scholarly journals Effect of COVID-19 on demand for healthcare in Togo

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yaovi Tossou
Keyword(s):  
Public Health ◽  
Health Care ◽  
Relative Risk ◽  
Risk Ratio ◽  
Health Care Services ◽  
Health Facilities ◽  
Relative Risk Ratio ◽  
Self Medication ◽  
Public Health Facilities ◽  
Care Services

Abstract Background Demand-side barriers to health care are as important as supply-side factors in deterring patients from obtaining effective treatment during COVID-19. Developing countries, including Togo, have focused on reducing the risk of health care utilization during this period by ensuring basic health care services as an important policy to improve health outcomes and meet international obligations to make health services accessible. Methods The data used to cover all 44 districts in the six (6) health regions of Togo, are from a national home survey. They are collected from July 8th to 17th, 2020. In each district chief town, a minimum of thirty (30) households were included by a systematic two-stage random draw (neighborhood and then home). Based on these data, the multinomial regression model was used to identify risk factors for the request for health care services during COVID-19. Results A total of 1946 (with a response rate of 98.3%) participants were addressed in the study. The finding on households with age above 60 years indicated that the relative risk ratio (RRR = 23.97; 95% CI = 0.93; 615.38) allowed them to practice self-medication in lieu of modern healthcare facilities. The multinomial model revealed that the relative risk ratio of pre-COVID-19 activities (RRR = 4.87; 95% CI = 1.018; 23.38) permits households to rely on their self-medication choice and (RRR = 3.14; 95% CI = 0.91; 0.83) prefer public health facilities. Given that the head of the households (RRR = 0.19; 95% CI = 0.017, 2.11) is educated, he prefers the choice of private health centers during COVID-19 pandemic to public health facilities. Conclusion This study has demonstrated that the majority (30.49%) of patients sought health care. The analysis shows that the loss of employment, activities before COVID-19 in households and areas not infected by the pandemics allow them to ask for health care (self-medication and public hospitals) despite the COVID-19 impacts. However, higher education and age determine a different choice of health care delivery by households. Thus, policy makers need to cast special emphasis on social policies to address home health shocks.

scholarly journals Effect of COVID-19 on the risk of household demand for health care in Togo

2021 ◽  
Author(s):  
Yaovi TOSSOU
Keyword(s):  
Health Care ◽  
Relative Risk ◽  
Risk Ratio ◽  
Health Care Services ◽  
Health Centre ◽  
Relative Risk Ratio ◽  
Self Medication ◽  
Demand For Health Care ◽  
Care Services ◽  
Demand For Health

Abstract Background Barriers on the demand side of the health care system are as important as supply side factors in deterring patients from obtaining effective treatment during COVID-19. Developing countries, including Togo, have focused on reducing the risk of health care use during this period by ensuring basic health care services, as an important policy to improve health outcomes and meet international obligations to make health services accessible. Methods The data used come from a national household survey conducted from 8 to 17 July 2020 covering all 44 districts of Togo's 6 health regions. In each district capital, a minimum of 30 households were included by a systematic random draw at two levels (district then household). On the basis of these data, the multinomial regression model is used to identify the risk factors for the demand for health care services during COVID-19. Results A total of 1946 (with a response rate of 98.3%) participants were included in the study. The conclusion on households over 60 years of age indicates that the relative risk ratio (RRR = 23.97; 95% CI = 0.93; 615.38) allows households to practice self-medication instead of modern care structures. The multinomial model revealed that the relative risk ratio of activities before COVID-19 (RRR = 4.879; 95% CI = 1.018; 23.38) allows households to maintain their choice of self-medication and (RRR = 3.139; 95% CI = 0.91; 0.829) to prefer public health centre. As an educated head of household (RRR = 0.192; 95% CI = 0.017, 2.113) he prefers the choice of private health centre during COVID-19. Conclusions This study found that the majority (30.49%) of patients sought health care. The analysis shows that the loss of employment, pre-COVID-19 activities in households and regions not infected by the pandemic allow households to remain in the choice of health care demand (self-medication and public hospitals) despite the impacts of COVID-19. On the other hand, the level of higher education and age determine an alternative choice of health care provision by households. Therefore, policy makers need to put a particular emphasis on social policies to address household health shocks.

scholarly journals Health facility capacity to provide postabortion care in Afghanistan: a cross-sectional study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Farzana Maruf ◽  
Hannah Tappis ◽  
Enriquito Lu ◽  
Ghutai Sadeq Yaqubi ◽  
Jelle Stekelenburg ◽  
...  
Keyword(s):  
Public Health ◽  
Family Planning ◽  
High Volume ◽  
Health Facilities ◽  
Public Health Facilities ◽  
Care Services ◽  
Vacuum Aspiration ◽  
Postabortion Care ◽  
Products Of Conception ◽  
Family Planning Counseling

