scholarly journals Determinants of health seeking behavior for chronic non-communicable diseases and related out-of-pocket expenditure: results from a cross-sectional survey in northern Bangladesh

Author(s):  
Fatema Binte Rasul ◽  
Olivier Kalmus ◽  
Malabika Sarker ◽  
Hossain Ishrath Adib ◽  
Md Shahadath Hossain ◽  
...  

Abstract Background In spite of high prevalence rates, little is known about health seeking and related expenditure for chronic non-communicable diseases in low-income countries. We assessed relevant patterns of health seeking and related out-of-pocket expenditure in Bangladesh. Methods We used data from a household survey of 2500 households conducted in 2013 in Rangpur district. We employed multinomial logistic regression to assess factors associated with health seeking choices (no care or self-care, semi-qualified professional care, and qualified professional care). We used descriptive statistics (5% trimmed mean and range, median) to assess related patterns of out-of-pocket expenditure (including only direct costs). Results Eight hundred sixty-six (12.5%) out of 6958 individuals reported at least one chronic non-communicable disease. Of these 866 individuals, 139 (16%) sought no care or self-care, 364 (42%) sought semi-qualified care, and 363 (42%) sought qualified care. Multivariate analysis confirmed that the following factors increased the likelihood of seeking qualified care: a higher education, a major chronic non-communicable disease, a higher socio-economic status, a lower proportion of chronic household patients, and a shorter distance between a household and a sub-district public referral health facility. Seven hundred fifty-four (87 %) individuals reported out-of-pocket expenditure, with drugs absorbing the largest portion (85%) of total expenditure. On average, qualified care seekers encountered the highest out-of-pocket expenditure, followed by those who sought semi-qualified care and no care, or self-care. Conclusion Our study reveals insufficiencies in health provision for chronic conditions, with more than half of all affected people still not seeking qualified care, and the majority still encountering considerable out-of-pocket expenditure. This calls for urgent measures to secure better access to care and financial protection.

2021 ◽  
Vol 71 (5) ◽  
pp. 1534-38
Author(s):  
Syed Fawad Mashhadi ◽  
Saira Maroof ◽  
Aliya Hisam ◽  
Sumaira Masood ◽  
Sonia Riaz ◽  
...  

Objective: To examine the impact of 30-day hospital readmission for non-communicable diseases on limited health-care resources of a low-income country like Pakistan in the light of available data from Pakistan’s Sehat Sahulat Program. Study Design: Retrospective analytical cross-sectional study. Place and Duration of Study: Health Services Academy, Islamabad Pakistan, from Jan 2016 to Jul 2020. Methodology: Secondary data of patients readmitted with non-communicable diseases in Sehat Sahulat Program, Islamabad, Pakistan. Universal sampling technique was utilized. Data was analyzed using SPSS version 27. Results: Islamabad (ICT) stands second highest for readmissions (n=1270) in which the 30-days readmission rate was 13.69%. Maximum number of readmissions were found in 50-59 years (344, 27.12%). Of 1270 ICT readmissions, 559 (44%) cases were readmitted with non-communicable diseases while rest of 711 (56%) cases were readmitted for acute infectious diseases or surgical procedures. Of 559 non-communicable diseases cases, 236 (42.21%) readmissions were having one non-communicable disease, 63 (11.27%) readmissions exhibited two or more non-communicable diseases and 260 (46.51%) were readmitted because of cancers (CA). Among males, the most common malignancy was CA lungs/ bronchus 24 (19.8%) while among females, CA Breast 80 (56.3%). Conclusion: Non-communicable diseases represent a significant burden on resource constrained, low-income countries. In view of the recurrent admissions that these chronic diseases inevitably incur, better resource allocation may help lessen this burden on fragile health systems creating better clinical outcomes for the penurious strata of Pakistan’s population.


2021 ◽  
Vol 10 (2) ◽  
pp. 58-63
Author(s):  
Getahun Asmamaw ◽  
Dinksew Tewuhibo ◽  
Nardos Asffaw

