Informal Payments for Maternal and Neonatal Health Services in Public Hospitals in Central India

Background: Informal payments are unauthorised ‘unregistered’ out-of-pocket payments, outside the official payment system, for purchase or service meant to be covered/provided by the healthcare system. This study attempts to measure and report the extent and magnitude of informal payments based on the entitlements in Janani-Shishu Suraksha Karyakram (JSSK) in the Indian context. Methods: A cross-sectional study using convenience sampling and a semi-structured interview schedule was conducted among 281 participants in 2016 in 26 JSSK-notifying health facilities from all five divisions of Chhattisgarh. Pregnant women and women who delivered in the previous year, and provided informed consent, were included. After reviewing various definitions, informal payment was operationally defined in the context of JSSK for India as ‘payments made in cash or kind, unregistered or non-reimbursed, made by/on behalf of the beneficiary or someone related thereof, for free and cashless entitlements in a JSSK-listed health facility, to an individual or institutional healthcare provider/staff who provides/arranges for provision of the service’. Results: Of 281 participants, 91.8 per cent reported informal payments across all JSSK entitlements categories. A relative majority of these payments was made at the district hospital (37%), ranging from ₹2 to ₹6,500 (US$0.03–101). Investigations incurred the greatest median amount of informal payments, at, ₹455 (US$7). Informal payments ranged between three and seven times higher than the JSSK price cap in Chhattisgarh. No significant association was found between participant characteristics and informal payments. Conclusion: Further research is required to understand the magnitude and motivation of informal payments made in programmes like JSSK.

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A Cross-sectional Study on Challenges Faced and Strategies Adopted in Responding to Corona Virus Disease (COVID-19) by Hospital Administrators in Kaski District

Journal of Biomedical Research & Environmental Sciences ◽

10.37871/jbres1221 ◽

2021 ◽

Vol 2 (4) ◽

pp. 256-260

Author(s):

KC Deepti ◽

S Poudel ◽

SB Hamal Thakuri ◽

S Shrestha

Keyword(s):

Virus Disease ◽

Health Care Systems ◽

Structured Interview ◽

Cross Sectional Study ◽

Public Hospitals ◽

Cross Sectional ◽

Hospital Administrators ◽

Corona Virus ◽

Care Systems ◽

Private And Public

Background: Following the outbreak of Coronavirus disease in 2019, the year 2020/21 has been an incredibly challenging one for all global health-care systems. Methods: A cross sectional descriptive research design was used to conduct the study. The study was carried out in all general private and public hospitals of Kaski district of Nepal. Data were collected from 25th October to 5th December, 2020 from the Hospital administrators using a semi structured interview schedule. Descriptive statistics were used for data analysis. Results: Most (96.3%) of the hospitals reported that increased cost or expenses of the hospitals creating financial threat is the most challenging situation that hospitals are facing in this pandemic. In addition shortages of ventilators creating ethical dilemma for patient allocation and changing guidelines from authorities have been reported as a challenge by 88.9 percent of the hospitals respectively. All of the surveyed hospitals had developed the use of thermometers for screening at the hospital entrances to minimize the risk. Conclusion: Hospitals in this pandemic are facing a lot of challenges with regard to staff management, PPE management and so on. Hence they need to adopt best strategies in responding to the corona virus.

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Burden of out-of-pocket payments among patients with cardiovascular disease in public and private hospitals in Ibadan, South West, Nigeria: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-044044 ◽

2021 ◽

Vol 11 (6) ◽

pp. e044044

Author(s):

Folashayo Adeniji

Keyword(s):

