Older adults with non-communicable chronic conditions and their health care access amid COVID-19 pandemic in Bangladesh: Findings from a cross-sectional study

Background Burgeoning burden of non-communicable disease among older adults is one of the emerging public health problems. In the COVID-19 pandemic, health services in low- and middle-income countries, including Bangladesh, have been disrupted. This may have posed challenges for older adults with non-communicable chronic conditions in accessing essential health care services in the current pandemic. The present study aimed at exploring the challenges experienced by older Bangladeshi adults with non-communicable chronic conditions in receiving regular health care services during the COVID-19 pandemic. Materials and methods The study followed a cross-sectional design and was conducted among 1032 Bangladeshi older adults aged 60 years and above during October 2020 through telephone interviews. Self-reported information on nine non-communicable chronic conditions (osteoarthritis, hypertension, heart disease, stroke, hypercholesterolemia, diabetes, chronic respiratory diseases, chronic kidney disease, cancer) was collected. Participants were asked if they faced any difficulties in accessing medicine and receiving routine medical care for their medical conditions during the COVID-19 pandemic. The association between non-communicable chronic conditions and accessing medication and health care was analysed using binary logic regression model. Results Most of the participants aged 60–69 years (77.8%), male (65.5%), married (81.4%), had no formal schooling (58.3%) and resided in rural areas (73.9%). Although more than half of the participants (58.9%) reported having a single condition, nearly one-quarter (22.9%) had multimorbidity. About a quarter of the participants reported difficulties accessing medicine (23%) and receiving routine medical care (27%) during the pandemic, and this was significantly higher among those suffering from multimorbidity. In the adjusted analyses, participants with at least one condition (AOR: 1.95, 95% CI: 1.33–2.85) and with multimorbidity (AOR: 4.75, 95% CI: 3.17–7.10) had a higher likelihood of experiencing difficulties accessing medicine. Similarly, participants with at least one condition (AOR: 3.08, 95% CI: 2.11–4.89) and with multimorbidity (AOR: 6.34, 95% CI: 4.03–9.05) were significantly more likely to face difficulties receiving routine medical care during the COVID-19 pandemic. Conclusions Our study found that a sizeable proportion of the older adults had difficulties in accessing medicine and receiving routine medical care during the pandemic. The study findings highlight the need to develop an appropriate health care delivery pathway and strategies to maintain essential health services during any emergencies and beyond. We also argue the need to prioritise the health of older adults with non-communicable chronic conditions in the centre of any emergency response plan and policies of Bangladesh.

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Impact of COVID-19 and mitigation plans on essential health services: institutional experience of a hospital in Ethiopia

BMC Health Services Research ◽

10.1186/s12913-021-07106-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Firaol Dandena ◽

Berhanetsehay Teklewold ◽

Dagmawi Anteneh

Keyword(s):

Health Care ◽

Health Services ◽

Health Care Services ◽

Cross Sectional Study ◽

Vital Role ◽

Treatment Center ◽

Cross Sectional ◽

Poor Countries ◽

Care Services ◽

The Impact

Abstract Background Health systems around the world are being challenged by an on-going COVID-19 pandemic. The COVID-19 pandemic and associated response can have a significant downstream effect on access to routine health care services, and indirectly cause morbidity and mortality from causes other than the disease itself, especially in resource-poor countries such as Ethiopia. This study aimed to explore the impact of the pandemic on these services and measures taken to combat the effect. Methods The study was conducted at St. Paul’s hospital millennium medical college (SPHMMC) from December 15, 2020 to January 15, 2021 using a comparative cross-sectional study design. We collected data on the number of clients getting different essential health care services from May to October 2019 (Pre COVID) and the same period in 2020 (during a COVID-19 pandemic) from the patient registry book. The analysis was done with SPSS version 24 software. Result Overall, the essential services of SPHMMC were affected by the COVID-19 pandemic. The most affected service is inpatient admission, which showed a 73.3% (2044 to 682) reduction from the pre-COVID period and the least affected is maternal service, which only decreased by 13% (3671 to 3177). During the 6 months after the COVID-19 pandemic, there was a progressive increment in the number of clients getting essential health services. Conclusion and recommendation The establishment of a triple setup for fighting against COVID-19, which encompasses non-COVID services, an isolation center and a COVID-19 treatment center, played a vital role in preserving essential health services.

