scholarly journals Targeting vulnerable groups of health poverty alleviation in rural China— what is the role of the New Rural Cooperative Medical Scheme for the middle age and elderly population?

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Nianshi Wang ◽  
Jing Xu ◽  
Meiyan Ma ◽  
Linghan Shan ◽  
Mingli Jiao ◽  
...  
Keyword(s):  
Elderly People ◽  
Poverty Alleviation ◽  
Rural China ◽  
Catastrophic Health Expenditure ◽  
World Health ◽  
Vulnerable Groups ◽  
Middle Aged ◽  
Medical Expense ◽  
Out Of Pocket Payments ◽  
Health Organization

Abstract Background In light of the health poverty alleviation policy, we explore whether the New Rural Cooperative Medical System (NRCMS) has effectively reduced the economic burden of medical expenses on rural middle-aged and elderly people and other impoverished vulnerable groups. The study aims to provide evidence that can be used to improve the medical insurance system. Methods Data were obtained from the 2015 China Health and Retirement Longitudinal Study (CHARLS). The method of calculating the catastrophic health expenditure (CHE) and impoverishment by medical expense (IME) was adopted from the World Health Organization (WHO). The treatment effect model was used to identify the determinants of CHE for rural middle-aged and elderly people. Results The incidence of CHE in rural China for middle-aged and elderly people is 21.8%, and the IME is 8.0%. The households that had enrolled in the NRCMS suffered higher CHE (21.9%) and IME (8.0%), than those that had not enrolled (CHE: 20.6% and IME: 7.7%). The NRCMS did not provide sufficient economic protection from CHE for households with three or more chronic diseases, inpatients, or households with members aged over 65 years. Key risk factors for the CHE included education levels, households with inpatients, households with members aged over 65 years, and households with disabilities. Conclusions Although the NRCMS has reduced barriers to the usage of household health services by reducing people’s out-of-pocket payments, it has not effectively reduced the risk of these households falling into poverty. Our research identifies the characteristics of vulnerable groups that the NRCMS does not provide enough support for, and which puts them at a greater risk of falling into poverty due to health impoverishment.

scholarly journals Targeting vulnerable groups of health poverty alleviation in rural China— what is the role of the New Rural Cooperative Medical Scheme for the elderly population?

2020 ◽  
Author(s):  
Nianshi Wang ◽  
Ye Li ◽  
Meiyan Ma ◽  
Mingli Jiao ◽  
Qunhong Wu ◽  
...  
Keyword(s):  
Poverty Alleviation ◽  
Elderly Population ◽  
Rural China ◽  
The Elderly ◽  
Catastrophic Health Expenditure ◽  
Rural Elderly ◽  
Vulnerable Groups ◽  
Medical Expense ◽  
Out Of Pocket Payments ◽  
Education Levels

Abstract BACKGROUND : Based on the health poverty alleviation policy, we explored whether the New Rural Cooperative Medical System (NRCMS) had effectively reduced the economic burden of the rural elderly population and impoverished vulnerable groups with regard to medical expenses, providing further evidence for increasing the medical insurance system. METHODS: Data were obtained from the 2015 China Health and Retirement Longitudinal Study. The method was adapted from WHO to calculate the catastrophic health expenditure (CHE) and impoverishment by medical expense (IME). The treatment effect model was used to identify the determinants of CHE in the rural elderly residents. RESULTS: The incidence of CHE in rural China for the elderly is 19.65%, and the impoverishment by medical expense has reached 6.94%. The households enrolled in NRCMS suffered higher CHE (21.9%) and IME (8.0%), than unenrolled households (20.6%, 7.7%). The NRCMS did not provide sufficient economic protection from CHE for households with 3 chronic diseases, inpatients, or adults over 65, Risk factors for CHE included education levels, households with inpatients, people over 65 years old, disabilities, and so on. CONCLUSIONS: Although the NRCMS had reduced barriers to the use of household health services while reducing their out of pocket payments, in some respects, it was still not effective to reduce the risk of residents falling into poverty. Our research identifies the characteristics of vulnerable groups that the NRCMS does not provide enough support for, and are at risk of falling into poverty through health impoverishment.

