Health disparities and the digital divide within South African disadvantaged communities during the COVID-19 pandemic

2021 ◽  
Vol 13 (2) ◽  
pp. 285-302 ◽  
Author(s):  
Elizabeth Lubinga ◽  
Karabo Sitto ◽  
Keke Molebatsi

The purpose of this article is to highlight how technologies, which have for centuries revolutionalized healthcare, have conversely increased health disparities among disadvantaged communities in South Africa during coronavirus disease (COVID-19). A hard lockdown imposed on the country in March 2020, as an initial measure of containment of the novel virus, became unfeasible due to detrimental, mostly economic effects on the economy. From 1 May, the government eased the lockdown restrictions and shifted the emphasis from containment to behaviour change measures using communication strategies that promoted adherence. Yet, even within disadvantaged communities, there have been differences in health-related access with differing levels of disadvantage. Secondary data were analysed from a cross-sectional quantitative survey conducted in ten disadvantaged communities in the Northern Cape and Gauteng Provinces involving 1742 participants. Results show that the lack of digital access to information created an obstacle to adherence to some recommended COVID-19-related behaviour change measures. Disparities existed between the two provinces’ disadvantaged communities based on an urban versus a rural province. The study emphasized the need to assess the extent of underlying obstacles to health equity and achievement of healthcare goals propagated by an interface between healthcare and socio-economic factors. Breakthroughs in healthcare, facilitated by virtual modes of communication may be undermined by a digital divide exacerbating disparities in disadvantaged communities.

2020 ◽  
Vol 8 (2) ◽  
pp. 117
Author(s):  
Mohamad Anis Fahmi

Background: Low public awareness of the impact of smoking makes the implementation of smoke-free areas (KTR) difficult. Smoke-free areas aim to protect the public from the direct and indirect effects of smoking. Purpose: This study aimed to analyze the correlation between the application of smoke-free areas and the prevalence of active and ex-smokers in Indonesia. Method: This study implemented a cross-sectional design, using secondary data from the Riskesdas 2018 on active and ex-smokers. KTR application data were obtained from the Profile of Non-Communicable Diseases in 2016. A Pearson product-moment test was conducted by a computer application to determine the correlation coefficient (r). This coefficient was used to describe the level of correlation between the two variables; significance was determined as a p value of 5%. Results: This study showed that the average application of KTR throughout Indonesia was 50.83%, active smokers comprised 23.49% of the population, and ex-smokers comprised 4.94%. Most active smokers were in Java and Sumatra, while the majority of ex-smokers were in Java and Sulawesi and the majority of KTR was in Java. This study shows that there is a positive correlation between KTR application and the percentage of ex-smokers (r = 0.46; p value = 0.01). Conclusion: There is a positive correlation between the application of KTR and an increase in ex-smokers. The government needs to increase the application of KTR policies.


Author(s):  
Tri Wahyuni ◽  
Suherman Suherman ◽  
Nazarwin Saputra ◽  
Istianah Surury

The world is undergoing the new pandemic named COVID-19 of early 2020 announced in China and all over the world and infect more than 10 million people in the world (incidence rate 1.3). Indonesia has the number of cases 28.818 per June 04, 2020, with a CFR of 6%, the highest in Southeast Asia. Besides confirming the case, the suspect like ODP, PDP, and OTG should also be monitored. Although the number of cases and suspects in the Kebayoran Baru district is not the highest in South Jakarta, as the center of South Jakarta where many offices and high mobility, and the population is not as much as another district, so the possible transmission of COVID-19 in Kebayoran Baru still high. To find out the relationship between age, sex, comorbid hypertension, diabetes mellitus, and heart disease with the severity of symptoms in COVID-19 suspect of Kebayoran Baru district March – June 2020. The design of this study used cross-sectional secondary data of COVID-19 suspect monitoring in Community Health Center Kebayoran Baru. Analysis with chi-square 0.005. Statistical results of COVID-19 suspects in the Kebayoran Baru district are 44% having symptoms. The research suggests that a significant relationship between age, hypertension comorbid, diabetes mellitus comorbid, and heart disease with the symptoms. While sex has no significant relation with symptoms. The government should have more attention to protect people that having comorbid such as hypertension, diabetes mellitus, or heart disease.


2003 ◽  
Vol 80 (3) ◽  
pp. 646-665 ◽  
Author(s):  
Eliza Tanner Hawkins ◽  
Kirk A. Hawkins

Latin American governments are attempting to close the digital divide by enacting policies to increase access to information technologies. This cross-sectional time-series analysis of nineteen countries between 1990 and 2001 examines government policies and Internet usage. Based on the social shaping of technology perspective, this study finds Internet use is strongly associated with wealth and the telecommunications infrastructure. The government policy with the strongest influence on increasing access is changing the tariff structure—such as creating flat-price dialing schemes. Market liberalization and the worldwide spread of the Internet are also associated with increased access.


