Inequalities in Household Catastrophic Health Expenditure and Impoverishment Associated With Noncommunicable Diseases in Chi Linh, Hai Duong, Vietnam

2017 ◽  
Vol 29 (5_suppl) ◽  
pp. 35S-44S ◽  
Author(s):  
Vu Duy Kien ◽  
Hoang Van Minh ◽  
Nguyen Bao Ngoc ◽  
Tran Bich Phuong ◽  
Tran Thu Ngan ◽  
...  
Keyword(s):  
Urban Areas ◽  
Health Expenditure ◽  
Catastrophic Health Expenditure ◽  
Socioeconomic Inequalities ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Economic Losses ◽  
Double Burden ◽  
Catastrophic Health Expenditures ◽  
Health Organization

A costly modern-day double burden, the expenses of noncommunicable diseases (NCDs) are becoming a devastating epidemic. The World Health Organization estimates $7 trillion in economic losses from NCDs in 2011-2025. Although regarded as affluent diseases, the burden of NCDs is shifting into poorer groups. In this study, we assessed the socioeconomic inequalities in catastrophic health expenditure and impoverishment associated with NCDs in Northern Vietnam. We also identified associated factors for catastrophic health expenditure and impoverishment. Households self-reporting NCD diagnoses had the highest association with both catastrophic health expenditure and impoverishment, followed by those in urban areas. Such households were likely poorer according to our calculations estimating socioeconomic inequalities. Households with at least 1 member older than 60 years were also more likely to suffer catastrophic health expenditures. These findings suggest that targeted policy to prevent or subsidize care for NCDs could prevent catastrophic health expenditure and impoverishment among those already most disadvantaged.

scholarly journals Changes in Catastrophic Health Expenditures Depending on Health Policies in Turkey

2021 ◽  
Vol 8 ◽  
Author(s):  
Guvenc Kockaya ◽  
Gülpembe Oguzhan ◽  
Zafer Çalşkan
Keyword(s):  
Health Services ◽  
Health Expenditure ◽  
Positive Impact ◽  
Health Expenditures ◽  
Catastrophic Health Expenditure ◽  
Health Policies ◽  
World Health ◽  
Positive Health ◽  
Catastrophic Health Expenditures ◽  
The Impact

Without any financial protection out of pocket health expenses are essential both because their increase causes difficulties in accessing higher quality health services for households and more importantly because it complicates access to most basic health services. As a result of the Health Transformation Program in practice in the Turkish healthcare system since 2003, significant changes have been done in all layers of the health system. Turkish Statistics Institute (TurkStat) publishes the ratio of households that bear catastrophic health expenditures since 2002. According to TurkStat data, the ratio of households with catastrophic expenditure has fallen from 0.81% in 2002 to 0.17% in 2011 with the health transformation project. However, it has started to rise since 2012 and has reached 0.31% in 2014. This study aims to evaluate the expenditure items that may have caused the rise of the ratio of households with catastrophic health expenditures since 2012, which had previously dropped with the Health Transformation Program that has caused fundamental changes in health policies. Methodology and definitions presented in the article named “Distribution of health payments and catastrophic expenditures: Methodology” by Ke Xu published by the World Health Organization in 2005 have been used. Percentages of health expenditure items among the total expenditure of households with positive health expenditure and households with catastrophic health expenditure between 2007 and 2014 have been evaluated using descriptive analysis. Findings have been interpreted in light of the health policies in practice between 2007 and 2014. An overview of the impact of the health policies reveals that medicine expenditures have decreased both for household and public health expenditures. Despite the impact of policies on the pharmaceutical industry was criticized by the industry, the positive impact can be seen by the decrease in the spending on medicine for households spending on health. Hospital service with positive health expenditure is seen to decrease health expenditure. The reasons for the increase in households with catastrophic health expenditure need further research. As a result, the study strives to discuss the possible policy reasons for the observed effects.

scholarly journals The Basic vs. Ability-to-Pay Approach: Evidence From China's Critical Illness Insurance on Whether Different Measurements of Catastrophic Health Expenditure Matter