scholarly journals Ten-Year Poverty Alleviation Effect of the Medical Insurance System on Families With Members Who Have a Non-communicable Disease: Evidence From Heilongjiang Province in China

2021 ◽  
Vol 9 ◽  
Author(s):  
Qi Xia ◽  
Lichun Wu ◽  
Wanxin Tian ◽  
Wenqing Miao ◽  
Xiyu Zhang ◽  
...  
Keyword(s):  
Poverty Alleviation ◽  
Health Expenditure ◽  
Communicable Disease ◽  
Medical Insurance ◽  
Catastrophic Health Expenditure ◽  
Vulnerable Groups ◽  
Weak Links ◽  
Heilongjiang Province ◽  
Healthcare Needs ◽  
Out Of Pocket Payments

Aims: Non-communicable diseases (NCD) drag the NCD patients' families to the abyss of poverty. Medical insurance due to weak control over medical expenses and low benefits levels, may have actually contributed to a higher burden of out-of-pocket payments. By making a multi-dimensional calculation on catastrophic health expenditure (CHE) in Heilongjiang Province over 10 years, it is significant to find the weak links in the implementation of medical insurance to achieve poverty alleviation.Methods: A logistic regression was undertaken to predict the determinants of catastrophic health expenditure.Results: The average CHE of households dropped from 18.9% in 2003 to 14.9% in 2013. 33.2% of the households with three or more NCD members suffered CHE in 2013, which was 7.2 times higher than the households without it (4.6%). The uninsured households with cardiovascular disease had CHE of 12.0%, which were nearly 10% points lower than insured households (20.4–22.4%). For Medical Insurance for Urban Employees Scheme enrolled households, the increasing number of NCD members raised the risk of impoverishment from 3.4 to 20.0% in 2003, and from 0.3 to 3.1% in 2008. Households with hospital in-patient members were at higher risk of CHE (OR: 3.10–3.56).Conclusions: Healthcare needs and utilization are one of the most significant determinants of CHE. Households with NCD and in-patient members are most vulnerable groups of falling into a poverty trap. The targeting of the NCD groups, the poorest groups, uninsured groups need to be primary considerations in prioritizing services that are contained in medical insurance and poverty alleviation.

Kesehatan Mental Mahasiswa Fakultas Kedokteran Di Masa Pandemi COVID-19

2021 ◽  
Vol 2 (4) ◽  
pp. 113-120
Author(s):  
Athaya Taufiqy
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Literature Review ◽  
World Health ◽  
Vulnerable Groups ◽  
Future Research ◽  
Learning Material ◽  
Learning Programs ◽  
Learning Platforms ◽  
Health Organization

December 2019, COVID-19 was first reported in Wuhan, Hubei Province, China. March 11, 2020, the World Health Organization declared COVID-19 a worldwide pandemic. The COVID-19 pandemic has focused attention on the mental health of the various affected populations, medical students being one of the more vulnerable groups. Therefore, this literature review aims to find out how the mental health of Faculty of Medicine students during the COVID-19 pandemic, so that it can be used as learning material to always maintain mental health stability. The method used in this study is a literature review and literature search which was carried out by collecting several electronic journals such as PubMed, NCBI and Google Scholar. Conducted by reviewing journals related to the mental health of medical faculty students during the COVID-19 pandemic. This study involved 49 library sources from 2018-2020. From 7,143 students, 0.9% of them experienced severe anxiety, 2.7% moderate, and 21.3% experienced mild anxiety. In addition, delay in academic activities is a risk factor for experiencing symptoms of anxiety. 40% of students also experience financial difficulties, in terms of e-learning platforms, this problem is a challenge for medical students because financial and social factors can be an obstacle to the development and implementation of effective online learning programs. Future research is urgently needed to provide a better explanation of the tips needed for students in adapting to the changes that occur in order to lead a mentally healthy life in the midst of the COVID-19 pandemic.

scholarly journals Coronavirus Pandemic: Coping with the Psychological Outcomes, Mental Changes, and the “New Normal” During and After COVID-19