Abstract Background Afghanistan has one of the highest burdens of maternal mortality in the world, estimated at 638 deaths per 100,000 live births in 2017. Infections, obstetric hemorrhage, and unsafe abortion are the three leading causes of maternal death. Contraceptive prevalence rate has fluctuated between 10 and 20% since 2006. The 2016 Afghanistan National Maternal and Newborn Health Quality of Care Assessment evaluated facility readiness to provide quality routine and emergency obstetric and newborn care, including postabortion care services. Methods Accessible public health facilities with at least five births per day (n = 77), a nationally representative sample of public health facilities with fewer than five births per day (n = 149), and 20 purposively selected private health facilities were assessed. Assessment components examining postabortion care included a facility inventory and record review tool to verify drug, supply, equipment, and facility record availability, and an interview tool to collect information on skilled birth attendants’ knowledge and perceptions. Results Most facilities had supplies, equipment, and drugs to manage postabortion care, including family planning counseling and services provision. At public facilities, 36% of skilled birth attendants asked to name essential actions to address abortion complications mentioned manual vacuum aspiration (23% at private facilities); fewer than one-quarter mentioned counseling. When asked what information should be given to postabortion clients, 73% described family planning counseling need (70% at private facilities). Nearly all high-volume public health facilities with an average of five or more births per day and less than 5% of low volume public health facilities with an average of 0–4 deliveries per day reported removal of retained products of conception in the past 3 months. Among the 77 high volume facilities assessed, 58 (75%) reported using misoprostol for removal of retained products of conception, 59 (77%) reported using manual vacuum aspiration, and 67 (87%) reported using dilation and curettage. Conclusions This study provides evidence that there is room for improvement in postabortion care services provision in Afghanistan health facilities including post abortion family planning. Access to high-quality postabortion care needs additional investments to improve providers’ knowledge and practice, availability of supplies and equipment.

scholarly journals The Association of Residence Permits on Utilization of Health Care Services by Migrant Workers in China

2021 ◽  
Vol 18 (18) ◽  
pp. 9623
Author(s):  
Haochuan Xu ◽  
Han Yang ◽  
Hui Wang ◽  
Xuefeng Li
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Access ◽  
Migrant Workers ◽  
Health Care Services ◽  
Public Health Care ◽  
Chinese Government ◽  
Care Access ◽  
Care Services ◽  
The Impact

Due to the limitations in the verifiability of individual identity, migrant workers have encountered some obstacles in access to public health care services. Residence permits issued by the Chinese government are a solution to address the health care access inequality faced by migrant workers. In principle, migrant workers with residence permits have similar rights as urban locals. However, the validity of residence permits is still controversial. This study aimed to examine the impact of residence permits on public health care services. Data were taken from the China Migrants Dynamic Survey (CMDS). Our results showed that the utilization of health care services of migrant workers with residence permits was significantly better than others. However, although statistically significant, the substantive significance is modest. In addition, megacities had significant negative moderating effects between residence permits and health care services utilization. Our research results emphasized that reforms of the household registration system, taking the residence permit system as a breakthrough, cannot wholly address the health care access inequality in China. For developing countries with uneven regional development, the health care access inequality faced by migrant workers is a structural issue.

scholarly journals Prison Health as Public Health in Ontario Corrections

2020 ◽  
Vol 5 (1) ◽  
pp. 19
Author(s):  
Yoko Murphy ◽  
Howard Sapers
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Services ◽  
Care Needs ◽  
Term Care ◽  
Care Services ◽  
Prison Health ◽  
Independent Review ◽  
Recent Reform ◽  
The Government

The majority of incarcerated individuals in Canada, and especially in Ontario provincial correctional institutions, are released into the community after a short duration in custody. Adult correctional populations have generally poor health, including a heightened prevalence of mental health and substance use disorders. There are legal and ethical obligations to address health care needs of incarcerated individuals, and also public health benefits from ensuring adequate, appropriate, and accessible health services to individuals in custody. The Independent Review of Ontario Corrections recommended the transformation of health care in Ontario provincial corrections in 2017, including transferring health service responsibilities to the Ministry of Health and Long-Term Care. The Correctional Services and Reintegration Act, 2018, would affirm the provincial government’s obligation to provide patient-centred, equitable health care services for individuals in custody. We encourage the Government of Ontario to proclaim the Act and continue the momentum of recent reform efforts in Ontario.

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