2021 ◽  
Vol 9 ◽  
Author(s):  
Ying Zhang ◽  
Yongmei Guan ◽  
Ding Hu ◽  
Jacques Vanneste ◽  
Dongmei Zhu
Keyword(s):  
Critical Illness ◽  
Health Expenditure ◽  
Catastrophic Health Expenditure ◽  
World Health ◽  
Basic Approach ◽  
Ability To Pay ◽  
Basic Medical Insurance ◽  
The World ◽  
Health Organization ◽  
Basic Medical

Alleviating catastrophic health expenditure (CHE) is one of the vital objectives of health systems, as defined by the World Health Organization. However, no consensus has yet been reached on the measurement of CHE. With the aim of further relieving the adverse effects of CHE and alleviating the problem of illness-caused poverty, the Critical Illness Insurance (CII) program has been operational in China since 2012. In order to verify whether the different measurements of CHE matter under China's CII program, we compare the two-layer CII models built by using the basic approach and the ability-to-pay (ATP) approach at a range of thresholds. Exploiting the latest China family panel studies dataset, we demonstrate that the basic approach is more effective in relieving CHE for all insured households, while the ATP approach works better in reducing the severity of CHE in households facing it. These findings have meaningful implications for policymaking. The CII program should be promoted widely as a supplement to the current Social Basic Medical Insurance system. To improve the CII program's effectiveness, it should be based on the basic approach, and the threshold used to measure CHE should be determined by the goal pursued by the program.

scholarly journals Physical Activity Patterns in India Stratified by Zones, Age, Region, BMI and Implications for COVID-19: A Nationwide Study

2021 ◽  
pp. 097275312199850
Author(s):  
Vivek Podder ◽  
Raghuram Nagarathna ◽  
Akshay Anand ◽  
Patil S. Suchitra ◽  
Amit Kumar Singh ◽  
...  
Keyword(s):  
Physical Activity ◽  
World Health Organization ◽  
Rural Areas ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Home Work ◽  
The World ◽  
Health Organization ◽  
Physically Inactive ◽  
At Home

Rationale: India has a high prevalence of noncommunicable diseases (NCDs), which can be lowered by regular physical activity. To understand this association, recent population data is required which is representative of all the states and union territories of the country. Objective: We aimed to investigate the patterns of physical activity in India, stratified by zones, body mass index (BMI), urban, rural areas, and gender. Method: We present the analysis of physical activity status from the data collected during the phase 1 of a pan-India study. This ( Niyantrita Madhumeha Bharata 2017) was a multicenter pan-India cluster sampled trial with dual objectives. A survey to identify all individuals at a high risk for diabetes, using a validated instrument called the Indian Diabetes Risk Score (IDRS), was followed by a two-armed randomized yoga-based lifestyle intervention for the primary prevention of diabetes. The physical activity was scored as per IDRS (vigorous exercise or strenuous at work = 0, moderate exercise at home/work = 10, mild exercise at home/work = 20, no exercise = 30). This was done in a selected cluster using a mobile application. A weighted prevalence was calculated based on the nonresponse rate and design weight. Results: We analyzed the data from 2,33,805 individuals; the mean age was 41.4 years (SD 13.4). Of these, 50.6% were females and 49.4% were males; 45.8% were from rural areas and 54% from urban areas. The BMI was 24.7 ± 4.6 kg/m 2 . Briefly, 20% were physically inactive and 57% of the people were either inactive or mildly active. 21.2% of females were found physically inactive, whereas 19.2% of males were inactive. Individuals living in urban localities were proportionately more inactive (21.7% vs. 18.8%) or mildly active (38.9% vs. 34.8%) than the rural people. Individuals from the central (29.6%) and south zones (28.6%) of the country were also relatively inactive, in contrast to those from the northwest zone (14.2%). The known diabetics were found to be physically inactive (28.3% vs. 19.8%) when compared with those unaware of their diabetic status. Conclusion: 20% and 37% of the population in India are not active or mildly active, respectively, and thus 57% of the surveyed population do not meet the physical activity regimen recommended by the World Health Organization. This puts a large Indian population at risk of developing various NCDs, which are being increasingly reported to be vulnerable to COVID-19 infections. India needs to adopt the four strategic objectives recommended by the World Health Organization for reducing the prevalence of physical inactivity.