2020 ◽  
pp. 07-19
Author(s):  
Hiba Takieddine ◽  
Samaa AL Tabbah
Keyword(s):  
Healthcare Providers ◽  
Well Being ◽  
World Health ◽  
Vulnerable Groups ◽  
Public Health Response ◽  
New Normal ◽  
The World ◽  
Health Organization ◽  
The Impact

Coronavirus disease 2019 (COVID-19) is a highly infectious disease that has rapidly swept across the world, inducing a considerable degree of fear, worry and concern in the population at large and among certain groups in particular, such as older adults, healthcare providers and people with underlying health conditions. Authorities around the world tried to prevent the virus spread by imposing social distancing measures, quarantining citizens and isolating infected persons. Apart from its physical impact, COVID-19 pandemic has brought numerous changes to people’s lives. It changed daily routines, caused worldwide economic crisis, increased unemployment, and placed people under emotional and financial pressures. It affected people psychologically and mentally especially in terms of emotions and cognition. During the acute crisis, everyone to varying degrees experienced fear of infection, somatic concerns, worries about the pandemic’s consequences, loneliness, depression, stress, as well as increased alcohol and drug use. As part of its public health response, the World Health Organization (WHO) has worked with partners to develop a set of new guidelines and messages that can be used to prevent, manage, and support mental and psychological well-being in different vulnerable target groups during the outbreak. Whether people like it or not, the psychological sequela of this pandemic will emerge and persist for months and years to come leading to long-term consequences. New lifestyles and “New Normals” will surely emerge. The main purpose of this review is to summarize the impact of coronavirus pandemic on the psychological and mental health of people around the world especially vulnerable groups. It also presents the relevant intervention actions and recommendations to cope efficiently and effectively with the psychological short-term and long-term outcomes, mental changes, and the “New Normal” during and after COVID-19. Keywords: COVID-19; Coronavirus, Psychological; Mental; New Normal

scholarly journals Co-exploring the effects of COVID-19 pandemic on the livelihood of persons with disabilities in Bangladesh

2021 ◽  
Vol 41 (3) ◽  
Author(s):  
Adity Shayontony Das ◽  
Fatema Akter Bonny ◽  
Arifa Bente Mohosin ◽  
Sabina Faiz Rashid ◽  
Md Tanvir Hasan
Keyword(s):  
Social Life ◽  
World Health ◽  
Vulnerable Groups ◽  
Formal Sector ◽  
Economic Activities ◽  
Middle Income ◽  
Persons With Disabilities ◽  
Household Level ◽  
The Government ◽  
Health Organization

Background: According to World Health Organization (WHO), vulnerable groups such as persons with disabilities are facing severe impacts of the pandemic. There has always been significant challenges and hurdles in terms of achieving adequate and equitable inclusivity of persons with disabilities in all sections of social life. Education and employment of persons with disabilities were least focused which created more marginalization for the community. The long term impact of these marginalization has also led to the lack of jobs and social security of persons with disabilities, which is very clear now given the crisis in place. In low and middle income countries like Bangladesh the situation is even worse. To better understand the conditions of persons with disabilities in this crisis situation, the present study was initiated to explore the dimensions of livelihood with respect to income and wellbeing of persons with disabilities and to generate evidence for developing policies around these issues.Methods: A qualitative study was undertaken among 30 persons with disabilities from 8 different geographical divisions of Bangladesh. The interviews were conducted through telephone calls due to the existing COVID-19 crisis and mobility restrictions. The respondents were purposively selected based on gender, type of disability, area of resident (urban, rural) and their ability to communicate, therefore most (25/30) respondents were persons with physical disability. Thematic analysis was conducted to generate the findings of the study.Findings: Study findings revealed that majority of the respondents were involved in informal jobs. Predominantly males were daily wage-earners and often the sole breadwinner of the families, very few females were involved in economic activities. Since they had no stable income, the economic shock from the COVID-19 pandemic had affected them badly even leading to household level famine. The study identifies low level of education and informal job security as the primary causes of socio-economic insecurity among persons with disabilities, resulting in challenges in ensuring a stable livelihood during crisis situations, such as COVID-19.Conclusion: Constant alienation of persons of disabilities from the formal sector results in the deterioration of their livelihood standards which even worsen during any emergency crisis such as COVID-19. The study pinpoints that only aided services are not adequate to ensure persons with disabilities' rights rather there is an urgent need of disability inclusion in formal job sector and livelihood training for persons with disabilities. To achieve the Sustainable Development Goals 2030 and to irradiate the inequality towards persons with disabilities in the society it is important for the Government and concern bodies to focus on the inclusiveness with better implementation and monitoring strategies.

