.001)]. Most of the respondents rated the quality of care as poor.Conclusion: Health service utilization remains quite low in many rural health facilities of Uganda.  

scholarly journals Health literacy and health outcomes in China’s floating population: mediating effects of health service

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hai-YanYu ◽  
Wei-Ling Wu ◽  
Lin-Wei Yu ◽  
Lei Wu
Keyword(s):  
Health Literacy ◽  
Health Service ◽  
Health Services ◽  
Health Outcomes ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Mediating Effect ◽  
Floating Population ◽  
Equation Modeling ◽  
Mediating Effects

Abstract Background The floating population in China consists primarily of internal immigrants and represents a typical health vulnerable group. Poor health literacy has recently become an obstacle in the accessibility and utilization of health services for the vulnerable population, leading to adverse health outcomes. This study aimed to examine whether health literacy affected health outcomes in China’s floating population and whether health service utilization had a mediating effect between health literacy and health outcomes. Method The current study utilized a cross-sectional stratified, multistage, proportional to scale (PPS) study in Zhejiang Province, China, in November and December 2019. In total, 657 valid self-reported questionnaires were recovered and used for data collection. Questionnaires included questions regarding sociodemographic characteristics, health literacy, health outcomes, and health service utilization. Confirmatory factor analysis was used to test questionnaire validity; descriptive statistics were used to understand the demographic characteristics of the floating population; and structural equation modeling was used to determine whether health service utilization mediated health literacy and health outcomes. Results We report positive correlations between health literacy, health service utilization, and health outcomes. Mediation analysis demonstrated that health service utilization had partial mediating effects between health literacy and health outcomes. In the relationship between health literacy and health outcomes, the indirect effects of health service utilization accounted for 6.6–8.7% of the total effects. Conclusion Complete health literacy, through health care literacy and health promotion literacy, affects the mobile population’s initiative to use health services, which, in turn, affects health outcomes. Thus, improving the health literacy of the floating population will help to improve health outcomes. Furthermore, health service providers should enhance the diversity of health service supply to ensure that the floating population has the external resources to improve personal health literacy.

scholarly journals Youth Reproductive Health Service Utilization and Associated Factors among Amhara Region Female Night Students, Ethiopia

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Tewachew Muche Liyeh ◽  
Yitayal Ayalew Goshu ◽  
Habtamu Gebrehana Belay ◽  
Habtamu Abie Tasew ◽  
Gedefaye Nibret Mihiretie ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Sexual And Reproductive Health ◽  
Reproductive Health Service ◽  
Health Issues ◽  
Reproductive Health Services ◽  
Amhara Region

Introduction. Youth is a decisive age to shape the direction of their life and that of their family. However, due to the host of biological, social, and economic factors, adolescent females can be at high risk of adverse sexual and reproductive health outcomes. Therefore, assessing youth reproductive service utilization and associated factors among female night students is very crucial for timely intervention to their gaps. Method. An institutional-based cross-sectional study design was conducted in Amhara region among 2,050 female night students from September 15 to November 15, 2018. A self-administered pretested questionnaire was used to collect the data. Bivariate and multivariable logistic regression models were used. Odds ratio with 95% confidence interval was computed to determine the strength of association between predictor and outcome variables. P value less than or equal to 0.05 is considered as the level of significance. Results. Out of the total respondents, about 54.6%(CI: 52.5%-56.8%) of them utilized reproductive health services. Respondents who were attending secondary education ( AOR = 2.55 , 95 % CI = 1.97 ‐ 5.62 ), attitude towards youth reproductive health services ( AOR = 2.74 , 95 % CI = 2.07 ‐ 5.30 ), those who had a habit of communicating on sexual and reproductive health issues with their family ( AOR = 3.66 , 95 % CI = 3.59 ‐ 7.41 ), discussion on sexual and reproductive health issue with peers/friends ( AOR = 1.43 , 95 % CI = 1.01 ‐ 2.02 ), respondents with good knowledge on youth reproductive health services ( AOR = 2.03 , 95 % CI = 1.49 ‐ 2.75 ), and those who had faced reproductive health problems ( AOR = 2.03 , 95 % CI = 1.49 ‐ 2.75 ) were significantly associated with youth reproductive health service utilization. Conclusion. Youth reproductive health service utilization among female night students was not satisfactory. Therefore, special focus should be given to female night students by providing accessible, acceptable, confidential, flexible, and friendly reproductive health service utilization. Finally, community health promotion and education are mandatory to promote the practice of discussing youth reproductive health issues with their children.

