scholarly journals The economic burden of malaria on households and the health system in a high transmission district of Mozambique

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Sergi Alonso ◽  
Carlos J. Chaccour ◽  
Eldo Elobolobo ◽  
Amilcar Nacima ◽  
Baltazar Candrinho ◽  
...  
Keyword(s):  
Health System ◽  
Uncomplicated Malaria ◽  
Severe Case ◽  
Opportunity Costs ◽  
Care Seeking ◽  
District Health ◽  
Cross Sectional ◽  
High Burden ◽  
Uncomplicated Case ◽  
Household Costs

Abstract Background Malaria remains a leading cause of morbidity and mortality in Mozambique. Increased investments in malaria control have reduced the burden, but few studies have estimated the costs of malaria in the country. This paper estimates the economic costs associated with malaria care to households and to the health system in the high burden district of Mopeia in central Mozambique. Methods Malaria care-seeking and morbidity costs were routinely collected among 1373 households with at least one child enrolled in an active case detection (ACD) cohort in Mopeia, and through cross-sectional surveys with 824 families in 2017 and 805 families in 2018. Household costs included direct medical expenses, transportation and opportunity costs of the time lost due to illness. Structured questionnaires were used to estimate the health system costs associated with malaria care in all 13 district health facilities. Cost estimations followed an ingredient-based approach with a top-down allocation approach for health system expenses. Results Among participants in cross-sectional studies, households sought care for nine severe malaria cases requiring hospital admission and for 679 uncomplicated malaria cases. Median household costs associated with uncomplicated malaria among individuals of all ages were US$ 3.46 (IQR US$ 0.07–22.41) and US$ 81.08 (IQR US$ 39.34–88.38) per severe case. Median household costs were lower among children under five (ACD cohort): US$ 1.63 (IQR US$ 0.00–7.79) per uncomplicated case and US$ 64.90 (IQR US$ 49.76–80.96) per severe case. Opportunity costs were the main source of household costs. Median health system costs associated with malaria among patients of all ages were US$ 4.34 (IQR US$ 4.32–4.35) per uncomplicated case and US$ 26.56 (IQR US$ 18.03–44.09) per severe case. Considering household and health system costs, the overall cost of malaria care to society was US$ 7.80 per uncomplicated case and US$ 107.64 per severe case, representing an economic malaria burden of US$ 332,286.24 (IQR US$ 186,355.84–1,091,212.90) per year only in Mopeia. Conclusions Despite the provision of free malaria services, households in Mopeia incur significant direct and indirect costs associated with the disease. Furthermore, the high malaria cost on the Mozambican health system underscores the need to strengthen malaria prevention to reduce the high burden and improve productivity in the region.

scholarly journals The perceived impact of family physicians on the district health system in South Africa: a cross-sectional survey

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Klaus B. von Pressentin ◽  
Robert J. Mash ◽  
Laurel Baldwin-Ragaven ◽  
Roelf Petrus Gerhardus Botha ◽  
Indiran Govender ◽  
...  
Keyword(s):  
South Africa ◽  
Health System ◽  
Family Physicians ◽  
Cross Sectional Survey ◽  
District Health ◽  
Cross Sectional ◽  
District Health System ◽  
Perceived Impact

scholarly journals In-Hospital Economic Burden for COVID-19 Infection Using Step-Down Cost Accounting; a Case from Central Iran

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Hadi Hamidi Parsa ◽  
Abedin Saghafipour ◽  
Alireza Koohpaei ◽  
Babak Farzinnia ◽  
Mohsen Barouni
Keyword(s):  
Health System ◽  
Economic Burden ◽  
Health Information System ◽  
Indirect Costs ◽  
Cost Accounting ◽  
Cross Sectional Study ◽  
Opportunity Costs ◽  
Cross Sectional ◽  
Personnel Costs ◽  
Step Down