scholarly journals Trajectories and Determinants of Physical Activity during COVID-19 Pandemic: A Population-Based Study of Middle-Aged and Elderly Individuals in The Netherlands

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3832
Author(s):  
Amy Hofman ◽  
Marlou A. M. Limpens ◽  
Tosca O. E. de Crom ◽  
Mohammad Arfan Ikram ◽  
Annemarie I. Luik ◽  
...  
Keyword(s):  
Physical Activity ◽  
The Netherlands ◽  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Public Health Problem ◽  
Population Based ◽  
World Health ◽  
Major Public Health Problem ◽  
Middle Aged ◽  
Health Organization

Physical inactivity is a major public health problem, and there are concerns this might have increased during the COVID-19 pandemic. We aimed to identify distinct trajectories of physical activity over a 6-week period after the first restrictive measures and to explore determinants of these trajectories in a population-based cohort of middle-aged and elderly in the Netherlands (n = 5777). We observed that at least 59% of participants did not meet the World Health Organization recommendations for physical activity. Using latent class trajectory analyses over three time points, we identified five distinct trajectories, including four steady trajectories at different levels (very low, low, medium and high) and one increasing trajectory. Using multinomial logistic regression analyses, we observed that, compared to the ‘steadily high’ trajectory, participants in the ‘steadily very low’ trajectory were more often older, lower educated, reporting poorer physical health, more depressive symptoms, consuming a less healthy diet, smoking, and lower alcohol use, and were less often retired. A similar pattern of determinants was seen for those in the increasing trajectory, albeit with smaller effect sizes. Concluding, we observed low levels of physical activity that generally remained during the pandemic. The determinants we described can help identify groups that require additional preventive interventions.

scholarly journals Epidemiology and Trend of Head and Neck Cancers in Iran

2015 ◽  
Vol 8 (1) ◽  
pp. 189 ◽  
Author(s):  
Maryam Mirzaei ◽  
Seyedeh Akram Hosseini ◽  
Mahshid Ghoncheh ◽  
Fahimeh Soheilipour ◽  
Shahin Soltani ◽  
...  
Keyword(s):  
Head And Neck ◽  
Incidence Rate ◽  
Linear Trend ◽  
Health Planning ◽  
Head And Neck Cancers ◽  
World Health ◽  
Vulnerable Groups ◽  
Standard Population ◽  
Health Organization ◽  
Increasing Trends

<p><strong>INTRODUCTION:</strong> Head and neck cancers are the sixth common cancer worldwide. It is necessary to inform the trend of incidence for health planning. This study aimed to investigate the trend of head and neck cancers in Iran.</p> <p><strong>METHODS:</strong> This study was carried out based on national report on cancer registry in Iran. The crude incidence rate was calculated as per 100,000 people, and Age Standardized incidence Rate (ASR) was estimated using direct standardization and the standard population of World Health Organization (W.H.O). Data was analyzed using the Cochran - Armitage test for linear trend and software of WinPepi 2.1.</p> <p><strong>RESULTS:</strong> A total of 25,952 cases of cancers of the head and neck have been registered between 2003 and 2009. The age-standardized incidence rate reached from 4.8 cases per 100,000 in 2003 to 8.5 and 7.4 in 2008 and 2009, respectively, which revealed significantly increasing trends.</p> <p><strong>CONCLUSIONS: </strong>According to increasing trend age-standardized rate of head and neck cancer in Iran, it is recommended to identify risk factors and vulnerable groups in order to reduce the burden of this type of cancers.</p>

scholarly journals Migration in times of pandemic: SARS-CoV-2 infection among the Warao indigenous refugees in Belém, Pará, Amazonia, Brazil

