scholarly journals Effects of health decentralization, financing and governance in Mexico

2006 ◽  
Vol 40 (1) ◽  
pp. 152-160 ◽  
Author(s):  
Armando Arredondo ◽  
Emanuel Orozco
Keyword(s):  
Community Participation ◽  
Low Income ◽  
Service Providers ◽  
Health Financing ◽  
Cross Sectional Study ◽  
Negative Effects ◽  
Cross Sectional ◽  
Final Destination ◽  
Use Of Resources ◽  
Health Service Providers

OBJECTIVE: To identify the effects of decentralization on health financing and governance policies in Mexico from the perspective of users and providers. METHODS: A cross-sectional study was carried out in four states that were selected according to geopolitical and administrative criteria. Four indicators were assessed: changes and effects on governance, financing sources and funds, the final destination of resources, and fund allocation mechanisms. Data collection was performed using in-depth interviews with health system key personnel and community leaders, consensus techniques and document analyses. The interviews were transcribed and analyzed by thematic segmentation. RESULTS: The results show different effectiveness levels for the four states regarding changes in financing policies and community participation. Effects on health financing after decentralization were identified in each state, including: greater participation of municipal and state governments in health expenditure, increased financial participation of households, greater community participation in low-income states, duality and confusion in the new mechanisms for coordination among the three government levels, absence of an accountability system, lack of human resources and technical skills to implement, monitor and evaluate changes in financing. CONCLUSIONS: In general, positive and negative effects of decentralization on health financing and governance were identified. The effects mentioned by health service providers and users were related to a diversification of financing sources, a greater margin for decisions around the use and final destination of financial resources and normative development for the use of resources. At the community level, direct financial contributions were mentioned, as well as in-kind contributions, particularly in the form of community work.

scholarly journals How marketing mix (7Ps) affect the patients’ selection of a hospital: experience of a low-income country

2020 ◽  
Vol 95 (1) ◽  
Author(s):  
Ramin Ravangard ◽  
Amir Khodadad ◽  
Peivand Bastani
Keyword(s):  
Low Income ◽  
Physical Environment ◽  
Service Providers ◽  
Cross Sectional Study ◽  
Marketing Mix ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Low Income Country ◽  
Health Service Providers ◽  
Selection Of

Abstract Background Applying marketing mix in the hospitals is necessary for their success. It is also important to optimize the price, developing services, increasing health literacy, and improving financial resources. Experts and patients may have different views about the factors that influence the decision for choosing a hospital. This study was conducted to identify the factors in the marketing mix which influence patients’ selection of hospitals in Shiraz, Iran. Methods A cross-sectional study involving patients assigned to six hospitals; three selected private and three corporate public hospitals in Shiraz in southern Iran in 2018 composed the study sample. From the inpatients and outpatients referring to these hospitals, 300 patients were included using a stratified sampling method proportional to size. Their views on the status of the selected hospitals regarding the 7Ps model of the hospital marketing mix (product, people, price, place, promotion, process, and physical environment) were assessed using a 5-point Likert scale. Data were collected by administering a validated researcher-developed questionnaire (CVI = 2.65, α = 0.929). Results Among 44 components of marketing mix according to 7Ps model, “specialty of health service providers” had the best status (mean (SD) 4.15 ± 0.82) from the patients’ viewpoints. Among the 7Ps, “physical environment” and “people” had better status respectively. In contrast, the studied hospitals had the poorest status in “promotion.” Significant relationship was revealed between the private and corporate public hospitals in terms of price, promotion, and process (P < 0.05). Pearson’s correlation revealed a direct relationship between all the components of marketing mix in the hospitals (P < 0.001). Conclusion The studied hospitals have an appropriate status in physical environment and people mix but poor status in promotion mix. It is therefore necessary for these hospitals to pay more attention to the “promotion mix” irrespective of the related costs. Moreover, as “process mix” had a high significant correlation with the other marketing mix, managers can improve their marketing services through correcting their current processes.

scholarly journals Basque Ethnic Identity and Collective Empowerment: Two Key Factors in Well-Being and Community Participation