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An epidemiological study regarding availability and utilization of public health care services in slum in Amritsar city

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20192297 ◽

2019 ◽

Vol 6 (6) ◽

pp. 2396

Author(s):

Richa Verma ◽

Tejbir Singh ◽

Mohan Lal ◽

Jasleen Kaur ◽

Sanjeev Mahajan ◽

...

Keyword(s):

Health Care ◽

Health Services ◽

Health Care Services ◽

Economic Status ◽

Health Indicators ◽

Public Health Care ◽

Cross Sectional ◽

Government Health ◽

Care Services ◽

The Government

Background: Low level of education of the slum dwellers along-with poor socio- economic status and pathetic environmental conditions lead to their poor health indicators. Since the National Urban Health Mission (NUHM) was launched in 2013, the health services are still in their initial stages. Assessment of the availability as well as the utilization of health care services of the urban slums is the need of the hour.Methods: The cross-sectional study was conducted in randomly selected slum in Amritsar city. All the houses were enumerated and visited by the interviewer herself. The eldest adult member of the family was selected as key respondent and written, informed consent was obtained. Predesigned questionnaire was used to collect the data which was then compiled and analyzed using statistical tests.Results: Out of the total respondents, one third respondents had knowledge about the government health center nearby (statistically significant) while out of these, only one third utilized the services at the center (statistically non-significant). Almost half of the respondents had knowledge about the medical camps and out of these, two-thirds utilized the services at medical camps.Conclusions: Overall utilization of services is poor. More respondents were aware of the medical camps than the static government health facility and utilization of medical camps was also more. So the static health services under NUHM need to be further strengthened.

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The Relations between Disability and Environmental Factors: A Pilot Study in Iranian Older Adults

Global Journal of Health Science ◽

10.5539/gjhs.v8n12p87 ◽

2016 ◽

Vol 8 (12) ◽

pp. 87 ◽

Cited By ~ 1

Author(s):

Mohammadreza Shahbazi ◽

Mahshid Foroughan ◽

Mahdi Rahgozar ◽

Reza Salmanroghani

Keyword(s):

Older Adults ◽

Health Care ◽

Environmental Factors ◽

Health Care Services ◽

Cross Sectional Study ◽

World Health ◽

Structural Barriers ◽

Cross Sectional ◽

Care Services ◽

Health Organization

OBJECTIVE: This study explored disability and its correlations with the environmental factors in a group of Iranian older adults.MATERIALS & METHODS: A cross sectional study was performed. One hundred participants receiving adult day care services in Kahrizak center in Iran were selected by using the complete enumeration method. The World Health Organization Disability Assessment Schedule 2 (WHODAS II) and the Craig Hospital Inventory of Environmental Factors (CHIEF) questionnaires were used to collect data.RESULTS: The mean score of disability was 20.61±13.66, and the scores were higher in women compared to men (P=0.001). Among the CHIEF-25 items‚ the most frequently perceived barrier by the participants was transportation followed by home design and unavailability of health care services. There was a significant association between the disability scores and the environmental factors (P<0.001). Also, significant relationships were found between the disability and all the subscales investigated in the study (polices‚ physical/structural‚ attitude/support‚ services/assistance) (P<0.001).CONCLUSION: Appropriate transportation‚ availability to health care services and removing physical/structural barriers should be taken in consideration.

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Socioeconomic Disparities in the demand for and use of virtual visits among senior adults during the COVID-19 pandemic: A cross-sectional study (Preprint)

10.2196/preprints.35221 ◽

2021 ◽

Author(s):

Ellie Yu

Keyword(s):

