scholarly journals Access to child care services in the Northeast and in the South Regions of Brazil

2017 ◽  
Vol 17 (3) ◽  
pp. 447-460
Author(s):  
Andréia Soprani dos Santos ◽  
Suele Manjourany Siva Duro ◽  
Nagela Valadão Cade ◽  
Luiz Augusto Fachini ◽  
Elaine Tomasi

Abstract Objectives: to estimate the incomplete follow-up on child care services and the associated factors in the municipalities in the Northeast and in the South of Brazil. Methods: a population-based cross-sectional study with 7,915 children. The incomplete follow-up on child care regarded the absence of at least one of the seven advocated care services. The Poisson regression was used for crude and adjusted analysis. Results: the prevalence of the incomplete follow-up child care was 53.6% (CI95%= 52.5-54.7) in the Northeast and 28.3% (CI95%= 27.3-29.3) in the South, therefore 91% was greater in the Northeast (PR=1.91; CI95%= 1.73-2.11). Protector effect was observed: in the muni-cipalities with 30 to 49 thousand inhabitants in the Northeast (PR= 0.72; CI95%= 0.64-0.82) and 100 to 999 thousand inhabitants in the South (PR=0.69; CI95%= 0.57-0.84); the South has the greatest income quartile (RP=0.77; CI95%= 0.63-0.95) and has six or more prenatal consultations (PR=0.83; CI95%= 0.75-0.92) in the Northeast and (PR=0.65; CI95%= 0.53-0.79) in the South. Social classes D and E showed risks (PR=1.41; CI95%= 1.19-1.67) in the Northeast and (PR=1.67; CI95%= 1.37-2.03) in the South. Conclusions: children in the Northeast are more likely not to have a complete child care follow-up, implying that the user does not come to be attended or finds difficulties to have access to the health services.

Author(s):  
Anne M. Gadomski ◽  
John Talarico ◽  
Kathryn S. Abernethy ◽  
Helen G. Cicirello

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029114 ◽  
Author(s):  
Srinivas Marmamula ◽  
Rohit C Khanna ◽  
Shashank Yellapragada ◽  
Rajesh Challa ◽  
Javed Mohd ◽  
...  

ObjectivesTo investigate the temporal trends in the prevalence and causes of visual impairment (VI) in South India.DesignPopulation-based cross-sectional studies conducted during the years 2011–2012 and 2017 using identical study methods and in geographical locations are compared. The L V Prasad Eye Institute established services in Khammam and not in Warangal district after the 2011–2012 study.SettingKhammam and Warangal districts in Telangana, India.ParticipantsIn total, 5357 participants aged ≥40 years were examined from two districts in the 2011–2012 study and 4923 participants were examined in the 2017 study.Main outcome measuresAge-adjusted and gender-adjusted temporal trends in the prevalence and causes of VI.Blindness and moderate VI (MVI) were defined as presenting visual acuity worse than 6/60 and 6/18–6/60 in the better eye, respectively. VI included MVI and blindness.ResultsNearly 2500 participants were examined in each location in both the 2011–2012 and 2017 studies. In Khammam district, overall VI declined by 2.5% from 15.5% to 13.0% (p<0.001). While there was no significant change in MVI (p=0.566), blindness declined by 3.0% from 5.4% to 2.4% (p<0.001). In Warangal district, the overall VI remained unchanged (p=0.60). While MVI increased by 3% from 9.3% to 12.3% (p=0.001), blindness declined by 3.5% from 6.5% to 3.0% (p<0.001). While MVI due to cataract increased in both districts, there was a significant decline in MVI due to refractive errors in Khammam.ConclusionThere was a significant decline in VI in Khammam district but not in Warangal district. The differential trends in prevalence and causes of VI can be explained by the availability and uptake of eye care services in these two districts.


2017 ◽  
Vol 17 (11) ◽  
pp. 2224-2231 ◽  
Author(s):  
Mei Feng ◽  
Ayumi Igarashi ◽  
Maiko Noguchi-Watanabe ◽  
Satoru Yoshie ◽  
Katsuya Iijima ◽  
...  

Author(s):  
Mologadi D. Ntsoane ◽  
Olalekan A. Oduntan ◽  
Benjamin L. Mpolokeng

Background: Visual impairment and blindness are major health problems worldwide, especially in the rural and remote areas of developing countries. Utilisation of eye care services is essential to reduce the burden of visual impairment and blindness, and it is therefore important that it is monitored.Objectives: The objectives of this study were to determine the level of utilisation of public eye care services and factors that might have influenced their usage in rural communities, Capricorn district, Limpopo Province, South Africa.Method: A population-based cross-sectional study design was used. Participants were residents in selected rural villages located within approximately 5 km of six Government hospitals. Following ethical approval and receipt of informed consent, a questionnaire with closed and open-ended questions was used to collect information on the utilisation of eye care services and factors that might influence utilisation. Descriptive statistics and Pearson’s Chisquare test were used to analyse and compare the data.Results: Many (62.7%) of the respondents had used the government eye care services in the past. Over fifty-nine per cent (59.3%) of them were satisfied with the services. Factors reported to influence utilisation (such as monthly income, knowledge of available services and the need for regular eye tests) were positively associated with utilisation of eye care services in this study (p < 0.05).Conclusion: Utilisation of eye care services was relatively good, but varied significantly between sites. An awareness campaign by government and non-governmental organisations about eye care services may increase utilisation amongst rural communities.