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hilton Pereira da Silva ◽  
Isabella Nogueira Abreu ◽  
Carlos Neandro Cordeiro Lima ◽  
Aline Cecy Rocha de Lima ◽  
Alexandre do Nascimento Barbosa ◽  
...  
Keyword(s):  
World Health ◽  
Epidemiological Surveillance ◽  
Vulnerable Groups ◽  
Enzyme Linked Immunosorbent Assay ◽  
Igg Antibodies ◽  
High Exposure ◽  
Unified Health System ◽  
Private And Public ◽  
Health Organization ◽  
The City

Abstract Background The emergence of the new causative agent of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the city of Wuhan, China, in December 2019, and its spread worldwide, led the World Health Organization (WHO) to declare a pandemic. The disease has caused high mortality among traditional populations and the most socially vulnerable groups such indigenous and refugees. The present study aims to investigate the prevalence of anti-SARS-CoV-2 IgG antibodies in the population of Venezuelan indigenous Warao refugees residing in private and public shelters in the city of Belem, capital of Para State, in the Brazilian Amazon. Methods One hundred one individuals of both sexes (43 men and 58 women) with ages varying from 18 to 77 years (average of 36 years) were investigated. Whole blood samples were collected and subsequently separated into plasma and leukocytes. Serological analysis was performed using an enzyme-linked immunosorbent assay - ELISA (Anti-SARS-COV-2 S1 IgG, EUROIMMUN, USA). Results The results indicate a positive serum prevalence of 83.2% (84), of which 77.6% (45/58) were females and 90.7% (39/43) were males. An indeterminate profile was observed in 6.9% (7), where it was not possible to confirm the presence of antibodies, and 9.9% (10) individuals were negative for IgG antibodies. Conclusions The finding of the high seroprevalence of IgG anti-SARS-CoV-2 antibodies reveals a high exposure of the Warao population in Belem to infection with the new coronavirus. These results underscore the importance of maintaining epidemiological surveillance with testing in traditional populations due to the high possibility of spreading the virus, especially among the most socioeconomically vulnerable groups, which depend exclusively on the Unified Health System (SUS), such as refugees and indigenous people.

scholarly journals A systematic review and meta-analysis of the catastrophic costs incurred by tuberculosis patients

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Ramy Mohamed Ghazy ◽  
Haider M. El Saeh ◽  
Shaimaa Abdulaziz ◽  
Esraa Abdellatif Hammouda ◽  
Amira Mohamed Elzorkany ◽  
...  
Keyword(s):  
Financial Burden ◽  
Meta Analysis ◽  
Final Analysis ◽  
Catastrophic Health Expenditure ◽  
World Health ◽  
Human Immune Deficiency Virus ◽  
Tuberculosis Patients ◽  
Cost Cutting ◽  
Human Immune ◽  
Health Organization

AbstractOne of the strategies of the World Health Organization End Tuberculosis (TB) was to reduce the catastrophic costs incurred by TB-affected families to 0% by 2020.Catastrophic cost is defined by the total cost related to TB management exceeding 20% of the annual pre-TB household income. This study aimed to estimate the pooled proportion of TB affected households who incurred catastrophic costs. We searched PubMed, SciELO, Scopus, Embase, Google Scholar, ProQuest, SAGE, and Web of Science databases according to Preferred Reporting Items of the Systematic Reviews and Meta-Analysis (PRISMA) guidelines till November 20, 2020. Eligible studies were identified and data on catastrophic costs due to TB were extracted. We performed a meta-analysis to generate the pooled proportion of patients with TB facing catastrophic costs. From 5114 studies identified, 29 articles were included in the final analysis. The pooled proportion of patients faced catastrophic costs was (43%, 95% CI [34–51]). Meta-regression revealed that country, drug sensitivity, and Human immune-deficiency Virus (HIV) co-infection were the main predictors of such costs. Catastrophic costs incurred by drug sensitive, drug resistant, and HIV co-infection were 32%, 81%, and 81%, respectively. The catastrophic costs incurred were lower among active than passive case findings (12% vs. 30%). Half (50%) of TB-affected households faced catastrophic health expenditure at 10% cut-off point. The financial burden of patients seeking TB diagnosis and treatment continues to be a worldwide impediment. Therefore, the End TB approach should rely on socioeconomic support and cost-cutting initiatives.PROSPERO registration: CRD42020221283.

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