Older Adults ◽

Health Care ◽

Health Care Services ◽

Socioeconomic Disparities ◽

Cross Sectional ◽

Secure Messaging ◽

Negatively Associated ◽

Care Services ◽

Virtual Care ◽

Virtual Visits

BACKGROUND The COVID-19 pandemic has limited the provision of in-person care and accelerated the need for virtual care. Older adults (65+) were one of the highest user groups of in-person health care services prior to the pandemic. Social-distancing guidelines and high rates of mortality from coronavirus infections among older adults made receiving in-person health care services challenging for older adults. The provision of virtual care technologies can help to ensure continuity of care and provide essential health care services during the pandemic to those in high-risk groups at contracting the COVID-19 coronavirus including older adults. It is also essential to understand and address potential socioeconomic, demographic, and health disparities in the demand for use of virtual care technologies among older adults. OBJECTIVE The objective of this study is to investigate socioeconomic disparities in the demand for and use of virtual visit during the COVID-19 pandemic among older adults in Canada. METHODS A cross-sectional web survey was conducted with 12,052 Canadians over the age of 16, selected from Leger’s LEO panel between July 14th to August 6th, 2021. Associations between socioeconomic factors and the demand for and use of virtual visits were tested using the χ2 tests and logistic regression models. Weighting was applied using the 2016 census reference variables to render a representative sample of the Canadian population. RESULTS Approximately 20% (n=2,303) of the survey sample were older adults above the age of 65. The proportion of older adults who expressed demand for telephone visit, video visits, and secure messaging were 69.6%, 49.2%, and 47.2%, respectively. The proportion of older adults in our sample who have used telephone visit in the past 12 months was 47.3%, 9.2%, and 8.4%, respectively. eHealth literacy was positively associated with use of telephone visits (OR 1.03, p=0.01), use of video visits (OR 1.04, p=0.00), and the use of secure messaging (OR 1.03, p=0.00). Income was negatively associated with the use of video visits (OR 0.65, p=0.03). Having no private insurance coverage was negatively associated with use of secure messaging (OR 0.73, p=0.04) but living in a rural community (OR 1.72, p=0.01) and being born outside of Canada (OR 1.50, p=0.03) were positively associated with the use of secure messaging. Education (OR 0.78, p=0.02) and being non-White (OR=0.54, p=0.02) were negatively associated with the use of telephone visits. CONCLUSIONS This study found that demand for and use of telephone visit services were more prevalent among older adults during the pandemic. Although demand for secure messaging and video visit is high, usage for these modalities remains low. The results highlight several socioeconomic factors that are associated with demand for virtual visits including language, community size, and health coverage.

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Use of Health Services and Unmet Need among Adults of Russian, Somali, and Kurdish Origin in Finland

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052229 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2229

Author(s):

Katja Çilenti ◽

Shadia Rask ◽

Marko Elovainio ◽

Eero Lilja ◽

Hannamaria Kuusio ◽

...

Keyword(s):

Health Care ◽

General Population ◽

Health Services ◽

Access To Health Care ◽

Health Care Services ◽

Unmet Need ◽

Medical Doctor ◽

Cross Sectional ◽

Care Services ◽

Use Of Health Services

Equal access to health care is one of the key policy priorities in many European societies. Previous findings suggest that there may be wide differences in the use of health services between people of migrant origin and the general population. We analyzed cross-sectional data from a random sample of persons of Russian (n = 692), Somali (n = 489), and Kurdish (n = 614) origin and the Health 2011 survey data (n = 1406) representing the general population in Finland. Having at least one outpatient visit to any medical doctor during the previous 12 months was at the same level for groups of Russian and Kurdish origin, but lower for people of Somali origin, compared with the general population. Clear differences were found when examining where health care services were sought: people of migrant origin predominantly visited a doctor at municipal health centers whereas the general population also used private and occupational health care. Self-reported need for doctor’s treatment was especially high among Russian women and Kurdish men and women. Compared to the general population, all migrant origin groups reported much higher levels of unmet medical need and were less satisfied with the treatment they had received. Improving basic-level health services would serve besides the population at large, the wellbeing of the population of migrant origin.

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FAKTOR - FAKTOR YANG MEMPENGARUHI KEPUTUSAN MASYARAKAT TERHADAP PEMILIHAN JASA PELAYANAN KESEHATAN DI KECEMATAN LATIMOJONG TAHUN 2016

Voice of Midwifery ◽

10.35906/vom.v5i07.16 ◽

2018 ◽

Vol 5 (07) ◽

pp. 55-64

Author(s):

Lestari Lorna Lolo ◽

Ny. Julma

Keyword(s):

Health Care ◽

Health Services ◽

Significant Influence ◽

Urban Areas ◽

Health Care Services ◽

Simple Random Sampling ◽

Cross Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Care Services

Health services are any efforts that are held personal or together within an organization to maintain and improve health, prevent, and cure diseases and restore the health of individuals, families, groups, or society. Buntu Sarek villageis is one village in the village Latimojong district with the general state of the topografi. Buntu Sarek village is a plateau area and the hills and located at an altitude between 600-2500 m above sea level. Health services are always concentrated in urban areas alone and while it was preliminary study found the lack of utilization of health care services in the district Latimojong reasons long distances and can still be treated traditionally.The aims of the research to analyze the factors that influence decision of communities on the selection of a health care services in Latimojong district 2016. Descriptive analytic design with cross sectional study approach, the number of respondents as many as 61 heads of families who are assigned using method simple random sampling . Data collected by a questionnaire and analyzed using univariate and bivariate using Chi-Square statistical test.Conclusion of the research was prove there are significant influence on the distance of health care services selection (p= 0.006), there is a significant influence on the culture of health care services selection (p = 0.000) and there is significant effect on the information of health care services selection (p= 0.000). Suggestions in this research will wish governments and communities work together, care services in Latimojong district, so that people have the ability to reach quality health services and obtain health insurance.Key words : Distance, Culture, Information, Health Care Services Selection