scholarly journals Ghanaians Might Be at Risk of Excess Dietary Intake of Potassium Based on Food Supply Data

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
David Oscar Yawson ◽  
Michael Osei Adu ◽  
Benjamin Ason ◽  
Frederick Ato Armah ◽  
Emmanuel Boateng ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Food Supply ◽  
Crop Production ◽  
Production Systems ◽  
Balance Sheet ◽  
Food Composition ◽  
World Health ◽  
Noncommunicable Diseases ◽  
K Deficiency ◽  
Health Organization

The World Health Organization (WHO) has highlighted the beneficial role of adequate intake of potassium (K) in combating the global burden of noncommunicable diseases (NCDs), mainly hypertension and cardiovascular diseases. Diets are the main source of K supply to humans and can contribute to both K deficiency (hypokalemia) and excess (hyperkalemia). While global attention is currently devoted to K deficiency, K excess can be even more dangerous and deserves equal attention. The objectives of this paper were to (i) estimate the K intake of Ghanaian population using food supply and food composition data and (ii) compare this estimate with the WHO-recommended requirement for K in order to assess if there is a risk of inadequate or excess K intake. Food supply data (1961–2011) were obtained from the Food Balance Sheet (FBS) of the Food and Agriculture Organization of the United Nations to derive trends in food and K supply. The average food supply in the FBS for 2010 and 2011 was used in assessing the risk of inadequate or excess dietary intake of K. The K content of the food items was obtained from food composition databases. Based on 2010-2011 average data, the K supply per capita per day was approximately 9,086 mg, about 2.6-fold larger than the WHO-recommended level (3,510 mg). The assessment suggests a potentially large risk of excess dietary K supply at both individual and population levels. The results suggest the need for assessing options for managing K excess as part of food security and public health strategies. The results further underscore a need for assessment of the K status of staple food crops and mixed diets, as well as K management in food crop production systems in Ghana.

scholarly journals The influence of medical and geographical factors on the appearance and development of allergic rhinitis and eczema among school children in Belgrade

2014 ◽  
Vol 94 (2) ◽  
pp. 65-82
Author(s):  
Sanja Topalovic
Keyword(s):  
Allergic Rhinitis ◽  
School Children ◽  
Urban Areas ◽  
International Study ◽  
World Health ◽  
Geographical Factors ◽  
Asthma And Allergy ◽  
City Core ◽  
Health Organization

Allergic rhinitis and eczema represent ailments which are increasingly linked with urban areas. Although they do not belong to illnesses which are predominantly caused by geographical factors, their importance for the development of these illnesses will be considered in this paper. As an example of the influence of urban environment on the development of these illnesses, the city core of Belgrade (the area included in the General Urban Plan) is taken into consideration. The emphasis is put especially on the quality of air, industry, traffic and the conditions for living. The research is based on tracking these illnesses among children, considering the frequent appearance of these illnesses especially among school children. The survey, whose results were partly presented in this research paper, was an important method for examining the subject matter of this paper. Namely, the above mentioned survey was realized in the International Study of Asthma and Allergy among children (ISAAC), which was conducted by World Health Organization (WHO), 156 centres from 56 countries took part. Among them, there were four centres from Serbia: Belgrade, Nis, Podgorica and Sombor.

scholarly journals Inflammatory bowel disease and COVID-19: A review

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Rabin Hamal ◽  
◽  
Rahul Pathak ◽  
Brindeswari Kafle Bhandari ◽  
Anurag Jha ◽  
...  
Keyword(s):  
Immunosuppressive Drugs ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Severe Illness ◽  
Infectious Risk ◽  
The World ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Health Organization ◽  
Chronic Inflammatory Bowel