Background: The novel coronavirus disease 2019 (COVID-19) has placed heavy direct and indirect economic burden on the people and the health system. Objectives: The present study aimed to estimate the economic burden of COVID-19 in Qom Province, using the step-down cost accounting (SDCA) method. Methods: This descriptive, cross-sectional study included all COVID-19 patients in Qom Province from February 19, 2020, to June 19, 2020. The patients’ data were collected in the form of major cost groups with integrated health system (IHS), health information system (HIS), and a financial software called Roozamad. The governmental, out-of-pocket, and opportunity costs paid by patients and hospitals were calculated and evaluated using SDCA in Microsoft Excel software. Results: The incidence of COVID-19 infection was 518 per 100,000 populations in Qom Province in the aforementioned period. The total government costs for the treatment of the patients were calculated to be 2,229,216,930,370 Rials (8,916,867 $). Among the major governmental cost groups, personnel costs accounted for the highest total expenditures. In addition, out-of-pocket costs of patients and their families equaled 30,038,013,060 Rials (120,152 $). The costs of final service departments accounted for more than half of the total costs. The opportunity costs were calculated as 420 billion Rials (15.68% of total costs). Conclusions: According to the findings, the direct and indirect costs associated with the treatment of COVID-19 patients can impose a heavy economic burden on the households and health care system. Therefore, disease prevention strategies such as observing health protocols are recommended to reduce the burden of the disease.

scholarly journals Health System Factors Influencing Uptake of Human Papilloma Virus (Hpv) Vaccine Among Adolescent Girls 9-15 Years in Mbale District, Uganda

2019 ◽  
Author(s):  
JULIET NABIRYE ◽  
Okwi Livex Andrew ◽  
Rebecca Nuwematsiko ◽  
George Kiwanuka ◽  
Fiston Muneza ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Health System ◽  
Hpv Vaccine ◽  
Health Workers ◽  
Vaccine Coverage ◽  
Cross Sectional Study ◽  
Vaccine Uptake ◽  
District Health ◽  
Cross Sectional ◽  
Adequate Information

Abstract Introduction Globally, cervical cancer is the fourth most common cancer in women with more than 85% of the burden in developing countries. In Uganda, cervical cancer has shown an increase of 1.8% per annum over the last twenty years. The availability of the Human Papillomavirus (HPV) vaccine presents an opportunity to prevent cervical cancer. Understanding how the health system influences uptake of the vaccine is critical to improve it. This study aimed to assess how the health systems is influencing uptake of HPV vaccine so as to inform policy for vaccine implementation and uptake in Mbale district, Eastern Uganda. Methods We conducted a cross sectional study of 407 respondents, selected from 56 villages. Six key informant interviews were conducted with District Health Officials involved in implementation of the HPV vaccine. Quantitative data was analyzed using Stata V.13. Prevalence ratios with their confidence intervals were reported. Qualitative data was audio recorded, transcribed verbatim and analyzed using MAXQDA V.12, using the six steps of thematic analysis developed by Braun and Clarke. Results 56 (14%) of 407 adolescents self-reported vaccine uptake. 182 (52.3%) of 348 reported lack of awareness about the HPV vaccine as the major reason for not having received it. Receiving vaccines from outreach clinics (p=0.02), having many options from which to receive the vaccine (p=0.02), getting an explanation on possible side-effects (p=0.024), and receiving the vaccine alongside other services (p=0.024) were positively associated with uptake. Key informants reported inconsistency in vaccine supply, inadequate training on HPV vaccine, and the lack of a clear target for HPV vaccine coverage as the factors that contribute to low uptake. Recommendation We recommend training of health workers to provide adequate information on HPV vaccine, raising awareness of the vaccine in markets, schools, and radio talk shows, and communicating the target to health workers. Conclusion Uptake of the HPV vaccine was lower than the Ministry of health target of 80%. We recommend more training of health workers to clearly provide adequate information on HPV vaccine, increasing awareness about the vaccine to the adolescents and reaching out to adolescents in and out of school for vaccination..

scholarly journals Competency level assessment of healthcare practitioners in managing diabetes and diabetic eye disease in the district health system of Limpopo province, South Africa

2020 ◽  
Vol 79 (1) ◽  
Author(s):  
Zaheera Abdool ◽  
Kovin Naidoo ◽  
Linda Visser
Keyword(s):  
South Africa ◽  
Health System ◽  
Limpopo Province ◽  
Eye Disease ◽  
National Guidelines ◽  
District Health ◽  
Cross Sectional ◽  
District Health System ◽  
Screening Model ◽  
Diabetic Eye Disease