2014 ◽  
Vol 18 (9) ◽  
pp. 1610-1619 ◽  
Author(s):  
A Colin Bell ◽  
Lynda Davies ◽  
Meghan Finch ◽  
Luke Wolfenden ◽  
J Lynn Francis ◽  
...  

AbstractObjectiveTo determine the impact of an implementation intervention designed to introduce policies and practices supportive of healthy eating in centre-based child-care services. Intervention strategies included staff training, resources, incentives, follow-up support, and performance monitoring and feedback.DesignA quasi-experimental design was used to assess change over 20 months in healthy eating policy and practice in intervention and comparison child-care services.SettingThe Hunter New England (HNE) region of New South Wales (NSW), Australia.SubjectsAll centre-based child-care services (n 287) in the intervention region (HNE) were invited and 240 (91 % response rate) participated. Two hundred and ninety-six services in the rest of NSW were randomly selected as a comparison region and 191 participated (76 % response rate). A sub-analysis was conducted on those services that provided children food (n 196 at baseline and n 190 at follow-up). Ninety-six provided menus for analysis at baseline (HNE, n 36; NSW, n 50) and 102 provided menus at follow-up (HNE, n 50; NSW, n 52).ResultsServices in the intervention region were significantly more likely to provide only plain milk and water for children (P = 0·018) and to engage parents in nutrition policy or programmes (P = 0·002). They were also more likely (P = 0·056) to have nutrition policy on home packed food. In addition, menus of services that provided lunch were significantly more likely to comply with healthy eating guidelines for sweetened drinks (P < 0·001), fruit (P < 0·001) and vegetables (P = 0·01).ConclusionsAn implementation intervention was able to modify policy and practice in a large number of child-care services so that they were more supportive of healthy eating.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lovise S. Heimro ◽  
Monica Hermann ◽  
Therese Thuen Davies ◽  
Anne Haugstvedt ◽  
Johannes Haltbakk ◽  
...  

Abstract Background Home care services plays an important role in diabetes management, and to enable older adults remain home-dwellers. Adequate follow-up and systematic nursing documentation are necessary elements in high quality diabetes care. Therefore, the purpose of this study was to examine the diabetes treatment and management for older persons with diabetes receiving home care services. Methods A cross-sectional study was used to assess the diabetes treatment and management in a Norwegian municipality. Demographic (age, sex, living situation) and clinical data (diabetes diagnose, type of glucose lowering treatment, diabetes-related comorbidities, functional status) were collected from electronic home care records. Also, information on diabetes management; i.e. follow-up routines on glycated haemoglobin (HbA1c), self-monitoring of blood glucose, insulin administration and risk factors (blood pressure, body mass index and nutritional status) were registered. HbA1c was measured upon inclusion. Descriptive and inferential statistics were applied in the data analysis. Results A total of 92 home care records from older home-dwelling persons with diabetes, aged 66–99 years were assessed. Only 52 (57 %) of the individuals had the diabetes diagnosis documented in the home care record. A routine for self-monitoring of blood glucose was documented for 27 (29 %) of the individuals. Only 2 (2 %) had individual target for HbA1c documented and only 3 (3 %) had a documented routine for measuring HbA1c as recommended in international guidelines. Among 30 insulin treated older individuals, a description of the insulin regimen lacked in 4 (13 %) of the home care records. Also, documentation on who performed self-monitoring of blood glucose was unclear or lacking for 5 (17 %) individuals. Conclusions The study demonstrates lack of documentation in home care records with respect to diagnosis, treatment goals and routines for monitoring of blood glucose, as well as insufficient documentation on responsibilities of diabetes management among older home-dwelling adults living with diabetes. This indicates that home care services may be suboptimal and a potential threat to patient safety.


2018 ◽  
Vol 31 (07) ◽  
pp. 1027-1037
Author(s):  
Laetitia Rullier ◽  
Céline Meillon ◽  
Valérie Bergua ◽  
Clément Pimouguet ◽  
Magali Gonzalez-Colaço Harmand ◽  
...  

ABSTRACTBackground:Given the rate of the undiagnosed cases of dementia and the consequences of inappropriate care, understanding the factors that explain the use of medical and health care in dementia is a critical concern. Our objective was to identify the psychosocial and medical determinants of use of care in dementia.Methods:The study sample consisted of 308 participants: the persons with dementia (n = 99) selected from three French population-based cohorts (i.e. PAQUID, 3C, AMI), their family caregivers (primary, n = 96, and secondary, n = 51), and their general practitioners (n = 62). Use of care in dementia was considered according to two indicators: (1) recourse to secondary care, (2) number of community and health services used.Results:Multiple logistic models including sociodemographics and psychosocial variables revealed that the determinants of nonuse of care are similar both for the recourse to secondary care and for the number of community and health services used: lack of education and the contribution of the people with dementia to the decisions regarding their own care and dementia care services in the community area. In addition, satisfaction of the primary caregiver with the services used by his/her relative is associated with non-recourse to secondary care.Conclusions:Taken together, these results highlight the predominant role of psychosocial factors in the use of care in dementia and the importance of addressing this issue through an integrative approach including psychological, social, medical, and family dimensions.


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