Heart Failure ◽

Cardiovascular Disease ◽

Financial Burden ◽

Cross Sectional Study ◽

Public Hospitals ◽

Health Coverage ◽

Sectional Study ◽

Cross Sectional ◽

Out Of Pocket Payments ◽

Ibadan Nigeria

ObjectiveGiven that the mechanism for financial protection is underdeveloped in Nigeria, out-of-pocket (OOP) payment for treating cardiovascular disease could impose substantial financial burden on individuals and their families. This study estimated the burden of OOP expenditures incurred by a cohort of patients with cardiovascular disease (CVD) in Ibadan, Nigeria.Design and settingsThis study used a descriptive cross-sectional study design. A standardised survey questionnaire originally developed by Initiative for Cardiovascular Health Research in Developing Countries was used to electronically collect data from all the 744 patients with CVD who accessed healthcare between 4 November 2019 and 31 January 2020 in the cardiology departments of private and public hospitals in Ibadan, Nigeria. Baseline characteristics of respondents were presented using percentages and proportions. The OOP payments were reported as means±SDs. Costs/OOP payments were in Nigerian Naira (NGN). The average US dollar to NGN at the time of data collection was ₦362.12 per $1. All quantitative data were analysed using STATA V.15.Outcome measuresThe burden of outpatient, inpatient and rehabilitative care OOP payments.ResultsMajority of the patients with CVD were within the age range of 45–74 years and 68.55% of them were women. The diagnostic conditions reported among patients with CVD were hypertensive heart failure (84.01%), dilated cardiomyopathy (4.44%), ischaemic heart disease (3.9%) and anaemic heart failure (2.15%). Across all the hospital facilities, the annual direct and indirect outpatient costs were ₦421 595.7±₦855 962.0 ($1164.2±$2363.8) and ₦19 146.5±₦53 610.1 ($52.87±$148.05). Similarly, the average direct and indirect OOP payments per hospitalisation across all facilities were ₦182 302.4±₦249 090.4 ($503.43±$687.87) and ₦14 700.8±₦ 69 297.1 ($40.60±$191.37), respectively. The average rehabilitative cost after discharge from index hospitalisation was ₦30 012.0 ($82.88).ConclusionThe burden of OOP payment among patients with CVD is enormous. There is a need to increase efforts to achieve universal health coverage in Nigeria.

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Out-of-pocket payments in hospital bills: a challenge to management

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2016-0667 ◽

2018 ◽

Vol 71 (5) ◽

pp. 2511-2518 ◽

Cited By ~ 2

Author(s):

July Anne Rossi Michelin Rodrigues ◽

Isabel Cristina Kowal Olm Cunha ◽

Marli Terezinha Oliveira Vannuchi ◽

Maria do Carmo Fernandez Lourenço Haddad

Keyword(s):

Health Insurance ◽

Emergency Room ◽

Cross Sectional Study ◽

Health Insurance Company ◽

Insurance Company ◽

Sectional Study ◽

Cross Sectional ◽

The North ◽

Out Of Pocket Payments ◽

Made In

ABSTRACT Objetive: To analyse out-of-pocket payments (OOP) by health insurance company in hospital bills. Method: Cross-sectional study with quantitative approach. The information was obtained in the database of a health insurance company in the north of Paraná State and categorised into administrative and technical OOP. We analysed reports regarding OOP made in eight hospitals of the accredited network company, from 2013 to 2015. Results: The analysed data totalled 36 thousand items paid out-of-pocket. The highest OOP rates occurred in hospital 1 (67.6%); emergency room service (50.1%); time of hospitalization, ≤ 1 day (70.8%) and medical-hospital materials (59.2%). The year with the highest rates of administrative (54.51%) and technical (48.05%) OOP was 2013. Conclusion: We concluded that OOP are indicators for the institutions to check the critical topics to be improved and that managers must work on originator aspects of OOP, to prevent greater loss.

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Opportunities and Challenges of Nurses after Upgradation of Class 2 Status

Bangladesh Journal of Medical Education ◽

10.3329/bjme.v13i1.57502 ◽

2022 ◽

Vol 13 (1) ◽

pp. 20-26

Author(s):

M Akter ◽

MR Begum ◽

R Begum ◽

N Sultana

Keyword(s):

Care Delivery ◽

Group Discussion ◽

Structured Interview ◽

Health Care Delivery System ◽

Cross Sectional Study ◽

Public Hospitals ◽

Working Environment ◽

Staff Nurse ◽

Cross Sectional ◽

Depth Interview

Nurse’s job facilities and challenges have emerged as a burning issue in health care delivery system in Bangladesh. This descriptive cross sectional study with a mixed quantitative and qualitative design aimed to explore the opportunities and challenges of nurses after upgradation of class 2 status. The study was carried out in two specialized public hospitals for one year duration among purposively selected 144 nurses with a semi structured interview administered questionnaire In depth interview and focus group discussion (FGD) were conducted among selected personnel. The study revealed that the mean age of nurses was 42.3 (±6.3) years, majority (86.1%) were female, most of them (79.1%) were senior staff nurse with 16.8 years mean working experience. The study explored the opportunities of nurses after upgradation of class 2 status like increased responsibilities and honor in working place, promotional opportunities mentioned by majority of respondents. On the other hand, the challenges were noted as not changing the physicians attitude, not changing the working environment, limited scope for utilization of professional skill, not having job security mentioned by majority of respondents. The study also found that most of the nurses (90.3%) were satisfied after upgradation, but a large portion were not satisfied regarding fringe benefits and current salary structure. From FGD and in depth interview some suggestions come forward for nursing profession empowerment like good salary package, medical incentive, residence and training facilities etc. Few opportunities increased in upgradation of nurses in class 2 status, however nurses were depriving from many of their facilities, which indicated that 2nd class status was partially implemented in professionally, socially and culturally. Bangladesh Journal of Medical Education Vol.13(1) January 2022: 20-26