Background: There are many gaps in the management of diabetes mellitus (DM) and diabetic eye disease in the district health system (DHS) of South Africa (SA). National guidelines recommend annual eye examinations for patients with DM.Aim: The purpose of this study was to describe the self-reported skill levels of healthcare practitioners (HCPs) to conduct eye examination procedures required for a proposed diabetic retinopathy (DR) screening model.Setting: The study was conducted in public health institutions of Waterberg district and Mankweng Hospital complex (Capricorn district) in Limpopo province, SA.Methods: A cross-sectional design using purposive sampling was conducted, and questionnaires were distributed to a total of 74 HCPs. The questionnaires distributed included questions relating to the competency levels of primary healthcare nurses (PHC nurses), optometrists, ophthalmic nurses and medical officers (MOs) regarding examination procedures in the management of patients with DM and whether they agreed with the developed DR screening model.Results: All the PHC nurses had knowledge about all the examination procedures required in the proposed DR screening model, whilst 94.1% of MOs exhibited knowledge regarding the procedures required from them. Optometrists lacked knowledge of grading DR, and ophthalmic nurses were least knowledgeable about conducting internal and external eye examinations and in detecting and grading DR.Conclusion: The proposed DR screening model did not need modification. The involvement of dieticians and more ophthalmic nurses could be beneficial to the DR screening model.

scholarly journals Health System Factors Influencing Uptake Of Human Papilloma Virus (Hpv) Vaccine Among Adolescent Girls 9-15 Years In Mbale District, Uganda

2019 ◽  
Author(s):  
JULIET NABIRYE ◽  
Okwi Livex Andrew ◽  
Rebecca Nuwematsiko ◽  
George Kiwanuka ◽  
Fiston Muneza ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Health System ◽  
Hpv Vaccine ◽  
Health Workers ◽  
Vaccine Coverage ◽  
Cross Sectional Study ◽  
Vaccine Uptake ◽  
District Health ◽  
Cross Sectional ◽  
Adequate Information

Abstract Introduction Globally, cervical cancer is the fourth most common cancer in women with more than 85% of the burden in developing countries. In Uganda, cervical cancer has shown an increase of 1.8% per annum over the last twenty years. The availability of the Human Papillomavirus (HPV) vaccine presents an opportunity to prevent cervical cancer. Understanding how the health system influences uptake of the vaccine is critical to improve it. This study aimed to assess how the health systems is influencing uptake of HPV vaccine so as to inform policy for vaccine implementation and uptake in Mbale district, Eastern Uganda. Methods We conducted a cross sectional study of 407 respondents, selected from 56 villages. Six key informant interviews were conducted with District Health Officials involved in implementation of the HPV vaccine. Quantitative data was analyzed using Stata V.13. Prevalence ratios with their confidence intervals were reported. Qualitative data was audio recorded, transcribed verbatim and analyzed using MAXQDA V.12, using the six steps of thematic analysis developed by Braun and Clarke. Results 56 (14%) of 407 adolescents self-reported vaccine uptake. 182 (52.3%) of 348 reported lack of awareness about the HPV vaccine as the major reason for not having received it. Receiving vaccines from outreach clinics (p=0.02), having many options from which to receive the vaccine (p=0.02), getting an explanation on possible side-effects (p=0.024), and receiving the vaccine alongside other services (p=0.024) were positively associated with uptake. Key informants reported inconsistency in vaccine supply, inadequate training on HPV vaccine, and the lack of a clear target for HPV vaccine coverage as the factors that contribute to low uptake. Recommendation We recommend training of health workers to provide adequate information on HPV vaccine, raising awareness of the vaccine in markets, schools, and radio talk shows, and communicating the target to health workers. Conclusion Uptake of the HPV vaccine was lower than the Ministry of health target of 80%. We recommend more training of health workers to clearly provide adequate information on HPV vaccine, increasing awareness about the vaccine to the adolescents and reaching out to adolescents in and out of school for vaccination..

scholarly journals The Influence of Family Physicians Within the South African District Health System: A Cross-Sectional Study

2018 ◽  
Vol 16 (1) ◽  
pp. 28-36 ◽  
Author(s):  
Klaus B. von Pressentin ◽  
Robert J. Mash ◽  
Laurel Baldwin-Ragaven ◽  
Roelf Petrus Gerhardus Botha ◽  
Indiran Govender ◽  
...  
Keyword(s):  
Health System ◽  
South African ◽  
Family Physicians ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
The South ◽  
District Health ◽  
Cross Sectional ◽  
District Health System ◽  
System A

Knowledge, Attitudes and associated factors to Use District Health Information System (DHIS2 data) for decision making among health professionals in a Resource limited settings: Cross-sectional Survey (Preprint)