Author(s):  
Yuxuan Gu ◽  
Hao Zhang ◽  
Shahmir H. Ali ◽  
Minzhuo Huang ◽  
Jingming Wei ◽  
...  

Social determinants are closely related to health and play a significant role in shaping the quality of life of a population. This study aimed to explore the differences in HRQoL (health-related quality of life) scores of residents in the eastern province of Zhejiang and the western province of Qinghai and probe factors affecting the HRQoL among the two populations. A sample of 4210 residents from a cross-sectional survey was included in the analysis. The EQ-5D-3L instrument was used to measure the HRQoL of residents. A Chi-square test and a t-test were used to examine the differences between different variables and analysis of variance (ANOVA) with interaction effects was used to analyze factors associated with the HRQoL between the two provinces. Residents’ EQ-5D index score (EQ VAS score) was 0.963 (82.71) and 0.962 (81.51), respectively, in Zhejiang and Qinghai. Generally, residents in Qinghai displayed significantly worse HRQoL scores than those in Zhejiang. The differences between the two regions lay on mobility, pain/discomfort, and anxiety/depressions. In both regions, an increased education level and being employed were most strongly associated with a positive HRQoL; increased age and presence of chronic diseases were most strongly associated with a negative HRQoL. When formulating health policies, the significant health disparities between western and eastern provinces must be given greater consideration. The health of vulnerable groups should be particularly focused on to improve the observed health disparities.


2020 ◽  
Vol 8 (12) ◽  
pp. 622-634
Author(s):  
Warren Tibesigwa ◽  
◽  
Will Kaberuka ◽  
Joanina Ayebare ◽  
Ally Ndeshiuta Morris ◽  
...  

There are many studies on the relationship between household income and saving though very little is known about the influence of financial planning on the relationship between household income and saving.This paper examined the moderating effect of financial planning on the relationship between household income and saving in Tanzania.Based on cross-sectional secondary data (Finscope data,2017) that was collected using multistage sampling from 9457 respondents, descriptive, correlation, regression and moderation effect were performed to analyze the data.The findings indicate that household income and interaction effects have a positive relationship with level of saving. Finally, regression results show that household income and financial planning have a positive significant effect on household saving levels and that financial planning has a positive moderating effect on the relationship between household income and level of saving. From these study results,it is recommended that the government of Tanzania through the ministry of community development, gender and children in should introduce financial awareness programs to the communities in order for the people to realize the need of financial planning and hence improve their saving.Further more the government throughthe ministry of education and vocational training should introduce financial awareness in the school curriculum so that citizens learn how to plan for financial matters at early stages.


2019 ◽  
Vol 3 ◽  
pp. 1473
Author(s):  
Manish Gehani ◽  
Manoj Pal ◽  
Anupama Arya ◽  
Shobhana Singh ◽  
Kaushik S. ◽  
...  

Background: For accelerating its progress towards FP2020 goals, the Government of India has focused on improving the quality of intrauterine device (IUD) services. EngenderHealth has supported the Governments of Rajasthan and Gujarat since 2014 through its Expanding Access to IUD Services in India (EAISI) project by building the capacity of service providers, monitoring their compliance with standard practices, and strengthening health systems. This study sought to assess whether EAISI trained providers provide a better quality of IUD services as compared to non-EAISI trained providers, as indicated by a reduction in confirmed IUD complications? Methods: This study was an analytical cross-sectional study of secondary data collected from the follow-up registers of 176 intervention facilities (138 in Rajasthan and 38 in Gujarat) during Phase I of EAISI project. The analysis included clients who returned between April 2018 and March 2019 to the same facility for a follow-up visit. Multivariate logistic regression was performed to determine factors associated with IUD complications. Results: A total of 56,733 IUD insertions were conducted, and 10,747 (18.9%) client follow-ups were documented. Of these, 49.4% (N=5,305) clients received IUDs from EAISI-trained providers, while 50.6% (N=5,442) received IUDs from non-EAISI trained providers. A total of 4.0% (N=432) of clients experienced complications (Expulsion: 1.3%, Missing Strings: 1.7%, Infection: 1.1%). Clients who received IUDs from non-EAISI-trained providers were 55.5% more likely [95% CI (26.2%, 91.5%), p<0.0005] to have complications compared to clients who received insertions from EAISI-trained providers. Other significant factors include the type of IUD, timing of the follow-up visit and timing of the insertion. Conclusion: The findings demonstrate that intensive, hands-on training of providers to improve clinical skills for IUD insertions can have a positive impact on the reduction of post-insertion complications.