scholarly journals Does Antenatal Care Translate into Skilled Birth Attendance? Analysis of 2014 Ghana Demographic and Health Survey

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Linus Baatiema ◽  
Edward Kwabena Ameyaw ◽  
Aliu Moomin ◽  
Mukaila Mumuni Zankawah ◽  
Doris Koramah
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Health Survey ◽  
Tertiary Education ◽  
Binary Logistic Regression ◽  
Skilled Birth Attendance ◽  
Demographic And Health Survey ◽  
Rural Setting ◽  
Binary Logistic Regression Analysis ◽  
Birth Attendance

Background. Despite the high antenatal care attendance rate in Ghana, skilled birth attendance is relatively low. There is limited evidence on whether antenatal care attendance translates into skilled birth attendance in the Ghanaian research discourse. This study investigates whether antenatal care attendance translates into skilled birth. Methods. We extracted data from the 2014 Ghana Demographic and Health Survey. Data were analysed using descriptive and binary logistic regression analyses at 5% confidence interval. Results. The descriptive findings indicated a vast variation between antenatal care attendance and skilled birth attendance. Skilled birth attendance was consistently low across almost all sociodemographic characteristics as compared to antenatal care attendance. The binary logistic regression analysis however indicated higher inclination toward skilled birth attendance among women who had at least four antenatal care visits [OR=5.87, CI=4.86-7.08]. The category of women noted to have higher tendencies of skilled birth attendance was those with higher/tertiary education [OR=9.13, CI=2.19-37.93], the rich [OR=4.27, CI=3.02-6.06], urban residents [OR=2.35, CI=1.88-2.93], women with maximum of four children [OR=1.36, CI=1.08-1.72], and those using modern contraceptives [OR=1.24, CI=1.03-1.50]. Conclusion. We recommend that interventions to enhance skilled birth attendance must target women who do not achieve at least four antenatal visits, those with low wealth standing, those not using contraceptives, and women without formal education. Again, an in-depth qualitative study is envisaged to deepen the understanding of these dynamics in the rural setting.

scholarly journals Health Service Utilization and Out-Of-Pocket Health Expenditure Among Insured and Uninsured: A Comparative Study in Baglung District, Nepal

2019 ◽  
Author(s):  
Laxman Datt Bhatt ◽  
Shankar Singh Dhami
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Expenditure ◽  
Health Service Utilization ◽  
Social Health ◽  
Insurance Status ◽  
Community Based ◽  
Health Security

Abstract Background Nepal's Interim Constitution of 2007 addresses health as a fundamental right, stating that every citizen has the right to basic health services free of cost. Government of Nepal formed a Social Health Security Development Committee as a legal framework to start implementing a social health security scheme after the National Health Insurance Policy came out in 2013. The program has aimed to increase the access of health services to the poor and the marginalized, and people in hard to reach areas of the country, though challenges remain with financing. Several aspects should be considered in design, learning from earlier community-based health insurance schemes that suffered from low enrollment and retention of members as well as from a pro-rich bias.Method A community based cross-sectional comparative study was conducted in Baglung district of Nepal to find out and compare the health service utilization and direct out-of-pocket health care expenditure among the 225 insured and 225 uninsured households under the national health insurance program of Nepal. Insured households were randomly chosen from study area and uninsured households were selected by using neighborhood method.Result The study focused that insurance status was strongly associated with heath service utilization with odds ratio 1.774 (95% CI = 1.127-2.791, P = 0.013). The study also depicts that insurance status was major determinants of out of pocket health expenditure. The median out-of-pocket health expenditure among insured households Nepalese Rupees 200 while among uninsured was 1225, which was statistically significant (p = <0.001 MW-U test). Among uninsured group, non-dalit were 2.846 times more likely to utilize health services compared to the dalit (p = 0.003) but it was not significant (p = 0.47) among insured group.Conclusion Nepal’s Health Insurance Board is responsible for purchasing the quality health care service and make available at possible nearest point of its member. Our study reveals that Occupation, perceived health status, wealth status played significant role with health service utilization among uninsured group while it was not significant among insured group. Among both insured and uninsured group none of the study variables were found significant with out-of-pocket health expenditure.