Background: Availability and affordability of medicines are key determinants of universal health coverage, yet achieving them presents a major challenge especially in low-income countries. This study aims to overview the evidence on the accessibility of essential medicines in the African continent. Methods: A quantitative literature search published in English since 2014 was held from valid databases; such as, Scholar, Economic Literature, Global Health, PAIS International, and African Index Medicus. The search was erperformed from September 16 to 20, 2019. Two authors (G.A and D.T) screened the titles, reviewed the articles for inclusion, extracted the data, and conducted a quality assessment of the literature. The third author (N.A) commented on the review. We have used the universal definition of OOP, availability, and affordability. Results: Of 34, 06 articles initially identified, 19 were eligible for inclusion. These were cross-sectional and case-control household and health facility studies published in 2014 in Africa. They demonstrated that the availability of some essential medicine (antibiotics) >80% met WHO’s target. However, drugs for non-communicable diseases show unavailable that range within 20.1% to 60.8%. Households access health services mainly through OOP. An item patients’ expense more for, was fees for drugs (62.3%) (Congo) and was an expensive component of expenditure in private and public health facilities with a mean of 16.7USD and 25.5USD, respectively (Burkina-Faso). Drugs for non-communicable diseases were the most expensive than drugs for infectious diseases (median = 0.62 USD) (Ethiopia). The majority of core essential medicines in private and public outlets are unaffordable. There was a considerable variation in the affordability of basic treatment for infectious and non-communicable diseases. Interestingly, the potential source of inadequate availability of essential medicines and the presence of unaffordability was not investigated in Africa. Conclusion: Evidence suggests that even though, African countries show progress in coverage and affordability for some core essential medicines, it tills needs an effort to convey the WHO’s goal particularly for drugs of non-communicable disease. Future studies need to explore reasons for the persistent unavailability, unaffordability as well as high OOPs for medicines.


2016 ◽  
Vol 5 (3) ◽  
pp. 294
Author(s):  
Yandrizal Yandrizal ◽  
Rizanda Machmud ◽  
Melinda Noer ◽  
Hardisman Hardisman ◽  
Afrizal Afrizal ◽  
...  

Non-Communicable disease has already been the main cause of death in many countries, as many as 57 million death in the world in 2008, 36 million (63 percent) is because of un-infectious disease, specifically heart illness, diabetes, cancer, and chronic respiratory diseases. Prevention and controlling efforts of un-infectious diseases developing in Indonesia is non-communicable disease integrated development post (Pospindu PTM). This research used combination method approach with exploratory design. Exploratory design with sequential procedure used combination consecutively, the first is qualitative and the second is quantitative method. Public Health Center formed Posbindu PTM has not disseminate yet to all stakeholders. Posbindu PTM members felt benefit by following this activity. Some of them did not know follow the activity because of unknown about it. There was  connection between coming behavior to Posbindu PTM to preventing behavior of non-communicable disease.Percentage for high blood pressure risk indicated 20-25 percent from all visitors. Formulation of its policy implementation started with stakeholder analysis; head of sub district, head of urban village, head of health department in regency/city, head of public health service, head of neighborhood Association, and the head of family welfare development.  Analysis of perception, power and authority found that every stakeholder had authority to manage the member directly or indirectly. It was not implemented because of the lack knowledge of stakeholders about the Posbindu PTM function.They would play a role after knowing the aim and advantage of the post by motivate the people to do early detection, prevention and control the non-communicable disease. The members were given wide knowledge about  early detection, preventing  and control the un-infectious disease, measuring and checking up their healthy continuously so that keep feeling the advantage of coming to the post.


2018 ◽  
pp. 15
Author(s):  
Rieski Prihastuti ◽  
Trisno Agung Wibowo ◽  
Misinem Misinem

Purpose: Non-communicable diseases are leading cause of the global death, especially from cardiovascular disease, cancers, chronic obstructive pulmonary disease, and diabetes. Prevention and primary detection of non-communicable disease in Indonesia were done through integrated community-based intervention called ‘Posbindu PTM’. Implementation of ‘Posbindu PTM’ needed to be evaluated to determine each component in the non-communicable disease surveillance systems. Methods: This study was descriptive. Respondent were programmer in district health office and programmer in 24 primary health care in Wonosobo. Surveillance system evaluation that used was programs evaluation based on WHO (structure, main function, support function and quality of surveillance system). Results: The weakness of ‘Posbindu PTM’ in Wonosobo were lack of knowledge in the regulation, networking, collaborating, risk factor detecting and reporting; not availability of technical guidebook; low training participant; low monitoring and evaluation activity; also complex reporting system. There was 84% ‘Posbindu PTM’ that had not reported on time and 87,50 % programmer had not done the analysis, interpretation, and dissemination. This was related to the completeness of the report caused too many data that needed to be collected and affect the timeliness of the report. Conclusion: Strengthening ‘Posbindu PTM’ should be done in the reporting system aspect, especially in the timeliness and analysis of the report. Monthly reminder and refreshing in reporting system were done to improve the reporting system aspect.


2020 ◽  
Vol 114 (4) ◽  
pp. 229-231 ◽  
Author(s):  
Frank Baiden

Abstract Primary healthcare (PHC) meets the needs of people's health throughout their lives and empowers individuals and communities to oversee their own health. Most of the community-based activities currently undertaken in PHC in sub-Saharan Africa (SSA) address child and maternal health. Non-communicable diseases are now major causes of morbidity and premature mortality in SSA. In this paper, I propose the formal integration of community-based, non-communicable disease prevention and early detection into PHC activities. I offer practical suggestions on how this can be achieved to ensure a continuum of care.