2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Satriya Wijaya

Abstrak Pelaksanaan JKN di Indonesia menghadapi berbagai tantangan, dari sisi pemberi layanan kesehatan, pengelola jaminan kesehatan, masyarakat sebagai pengguna, serta pemerintah sebagai regulator program. Berbagai studi telah dilakukan untuk menelaah dampak JKN pada pelayanan kesehatan di Indonesia, namun pemanfaatan hasil studi tersebut untuk menyempurnakan kebijakan masih terbatas. Jenis penelitian ini adalah penelitian deskriptif eksploratif, yang menggunakan metode deskriptif kualitatif serta penelaahan dokumen. Desain penelitian adalah cross-sectional dengan pendekatan retrospektif. Sampel penelitian ini adalah seluruh stakeholder kunci yang berada di wilayah kerja Puskesmas Wiyung yang terkait erat dengan pelaksanaan JKN. Analisa dan pengumpulan data dilakukan untuk memvalidasi: informasi dari institusi responden, indepth interview dengan stake holder kebijakan dan pelaksana program, kemudian cek silang oleh enumerator lapangan ke beberapa responden untuk temuan yang memerlukan, dan refleksi tim dalam bentuk pertemuan validasi data. Informasi yang diperoleh dari hasil indepth interview stake holder kebijakan dan pelaksana program, informasi cek silang dari enumerator lapangan maupun data sekunder akan diintegrasikan dengan informasi kualitatif yang terkumpul. Hasil analisis menunjukkan tidak semua pengunjung Puskesmas Wiyung telah menjadi peserta BPJS. Sistem administrasi dianggap rumit untuk dipahami dengan mudah oleh masyarakat.  Perlu sosialisasi kepada masyarakat tentang kepesertaan BPJS dan penguatan koordinasi dengan pihak BPJS apabila ada masalah anggota kepesertaan pasien BPJS.   Kata kunci: implementasi JKN, program JKN, kepesertaan BPJS Abstract   Implementation of National Health Insurance (JKN) in Indonesia faces various challenges, from the side of health care providers, health insurance managers, the community as users, and the government as the program regulator. Various studies have been conducted to examine the impact of JKN on health services in Indonesia, but the use of the results of these studies to improve policies is still limited. This type of research is explorative descriptive research, which uses qualitative descriptive methods and document review. The study design was cross-sectional with a retrospective approach. The sample of this study is all key stakeholders in the Wiyung Health Center working area which are closely related to JKN implementation. Analysis and data collection were carried out to validate: information from the respondent's institution, in-depth interviews with policy stakeholders and program implementers, then cross-check by field enumerators to several respondents for findings that needed, and team reflection in the form of data validation meetings. Information obtained from the results of an in-depth interview of policy stakeholders and program implementers, cross check information from field enumerators and secondary data will be integrated with qualitative information collected. The results of the analysis showed that not all visitors to the Wiyung Health Center had become BPJS participants. The administrative system is considered complicated to be easily understood by the community. Need to disseminate information to the public about BPJS membership and strengthening coordination with BPJS if there are problems with membership of BPJS patients.  Keywords: implementation of JKN, JKN program, BPJS membership


2020 ◽  
Vol 3 ◽  
pp. 1473
Author(s):  
Manish Gehani ◽  
Manoj Pal ◽  
Anupama Arya ◽  
Shobhana Singh ◽  
Kaushik S. ◽  
...  

Background: To accelerate progress toward Family Planning 2020 (FP2020) goals, the government of India focused on improving the quality of intrauterine device (IUD) services. EngenderHealth, an international sexual and reproductive health and rights organization, has been supporting the governments of Gujarat and Rajasthan since 2014 through the Expanding Access to IUD Services in India (EAISI) project by building the capacity of service providers, monitoring compliance with standard practices, and strengthening health systems. This study sought to assess whether EAISI-trained providers offer higher quality IUD services than non-EAISI-trained providers, as indicated by a reduction in confirmed IUD complications. Methods: The study team conducted an analytical cross-sectional study of secondary data collected from follow-up registers at 176 intervention facilities (38 in Gujarat and 138 in Rajasthan) during Phase I of the EAISI project. The analysis included follow-up clients who returned to the same facility between April 2018 and March 2019. We performed a multivariate logistic regression to determine factors associated with IUD complications. Results: During the period of assessment, 56,733 clients received IUD insertions, and 10,747 (18.9%) clients returned for follow-up services. Of the returning clients, 49.4% (N=5,305) had received IUDs from EAISI-trained providers, while 50.6% (N=5,442) had received IUDs from non-EAISI-trained providers. A total of 4.0% (N=432) of all returning clients experienced complications (expulsion: 1.3%, missing strings: 1.7%, infection: 1.1%). Clients who received IUDs from non-EAISI-trained providers were 55.5% more likely (95% CI [26.2%, 91.5%], p<0.0005) to have experienced complications than clients who received insertions from EAISI-trained providers. The type of IUD, the timing of the insertion, and the timing of the follow-up visit also affected complication prevalence. Conclusion: Our findings indicate that intensive, practical clinical skills training for IUD insertion can reduce the prevalence of complications.