scholarly journals Pattern of Outpatient Health Service Utilization by Older People in Iran

Salmand ◽  
2021 ◽  
Vol 15 (4) ◽  
pp. 410-427
Author(s):  
Maryam Tajvar ◽  
◽  
Mehdi Yaseri ◽  
Badriye Karami ◽  
Mariya Mohammadi ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Older People ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Health Planning ◽  
The Elderly ◽  
National Study ◽  
Outpatient Services ◽  
To Receive

Objectives: Considering the rapid growth of Iran’s elderly population with consequent increase in the costs of health services, it is necessary to be aware of the pattern of outpatient health service utilization, in the elderly for resource allocation and health planning. This study aims to determine the pattern of outpatient service utilization for the elderly in Iran and explore determinant factors. Methods & Materials: This is a cross-sectional study using secondary analysis method and the data from 2015 National Study of Health Service Utilization. Study population consists of older people aged ≥60 years. Of these, 8205 were selected as study samples. The data were collected using personal and household questionnaires collecting information on subjects’ need for, referral to, utilization from, and satisfaction with outpatient services. Logistic regression analysis was used to identify factors related to the need, referral, benefit, and satisfaction with the received outpatient services. Results: Out of 8205 participants, 3172 (39%) reported the need for outpatient services, of which 66% referred for services; of these, 98% (N=2060) benefited outpatient services. Females, older subjects, villagers, unmarried and illiterate subjects were more in need of outpatient services, but their referrals to receive the services were not more than those of other groups. Lack of basic insurance, supplementary insurance, and a personal care had a significant impact on reducing the number of subjects referred to receive outpatient services. Inability to pay treatment costs (30%), self-treatment (28%) and lack of proper insurance coverage (13%) were the most important reasons for not referring to receive outpatient services. The highest satisfaction was related to the behavior of physicians and medical staff and the lowest satisfaction was related to the cost of outpatient services. Conclusion: Although the use of outpatient health services should be based on the need for these services, the present study showed that the older people with higher socio-economic status had higher utilization from the services in Iran. Therefore, there is an inequality in access to outpatient services in the elderly. The reasons for not using outpatient services and dissatisfaction with these services should be seriously considered by health policy makers.

scholarly journals Depressive symptoms and health service utilization among Chinese middle aged and older adults: A national population-based longitudinal survey

2020 ◽  
Author(s):  
Jing Guo ◽  
Dexia Kong ◽  
Anao Zhang ◽  
Liming Fang ◽  
Yingxue Zhu
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Health Services Utilization ◽  
Middle Aged ◽  
Cross Sectional ◽  
Services Utilization

Abstract Background: The prevalence of depressive symptoms has been steadily increasing in recent years, however middle aged and older adults was less likely to use mental health services. The aims of this study were to 1) examine the cross-sectional and longitudinal relationships between depressive symptoms and health services utilization among Chinese middle-aged and older adults; and 2) evaluate whether there exists a rural-urban difference in such relationships. Methods: Data was obtained from China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015, a nationally representative survey of 13,551 adults aged 45 years and above in China. Multivariate logistic regression analyses were conducted to assess the cross-sectional and longitudinal relationship between depressive symptoms and health services utilization in the whole sample, and urban and rural subsamples respectively. Results: Depressive symptoms were positively associated with a greater likelihood of outpatient and inpatient health services utilization. In addition, the relationships between depressive symptoms and health service use were consistent across rural and urban settings, indicating the robustness of such findings across geographic areas. Conclusions: Findings indicate that depressive symptoms are significantly associated with both in-patient and out-patient health service utilization among Chinese adults. Screening for depressive symptoms needs to be incorporated in these care settings in China.

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