2020 ◽  
Author(s):  
Shuma Gosha Kanfe ◽  
Nebyu Demeke Mengiste ◽  
Mohammedjud Hassen Ahmed ◽  
Gebiso Roba Debele ◽  
Berhanu Fikadie Endehabtu
Keyword(s):  
Decision Making ◽  
Health Professionals ◽  
Associated Factors ◽  
Good Knowledge ◽  
Cross Sectional Survey ◽  
District Health ◽  
Cross Sectional ◽  
Determinant Factors ◽  
Knowledge And Attitudes ◽  
Health Need

BACKGROUND Evidence based practice is a key to increase effectiveness and efficiency of quality health services. To achieve this, utilization of health facility data (DHIS2 data) is required which is determined by knowledge and attitudes of health professionals. Thus, this study aimed to assess knowledge and attitudes of health professionals to use DHIS2 data for decision making. OBJECTIVE This study aimed to assess the knowledge, attitudes and its associated factors among health professionals to use DHIS2 data for decision making at South west of Ethiopia 2020 METHODS Cross sectional quantitative study methods was conducted to assess Knowledge and Attitudes of health professionals to use DHIS2 data. A total of 264 participants were approached. SPSS version 22 software was used for data entry and analysis. Descriptive and analytical statistics including Bivariable and Multivariable analyses was done RESULTS Overall 130(49.2%) of the respondents had good knowledge to use DHIS2 data (95% CI: [43, 55.3]), whereas over 149 (56.4%) of the respondents had favorable attitudes towards the use of DHIS2 data for decision making purpose (95% CI: [53.2, 59.8]). Skills [AOR=2.20,95% CI:(1.16, 4.19)], Age [AOR= 1.92, 95% CI: (1.03, 3.59)] ,Resources[AOR=2.56, 95% CI:(1.35,4.86)], Staffing[AOR= 2.85, 95% CI : (1.49, 5.48)] and Experiences[AOR= 4.66, 95% CI: (1.94, 5.78)] were variables associated with knowledge to use DHIS2 data whereas Training [AOR= 5.59, 95% CI: (2.48, 5.42)], Feedback [AOR= 4.08, 95% CI: (1.87, 8.91)], Motivation [AOR=2.87, 95% CI: (1.36, 6.06)] and Health need [AOR=2.32, 95% CI: (1.10-4.92)] were variables associated with attitudes of health professionals to use DHIS2 data CONCLUSIONS In general, about half of the study participants had good knowledge of DHIS2 data utilization whereas more than half of respondents had favorable attitudes. Skills, resources, ages, staffing and experiences were the most determinant factors for the knowledge to use DHIS2 data whereas health need, motivation, feedback and training were determinant factors for attitudes to use DHIS2 data

Evaluating the readiness of mobile technology in Saudi Arabia: An Integrative Perspective with respect to e-health (Preprint)

2020 ◽  
Author(s):  
Fahad Alanezi
Keyword(s):  
Saudi Arabia ◽  
Health System ◽  
Mobile Phones ◽  
Personal Data ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Apps ◽  
History Of ◽  
Vision 2030 ◽  
Awareness Programs

UNSTRUCTURED E-health system is emerging and providing health services and solutions through different electronic gadgets. Saudi Arabia has launched a program called Saudi Arabia vision 2030, in which providing state-of-the-art health facilities to their citizen is of topmost priority. After all the efforts, the residents of Saudi Arabia are still reluctant for the adaptation of e-health system. The current study was conducted to evaluate the obstacle in adoption of the e-health system through the mobile phones. The current study was cross-sectional survey and was conducted by developing a self-administered structured questionnaire asking the utilization of mobile phone in state of health emergency prior to ask any medical history. Majority of the participants was married and doing jobs in different firms and have their personal mobile phones (p = 0.100, > 0.05) which indicates easily access to the e-health apps. The majority of the participants suffers from either obesity or high blood pressure (p = 0.018, < 0.05) regardless of either history of mental disorder or other family history of mental diseases. The pattern of diseases with mental disorders correlate well with adoption of e-health in government policies. The obstacles in adopting e-health includes fear of the loss of personal data and information (p = 0.0401, < 0.05). Moreover, they did not trust on online medications as the doctor cannot prescribe medicines without seeing physical health of the patient. The current study concluded that by making improvement in policies and proper commercializing the e-health apps together with awareness programs can boast the adoption of e-health in Saudi Arabia.