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Building Health Services For A Post-Apartheid Era

Issue A Journal of Opinion ◽

10.1017/s0047160700501097 ◽

1990 ◽

Vol 18 (2) ◽

pp. 24-28

Author(s):

Michael Savage

Keyword(s):

South Africa ◽

Health Care ◽

Health Service ◽

Health Services ◽

Medical Care ◽

Health Care Services ◽

Care Services ◽

Racial Lines ◽

The Many ◽

Basic Medical

Health care services in South Africa are in decline. Inadequate resources, the fragmentation of services along racial lines, their division between a confused jumble of authorities together with a growing privatization of medical care are among the many factors having grave effects on an already poorly constructed health service. The persistence of high levels of infant mortality and the widespread nature of preventable disease provide clear measures indicating that existing health services have failed to meet the needs of the majority of the population for basic medical care. The changes that are currently underway in health services are making it less likely that they can adequately contribute to providing health for all.

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Utilization of Telehealth Services in Libya in Response to the COVID-19 Pandemic: Cross-sectional Analysis (Preprint)

10.2196/preprints.23335 ◽

2020 ◽

Author(s):

Muhammed Elhadi ◽

Ahmed Msherghi ◽

Ahmed Elhadi ◽

Aimen Ashini ◽

Ahmed Alsoufi ◽

...

Keyword(s):

Health Care ◽

Health Status ◽

Medical Care ◽

Text Messaging ◽

Health Care Services ◽

Effective Means ◽

Cross Sectional ◽

Telemedicine System ◽

Care Services ◽

Alternative Modality

BACKGROUND Health care systems in transitional countries have witnessed unprecedented challenges related to adequate and continuous health care provision during the COVID-19 pandemic. In many countries, including Libya, institutions and organizations have begun to implement telehealth technology for the first time. This serves to establish an alternative modality for direct physician-patient interviews to reduce the risk of COVID-19 transmission. OBJECTIVE This study aimed to assess the usability of telehealth services in Libya and to provide an overview of the current COVID-19 scenario. METHODS In this cross-sectional study, an anonymous web-based survey was administered to Libyan residents between April and May 2020. Participants were contacted through text messaging, emails, and social media. The survey items yielded information on the sociodemographic characteristics, availability and accessibility of health care services, effects of the COVID-19 pandemic on health care services, mental health status, and the feasibility and application of the telehealth system. RESULTS We obtained 2512 valid responses, of which 1721 (68.5%) were from females. The participants were aged 28.2 (SD 7.6) years, of whom 2333 (92.9%) were aged <40 years, and 1463 (58.2%) were single. Regarding the health care services and their accessibility, 786 (31.1%) participants reported having a poor health status in general, and 492 (19.6%) reported having a confirmed diagnosis of at least one chronic disease. Furthermore, 498 (19.9%) participants reported varying degrees of difficulty in accessing health care centers, and 1558 (62.0%) could not access their medical records. Additionally, 1546 (61.6%) participants experienced problems in covering medical costs, and 1429 (56.9%) avoided seeking medical care owing to financial concerns. Regarding the feasibility of the telehealth system, approximately half of the participants reported that telehealth services were useful during the COVID-19 pandemic, and 1545 (61.5%) reported that the system was an effective means of communication and of obtaining health care services. Furthermore, 1435 (57.1%) participants felt comfortable using the telehealth system, and 1129 (44.9%) felt that they were able to express themselves effectively. Moreover, 1389 (55.3%) participants found the system easy to understand, and 1354 (53.9%) reported having excellent communication with physicians through the telehealth system. However, only 1018 (40.5%) participants reported that communication was better with the telehealth system than with traditional methods. CONCLUSIONS Our study revealed high levels of usability and willingness to use the telemedicine system as an alternative modality to in-person consultations among the Libyan residents in this study. This system is advantageous because it helps overcome health care costs, increases access to prompt medical care and follow-up evaluation, and reduces the risk of COVID-19 transmission. However, internet connectivity and electricity issues could be a substantial barrier for many resource-limited communities, and further studies should address such obstacles.