2020 ◽  
Vol 6 (6) ◽  
pp. 29
Author(s):  
Locha Erukudi ◽  
Paul Edabu

Purpose: This study sought to establish the influence of SFP on children enrolment in early childhood education centers in Turkana Central Sub-County, Kenya. Specific objective was to establish the influence of food adequacy on enrolment in ECE centres in Turkana Central Sub County, Turkana County, Kenya. Methodology: The study was based on Maslow hierarchy of needs, the program theory and liberal egalitarian theory. The study used a mixed research method. The study adopted the cross-sectional research design. The target population was 250 schools, 78 teachers and head teachers and 5,000 parents in pre-schools in Turkana Central Sub County. The study used purposive sampling to select respondents. The sample size of the study was 150 schools, 60 teachers and head teachers and 357 parents. Primary data was gathered by use of questionnaires and interviews guides. Secondary data consisted of report forms of pre-schoolers. Quantitative information was analyzed using descriptive statistics which was computed using SPSS version 21. Qualitative data was analyzed using content analysis. Multiple regressions were done to analyze the influence of SFPs on children enrolment in ECDE centres in Turkana Central Sub County. Findings: The study found that food adequacy significantly and positively relate with children enrolment in ECE centres in Turkana Central Sub County, Turkana County, Kenya. Food adequacy had statistically significant effect of school enrolment in ECD (β = 0.415, P = 0.005). It implies that food adequacy significantly and positively relate with children enrolment in ECE centres in Turkana Central Sub County, Turkana County, Kenya. This implies that increasing food adequacy will lead to increase in children enrolment in ECE centres in Turkana Central Sub County, Turkana County, Kenya. Unique contribution to theory, practice and policy: The study therefore recommends the government to increase food supply to ensure adequacy. There is need to continue supply of balanced diet to children because it improves their growth and learning. Some of the children are from very poor families and during school holidays they suffer because of lack of food; the study therefore recommends orphans, poor and disabled to be fed even during holidays.


2018 ◽  
Author(s):  
Robert T Trotter II ◽  
Ricky Camplain ◽  
Emery R Eaves ◽  
Viacheslav Y Fofanov ◽  
Natalia O Dmitrieva ◽  
...  

BACKGROUND Incarcerated populations have increased in the last 20 years and >12 million individuals cycle in and out of jails each year. Previous research has predominately focused on the prison population. However, a substantial gap exists in understanding the health, well-being, and health care utilization patterns in jail populations. OBJECTIVE This pilot study has 5 main objectives: (1) define recidivists of the jail system, individuals characterized by high incarceration rates; (2) describe and compare the demographic and clinical characteristics of incarcerated individuals; (3) identify jail-associated health disparities; (4) estimate associations between incarceration and health; and (5) describe model patterns in health care and jail utilization. METHODS The project has two processes—a secondary data analysis and primary data collection—which includes a cross-sectional health survey and biological sample collection to investigate infectious disease characteristics of the jail population. This protocol contains pilot elements in four areas: (1) instrument validity and reliability; (2) individual item assessment; (3) proof of concept of content and database accessibility; and (4) pilot test of the “honest broker” system. Secondary data analysis includes the analysis of 6 distinct databases, each covered by a formal memorandum of agreement between Northern Arizona University and the designated institution: (1) the Superior Court of Arizona Public Case Finder database; (2) North Country Health Care; (3) Health Choice Integrated Care; (4) Criminal Justice Information Services; (5) Correctional Electronic Medical Records; and (6) iLEADS. We will perform data integration processes using an automated honest broker design. We will administer a cross-sectional health survey, which includes questions about health status, health history, health care utilization, substance use practices, physical activity, adverse childhood events, and behavioral health, among 200 Coconino County Detention Facility inmates. Concurrent with the survey administration, we will collect Methicillin-resistant and Methicillin-sensitive Staphylococcus aureus (samples from the nose) and dental microbiome (Streptococcus sobrinus and Streptococcus mutans samples from the mouth) from consenting participants. RESULTS To date, we have permission to link data across acquired databases. We have initiated data transfer, protection, and initial assessment of the 6 secondary databases. Of 199 inmates consented and enrolled, we have permission from 97.0% (193/199) to access and link electronic medical and incarceration records to their survey responses, and 95.0% (189/199) of interviewed inmates have given nasal and buccal swabs for analysis of S. aureus and the dental microbiome. CONCLUSIONS This study is designed to increase the understanding of health needs and health care utilization patterns among jail populations, with a special emphasis on frequently incarcerated individuals. Our findings will help identify intervention points throughout the criminal justice and health care systems to improve health and reduce health disparities among jail inmates. INTERNATIONAL REGISTERED REPOR RR1-10.2196/10337


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