Prevalence and health care seeking behaviour for sexually transmitted infections among in-school adolescents in Ado-Ekiti, South-Western Nigeria

2016 ◽  
Vol 29 (6) ◽  
Author(s):  
Patrick T. Adegun ◽  
Eyitope O. Amu
Keyword(s):  
Health Care ◽  
Sexually Transmitted Infections ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Self Medication ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Stomach Pain ◽  
Health Care Seeking Behaviour ◽  
Care Seeking Behaviour

Abstract Background: In Nigeria, adolescents are highly vulnerable to sexually transmitted infections (STIs) which have the potential of jeopardising their future reproductive lives if poorly treated. Objective: To determine the prevalence and health care seeking behaviour for STIs among secondary school adolescents in Ado, South-Western Nigeria. Subjects: Male and female adolescents aged 10–19 years. Methods: The study employed a descriptive cross-sectional design. A pre-tested, self-administered, semi-structured questionnaire was used to elicit information from 560 adolescents selected from public and private secondary schools in Ado Local Government Area (LGA) of Ekiti State, using a multistage sampling technique. The data were analyzed using descriptive and inferential statistics. Analyzed data were presented in the form of tables and charts. Results: Two hundred and fifty-one (47.1%) respondents had previous symptoms of STIs. The commonest symptoms among the males were penile discharge (30.5%), painful micturition (30.5%) and stomach pain with swollen testes (25.4%). The commonest symptoms among the females were genital itching (27.6%), genital sores (14.1%) and painful micturition (13.1%). Only 26.7% sought treatment from a health facility; 37.0% did nothing; 15.9% went to patent medicine stores, 10.0% used herbs; the rest did self-medication or prayed. Conclusion: The prevalence of STI symptoms among adolescents in Ado-Ekiti is high but their health care seeking behaviour is poor. Health education about the dangers of untreated STI and the importance of seeking treatment early, targeted at adolescents, should be intensified.

scholarly journals Socioeconomic determinants of unmet need for outpatient healthcare services in Iran: a national cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sajad Vahedi ◽  
Amin Torabipour ◽  
Amirhossein Takian ◽  
Saeed Mohammadpur ◽  
Alireza Olyaeemanesh ◽  
...  
Keyword(s):  
Health System ◽  
Age Groups ◽  
Unmet Need ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Outpatient Services ◽  
Self Medication ◽  
Cross Sectional ◽  
Organizational Policies ◽  
Utilization Of Healthcare

Abstract Background Unmet need is a critical indicator of access to healthcare services. Despite concrete evidence about unmet need in Iran’s health system, no recent evidence of this negative outcome is available. This study aimed to measure the subjective unmet need (SUN), the factors associated with it and various reasons behind it in Iran. Methods We used the data of 13,005 respondents over the age of 15 from the Iranian Utilization of Healthcare Services Survey in 2016. SUN was defined as citizens whose needs were not sought through formal healthcare services, while they did not show a history of self-medication. The reasons for SUN were categorized into availability, accessibility, responsibility and acceptability of the health system. The multivariable logistic regression was used to determine significant predictors of SUN and associated major reasons. Results About 17% of the respondents (N = 2217) had unmet need for outpatient services. Nearly 40% of the respondents chose only accessibility, 4% selected only availability, 78% chose only responsibility, and 13% selected only acceptability as the main reasons for their unmet need. Higher outpatient needs was the only factor that significantly increased SUN, responsibility-related SUN and acceptability-related SUN. Low education was associated with higher SUN and responsibility-related SUN, while it could also reduce acceptability-related SUN. While SUN and responsibility-related SUN were prevalent among lower economic quintiles, having a complementary insurance was associated with decreased SUN and responsibility-related SUN. The people with basic insurance had lower chances to face with responsibility-related SUN, while employed individuals were at risk to experience SUN. Although the middle-aged group had higher odds to experience SUN, the responsibility-related SUN were prevalent among elderly, while higher age groups had significant chance to be exposed to acceptability-related SUN. Conclusion It seems that Iran is still suffering from unmet need for outpatient services, most of which emerges from its health system performance. The majority of the unmet health needs could be addressed through improving financial as well as organizational policies. Special attention is needed to address the unmet need among individuals with poor health status.

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