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Acesso dos homens aos serviços de atenção primária à saúde

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963-v12i11a237446p2897-2905-2018 ◽

2018 ◽

Vol 12 (11) ◽

pp. 2897 ◽

Cited By ~ 2

Author(s):

Yuri Oliveira Barbosa ◽

Leonardo Philipe Lima Menezes ◽

Allan Dantas Santos ◽

Jéssica Oliveira Cunha ◽

Jose Marcos De Jesus Santos ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Services ◽

Health Care Services ◽

Access To Health Services ◽

Cross Sectional ◽

Adult Men ◽

Care Services ◽

Primary Health ◽

Primary Health Care Services

RESUMOObjetivo: analisar os aspectos gerais do acesso dos homens adultos aos serviços de atenção primária à saúde. Método: trata-se de estudo quantitativo, exploratório e transversal, com 485 homens adultos, por meio de questionário, dados armazenados no software SPSS 20.0, submetidos à estatística descritiva e apresentados em tabelas com distribuição de frequências absoluta e relativa. Resultados: 32,6% visitam os serviços de atenção primária à saúde com regularidade. A demora para ser atendido (35,7%) e a ausência de doenças (33,8%) são os principais fatores impeditivos da acessibilidade masculina aos serviços de saúde; 39,4% desconhecem os dias de funcionamento da unidade; 75% consideram ser difícil agendar consultas e 21% desconhecem a política nacional dos homens. Conclusão: a maioria dos homens adultos não buscou com regularidade os serviços de Atenção Primária à Saúde. Ressaltou-se a importância do conhecimento das razões masculinas para não buscarem os serviços da atenção primária à saúde. Este estudo pode contribuir aos gestores a compreenderem essa realidade singular masculina no planejamento de ações visando à garantia da assistência à saúde mais resolutiva. Descritores: Saúde do Homem; Acesso aos Serviços de Saúde; Atenção Primária à Saúde; Saúde Pública; Assistência à Saúde; Enfermagem.ABSTRACT Objective: to analyze the general aspects of adult men's access to primary health care services. Method: this is a quantitative, exploratory and cross-sectional study with 485 adult men, using a questionnaire, data stored in SPSS 20.0 software, submitted to descriptive statistics and presented in tables with absolute and relative frequency distribution. Results: 32.6% visit regular primary health care services. The delay to be treated (35.7%) and the absence of diseases (33.8%) are the main impediments to male accessibility to health services; 39.4% are unaware of the unit's operating days; 75% consider it difficult to schedule consultations and 21% are unaware of the national men's policy. Conclusion: the majority of adult men did not seek regular Primary Health Care services. The importance of knowing the reasons for not seeking primary health care was emphasized. This study can contribute to the managers to understand this singular masculine reality in the planning of actions aiming to guarantee the health care more resolute. Descritores: Human Health; Access to Health Services; Primary Health Care; Public Health; Health Care; Nursing. RESUMEN Objetivo: analizar los aspectos generales del acceso de los hombres adultos a los servicios de atención primaria a la salud. Método: se trata de un estudio cuantitativo, exploratorio y transversal, con 485 hombres adultos, mediante cuestionario, datos almacenados en el software SPSS 20.0, sometidos a la estadística descriptiva y presentados en tablas con distribución de frecuencias absoluta y relativa. Resultados: el 32,6% visitan los servicios de atención primaria a la salud con regularidad. La demora para ser atendida (35,7%) y la ausencia de enfermedades (33,8%) son los principales factores impeditivos de la accesibilidad masculina a los servicios de salud; 39,4% desconocen los días de funcionamiento de la unidad; El 75% considera que es difícil programar consultas y el 21% desconocen la política nacional de los hombres. Conclusión: la mayoría de los hombres adultos no buscó con regularidad los servicios de Atención Primaria a la Salud. Se resaltó la importancia del conocimiento de las razones masculinas para no buscar los servicios de atención primaria a la salud. Este estudio puede contribuir a los gestores a comprender esta realidad singular masculina en la planificación de acciones para la garantía de la asistencia sanitaria más resolutiva. Descritores: Salud del Hombre; Acceso a los Servicios de Salud; Atención Primaria a la Salud; Salud Pública; Asistencia Sanitária; Enfermería.

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