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Socioeconomic determinants of community knowledge and practice in relation to malaria in high- and low-transmission areas of central India

Journal of Biosocial Science ◽

10.1017/s0021932019000440 ◽

2019 ◽

Vol 52 (3) ◽

pp. 317-329 ◽

Cited By ~ 1

Author(s):

Mrigendra Pal Singh ◽

Kalyan Brata Saha ◽

Sunil Kumar Chand ◽

Deepali Savargaonkar

Keyword(s):

Socioeconomic Status ◽

Central India ◽

Structured Interview ◽

Cross Sectional Study ◽

Low Literacy ◽

Cross Sectional ◽

Community Knowledge ◽

Factors Affecting ◽

Low Transmission ◽

Treatment Practices

AbstractThis study was undertaken with an aim of exploring community knowledge and treatment practices related to malaria and their determinants in high- and low-transmission areas of central India. A community-based cross-sectional study was carried out between August 2015 and January 2016 in two high- and two low-malaria-endemic districts of central India. A total of 1470 respondents were interviewed using a pre-tested structured interview schedule. Respondents residing in high-transmission areas with higher literacy levels, and of higher socioeconomic status, were found to practise more modern preventive measures than those living in low-transmission areas with low literacy levels and who were economically poor. Level of literacy, socioeconomic status and area (district) of residence were found to be the main factors affecting people’s knowledge of malaria aetiology and clinical features, and prevention and treatment practices, in this community in central India.

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Nutritional status of multiple sclerosis (MS) patients attending Kasr Alainy MS unit: an exploratory cross-sectional study

Journal of Egyptian Public Health Association ◽

10.1186/s42506-021-00080-3 ◽

2021 ◽

Vol 96 (1) ◽

Author(s):

Zeinab E. Afifi ◽

Rania I. Shehata ◽

Asmaa F. El Sayed ◽

El Sayed M. Hammad ◽

Marwa R. Salem

Keyword(s):

Multiple Sclerosis ◽

Nutritional Status ◽

Dietary Habits ◽

Care Service ◽

Structured Interview ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Level Measurement ◽

Impact Scale

Abstract Background Nutrition was claimed to be a factor in MS causation, course, complications, and management. Several studies were conducted to assess the nutritional status of MS patients; however, few studies were conducted to assess this problem in Egypt. Therefore, the purpose of the current study was to assess the nutritional status of a sample of MS patients. Methods The researchers conducted an exploratory cross-sectional study among 76 relapsing-remitting MS (RRMS) patients attending Kasr Alainy Multiple Sclerosis Unit (KAMSU) from October 2018 to January 2019 to assess the nutritional status of a sample of MS patients. Data were collected using a structured interview questionnaire including an inquiry about the socioeconomic status, and nutritional status using anthropometric measurements, patient-generated subjective global assessment (PG-SGA), semi-quantitative food frequency questionnaires (SQFFQ), and hemoglobin level measurement. Assessment of fatigue was done using the Modified Fatigue Impact Scale 5-items version. Results The mean age of the study participants was 30 ± 6 years. The disease duration ranged from 2 to 264 months. Malnutrition was prevalent among 67.1% (27.6 % overweight, 36.8% obese, and 2.6% underweight). Half of the investigated patients were anemic. According to the PG-SGA, more than half of the studied patients (53.9%) were classified as moderately or suspected malnourished. The unhealthy dietary habits such as taking only a few meals, junk food intake and skipping breakfast were observed in considerable proportions of the group. The SQFFQ revealed overconsumption of energy and fat, and less than acceptable consumption of dietary fibers by most of the studied patients. Conclusions Overweight, obesity, anemia, and unhealthy dietary habits were prevalent among the RRMS patients attending the KAMSU. Nutrition care service is extremely needed for this group of patients.