The World Health Organization officially declared infection with severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), leading to coronavirus disease 2019 (COVID-19) as a Public Health Emergency of International Concern (PHEIC) on 30 January 2020 and then as a pandemic on March 11, 2020 with reports of infection from most of the countries of the world [1]. COVID-19 has severely disrupted prevention and treatment for noncommunicable diseases. Severe illness can occur in otherwise healthy individuals of any age, but it predominantly occurs in adults with advanced age or certain underlying medical comorbidities [2]. Since the beginning of the health emergency, particular attention has been paid to the management of patients with chronic Inflammatory Bowel Diseases (IBDs) because they frequently are treated with immunosuppressive drugs and therefore potentially are exposed to a greater infectious risk than the general population [3].

scholarly journals Microbiome First Approaches to Rescue Public Health and Reduce Human Suffering

Biomedicines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1581
Author(s):  
Rodney R. Dietert
Keyword(s):  
Public Health ◽  
Drugs Of Abuse ◽  
Review Article ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Human Suffering ◽  
Health Initiatives ◽  
Food Emulsifiers ◽  
Failure To Protect ◽  
Health Organization

The is a sequential article to an initial review suggesting that Microbiome First medical approaches to human health and wellness could both aid the fight against noncommunicable diseases and conditions (NCDs) and help to usher in sustainable healthcare. This current review article specifically focuses on public health programs and initiatives and what has been termed by medical journals as a catastrophic record of recent failures. Included in the review is a discussion of the four priority behavioral modifications (food choices, cessation of two drugs of abuse, and exercise) advocated by the World Health Organization as the way to stop the ongoing NCD epidemic. The lack of public health focus on the majority of cells and genes in the human superorganism, the microbiome, is highlighted as is the “regulatory gap” failure to protect humans, particularly the young, from a series of mass population toxic exposures (e.g., asbestos, trichloroethylene, dioxin, polychlorinated biphenyls, triclosan, bisphenol A and other plasticizers, polyfluorinated compounds, herbicides, food emulsifiers, high fructose corn syrup, certain nanoparticles, endocrine disruptors, and obesogens). The combination of early life toxicity for the microbiome and connected human physiological systems (e.g., immune, neurological), plus a lack of attention to the importance of microbial rebiosis has facilitated rather than suppressed, the NCD epidemic. This review article concludes with a call to place the microbiome first and foremost in public health initiatives as a way to both rescue public health effectiveness and reduce the human suffering connected to comorbid NCDs.

scholarly journals Quality of antimalarials in Kinshasa peri-urban areas with regard to local pharmaceutical legislation and regulation

2019 ◽  
Vol 12 (4) ◽  
pp. 253-263
Author(s):  
Don Jethro Mavungu Landu ◽  
Michel Frédérich ◽  
Joseph Manzambi Kuwekita ◽  
Christian Bongo-Pasi Nswe ◽  
J K Mbinze ◽  
...  
Keyword(s):  
Urban Areas ◽  
High Performance ◽  
Brand Names ◽  
Essential Medicines ◽  
World Health ◽  
Array Detector ◽  
Ministry Of Health ◽  
Health Organization ◽  
A Prospective Study ◽  
Health Commodities

Abstract Background In the context of old pharmaceutical legislation and regulations not adapted to current realities, the aim of the present study was to evaluate the existing pharmaceutical system in peri-urban areas of Kinshasa. Methods A prospective study was carried out during the period 2016–2018. The most used antimalarial medicines were identified through household and pharmaceutical establishment surveys. The samples of the obtained medicines were assayed with generic separation methods using the high-performance liquid chromatography technique coupled to a diode array detector. The registration status was checked for 126 antimalarial brand names. A characterization was carried out in 196 pharmaceutical establishments on the basis of standards set out by the Ministry of Health. Results Of the 75 samples assayed, 19% (14/75) were non-compliant. Of the 124 brand names, 46.0% (57/124) were unlicensed and 14.5% (18/124) had an expired licence. Of the 196 pharmaceutical establishments, only 2 (1.0%) had an authorization to practice, none met all the Ministry of Health minimum standards and 24.5% (48/196) met the World Health Organization Guidelines for the Storage of Essential Medicines and Other Health Commodities. Conclusions More resources should be mobilized to apply regulator sanctions.

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