2021 ◽  
Vol 34 (3) ◽  
pp. 340
Author(s):  
Erna Herawati ◽  
Yulia Sofiatin

Community responses to disease, including non-communicable diseases, are influenced by the socio-cultural system. The system shapes community knowledge and belief on diseases, as well as community attitude and practice towards prevention and treatment. Drawing on the case in West Java Province, this study aims at identifying socio-cultural aspects in preventing non-communicable diseases. This study was conducted by using a qualitative design. The data were collected through in-depth interviews and archival study. This study found four socio-cultural aspects related to disease and the prevention and treatment of disease in West Java: 1) knowledge and practice of medicine covered in a local knowledge system about the prevention and treatment of non-communicable diseases, 2) local institutions, involving social institutions ranging from families, mosque neighborhood groups, and recitation groups, 3) social actors involved, such as ustaz, traditional leaders, and youth groups, 4) local health communication, using visual and audiovisual aids. This study concludes that these four aspects must be considered in designing a socio-cultural-based non-communicable disease prevention strategy, to be effective and in accordance with the socio-cultural context in West Java.


2020 ◽  
Vol 2 (1) ◽  
pp. 11
Author(s):  
Aryanti Setyaningsih ◽  
Nastitie Cinintya Nurzihan

Abstrak Remaja merupakan kelompok kesehatan prima namun rentan karena mengalami perubahan perilaku berisiko sehingga akan menentukan status kesehatan pada saat dewasa. Salah satu permasalahan kesehatan yang meningkat pada remaja adalah meningkatnya penyakit tidak menular pada remaja, misalnya obesitas, hipertensi, diabetes dan hiperkolesterolemia. Remaja perlu mendapatkan pemaparan mengenai penyakit tidak menular perlu diberikan kepada remaja guna meningkatkan kesadaran dan pemahaman remaja mengenai risiko, dampak, dan deteksi dini penyakit tidak menular pada remaja. Oleh karena itu, perlu diberikan pendidikan kesehatan sebagai dasar penerapan hidup sehat dan cara deteksi dini yang dapat dilakukan oleh remaja guna pencegahan penyakit tidak menular pada remaja. Kegiatan ini dilaksanakan di di SMK 2 PGRI Surakarta yang dilakukan selama 2 hari pada Bulan Juli 2019. Metode kegiatan adalah pendidikan kesehatan dan pemeriksaan komposisi tubuh dengan pengukuran indeks massa tubuh. Tiga puluh dua siswa mengikuti kegiatan ini. Hasil evaluasi menunjukkan peningkatan pengetahuan penyakit tidak menular dan kemampuan siswa dalam memahami status gizi mereka melalui pengukuran komposisi tubuh sebagai bagian dari deteksi dini penyakit tidak menular. Dengan demikian, dapat disimpulkan bahwa terdapat peningkatan pengetahuan dan kesadaran peserta kegiatan dalam melakukan pencegahan terhadap penyakit tidak menular remaja. �Kata kunci: Deteksi Dini; Pendidikan Kesehatan; Pengetahuan; PTM; Remaja�Abstract Adolescents are a prime health group but are vulnerable because they experience changes in risky behavior that will determine their health status as adults. One of the increasing health problems in adolescents is the increase in non-communicable diseases in adolescents, such as obesity, hypertension, diabetes, and hypercholesterolemia. Adolescents need to get exposure to non-communicable diseases to increase awareness and understanding of the risks, impacts, and early detection of non-communicable diseases in adolescents. Therefore, it is necessary to provide health education as a basis for implementing a healthy lifestyle and early detection that can be done by adolescents to prevent non-communicable diseases in adolescents. This activity was carried out at SMK 2 PGRI Surakarta which was conducted for 2 days in July 2019. The method of the activity was health education and examination of body composition by measuring body mass index. Thirty-two students participated in this activity. Evaluation results show an increase in knowledge of non-communicable diseases and the ability of students to understand their nutritional status through measurement of body composition as part of early detection of non-communicable diseases. Thus, it can be concluded that there is an increase in the knowledge and awareness of participant activities in the prevention of adolescent non-communicable diseases.�Keywords: Early Detection; Health Education; Knowledge; Non-Communicable Disease; Adolescent


Author(s):  
R. Sathiya ◽  
A. Manoharan ◽  
A. Rajarajeshwari

The significance of medicinal plants used by the ethnic group of people (Kani/Kanikaran) of Karaiyar, Papanasam through an ethnobotanical survey for treating Non-communicable diseases (NCD) is documented. Data were collected through a questionnaire survey. Sample size in the survey covers 30 tribal people (men-13, women-17) to analyse various factors and their relationship to the diseases.  The survey has included the age range, diseases frequency, gender stats, occupation, BMI, habits and the medicinal practices used. It is estimated that 67% of people still use traditional means for the treatment of diseases. Major medicinal plants used are indigenous to their geographical area which revealed high esteem of ethnobotanical significance and proven to be an effective and sustainable means of treating Non-communicable diseases.


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