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Constrains for seeking post-abortion care among adolescents and young women in Guangzhou, China: a cross-sectional study

BMC Health Services Research ◽

10.1186/s12913-021-06263-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yiding Wang ◽

Jinzhi Liu ◽

Ribo Xiong ◽

Yan Liu

Keyword(s):

Young Women ◽

Cross Sectional Study ◽

Public Hospitals ◽

Sectional Study ◽

Cross Sectional ◽

Services Utilization ◽

Abortion Care ◽

Post Abortion Care ◽

Post Abortion ◽

Youth Friendly

Abstract Background In China, post-abortion care (PAC) services mainly focus on married couples, such that adolescents and unmarried young womenhave limited access to those services for contraception counseling. The provision of youth-friendly PAC services in public hospitals is a new concept in China. This study examined the magnitude of PAC services utilization as well as factors influencing it’s uptake among adolescents and young women in Guangzhou, China. Methods A cross-sectional study was performed from 1st March 2020 to 30th September 2020 using anonymous self-administered questionnaire among 688 women aged 15–24 years in Tianhe district, Guangzhou. The Multivariate logistic regression was used to determine factors that were significantly associated with the uptake of PAC services. Results The magnitude of PAC services utilization was 35.9% among adolescents and young women in Guangzhou, China. Students were 69.0% significantly less likely to use PAC services compared to women who had no job. Immigrants were 59.0% significantly less likely to use PAC services than their native counterparts. Women who had a feeling of stigma were 70.0% significantly less likely to use PAC services compared to those who did not feel stigmatized. Conclusions The study highlights the need to strengthen youth-friendly PAC services provision, and emphasizes the importance of education about both family planning and abortion services among disadvantaged sub-groups of women in the study setting.

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The Prevalence of Necrotizing Enterocolitis and Associated Factors Among Enteral Fed Preterm and Low Birth Weight Neonates Admitted in Selected Public Hospitals in Addis Ababa, Ethiopia: A Cross-sectional Study

Global Pediatric Health ◽

10.1177/2333794x211019695 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110196

Author(s):

Sitotaw Molla Mekonnen ◽

Daniel Mengistu Bekele ◽

Fikrtemariam Abebe Fenta ◽

Addisu Dabi Wake

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Necrotizing Enterocolitis ◽

Gestational Age ◽

Associated Factors ◽

Addis Ababa ◽

Cross Sectional Study ◽

Public Hospitals ◽

Sectional Study ◽

Cross Sectional

Necrotizing enterocolitis (NEC) remains to be the most critical and frequent gastrointestinal disorder understood in neonatal intensive care units (NICU). The presented study was intended to assess the prevalence of NEC and associated factors among enteral Fed preterm and low birth weight neonates. Institution based retrospective cross-sectional study was conducted on 350 enteral Fed preterm and low birth weight neonates who were admitted at selected public hospitals of Addis Ababa from March 25/2020 to May 10/2020. The data were collected through neonates’ medical record chart review. A total of 350 participants were enrolled in to the study with the response rate of 99.43%. One hundred eighty-four (52.6%) of them were male. The majority 123 (35.1%) of them were (32 + 1 to 34) weeks gestational age. The prevalence of NEC was (25.4%) (n = 89, [95% CI; 21.1, 30.0]). Being ≤28 weeks gestational age (AOR = 3.94, 95% CI [2.67, 9.97]), being (28 + 1 to 32 weeks) gestational age (AOR = 3.65, 95% CI [2.21, 8.31]), birth weight of 1000 to 1499 g (AOR = 2.29, 95% CI [1.22, 4.33]), APGAR score ≤3 (AOR = 2.34, 95% CI [1.32, 4.16]), prolonged labor (AOR = 2.21, 95% CI [1.35, 6.38]), maternal chronic disease particularly hypertension (AOR = 3.2, 95% CI [1.70, 5.90]), chorioamnionitis (AOR = 4.8, 95% CI [3.9, 13]), failure to breath/resuscitated (AOR = 2.1, 95% CI [1.7, 4.4]), CPAP ventilation (AOR = 3.7, 95% CI [1.50, 12.70]), mixed milk (AOR = 3.58, 95% CI [2.16, 9.32]) were factors significantly associated with NEC. Finally, the prevalence of NEC in the study area was high. So that, initiating the programs that could minimize this problem is required to avoid the substantial morbidity and mortality associated with NEC.

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