2020 ◽  
Vol 11 ◽  
Author(s):  
Jon Zabala ◽  
Susana Conejero ◽  
Aitziber Pascual ◽  
Itziar Alonso-Arbiol ◽  
Alberto Amutio ◽  
...  
Keyword(s):  
Ethnic Identity ◽  
Community Participation ◽  
Psychological Empowerment ◽  
Well Being ◽  
Cross Sectional Study ◽  
Social Identification ◽  
Negative Effects ◽  
Cross Sectional ◽  
Identity Fusion ◽  
Collective Empowerment

Social identity is a factor that is associated with well-being and community participation. Some studies have shown that ethnic identity goes along with empowerment, and that interaction between the two leads to greater indices of well-being and community participation. However, other works suggest a contextual circumstance (i.e., perceiving one’s own group as a minority and/or being discriminated) may condition the nature of these relations. By means of a cross-sectional study, we analyzed the relations of social identification (or identity fusion) and collective psychological empowerment with personal well-being, social well-being and community participation in a sample of Basques. A total of 748 Basques participated (63.1% women; age M = 39.28; SD = 12.13). Individuals who were highly identified or fused with Basque speakers and who were highly empowered showed higher indices of well-being (both personal and social) and of community participation than non-fused individuals with low empowerment. The results also suggest that social identification (or identity fusion) offsets the negative effects of perceiving the group as a linguistic minority. Collective psychological empowerment proved to be an especially relevant factor that needs to continue to be explored.

scholarly journals The misuse of antiretrovirals to boost pig and poultry productivity in Uganda and potential implications for public health

2021 ◽  
Vol 7 (1) ◽  
pp. 88-95
Author(s):  
Dickson Ndoboli ◽  
Fredrick Nganga ◽  
Ben Lukuyu ◽  
Barbara Wieland ◽  
Delia Grace ◽  
...  
Keyword(s):  
Service Providers ◽  
Smallholder Farmers ◽  
Animal Health ◽  
Cross Sectional Study ◽  
Antiretroviral Drugs ◽  
Human Consumption ◽  
Cross Sectional ◽  
News Reports ◽  
Health Service Providers ◽  
Poultry Farmers

Background and Aim: Since 2015, local newspapers reported that pig and poultry farmers in Uganda use antiretroviral drugs (ARVs) to promote growth in animals and control diseases. This study was conducted to assess farmers' knowledge, attitude and perceptions about the use of antiretroviral drugs as boosters in pigs and poultry and the possibility of detecting the antiretroviral drugs in meat using available laboratory methods. Materials and Methods: In 2019, a cross-sectional study was conducted in ten districts in Uganda. In 20 focus group discussions with 100 pig and poultry farmers and 70 animal health service providers, we assessed the use of ARV in livestock enterprises. Subsequently, samples of chicken, pigs, and animal feeds were collected from volunteer participants, and screened for residues of saquinavir, lopinavir, nevirapine, and efavirenz using liquid chromatography-tandem mass spectrophotometer. Results: Participants in all ten districts were predominantly smallholder farmers supplying the local markets. All groups reported the use of ARVs in pigs and broiler birds but not in layer hens. In the absence of good quality feeds, the motivation for feeding ARVs was rapid animal weight gain, as well as the control of animal diseases, for which farmers have no alternative solutions. ARVs were obtained within the community for free, against cash, or in-kind payment. Residues of lopinavir were detected in four, and saquinavir in seven districts, and all three sample matrices. Conclusion: Our study findings confirm anecdotal news reports on ARV use in livestock. While our findings are not generalizable to the whole country, they call for a representative follow-up. As the drugs were detected in tissues destined for human consumption, the potential risk to human health warrants further investigation.

scholarly journals Attitudes of health service providers: the perspective of Persons with Disabilities in the Kumasi Metropolis of Ghana

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Eric Badu ◽  
Maxwell P. Opoku ◽  
Seth C.Y. Appiah
Keyword(s):  
Service Providers ◽  
People With Disabilities ◽  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
Health Providers ◽  
Cross Sectional ◽  
Persons With Disabilities ◽  
Health Service Providers ◽  
Multi Stage ◽  
Service Training

Introduction: Awareness of disability issues has gained considerable interest by advocacy groups in recent years. However, it is uncertain whether attitudes and perceptions of all service providers and society have adjusted accordingly towards the health care of people with disabilities. This study sought to examine the attitudes of health providers from the perspective of people with disabilities in the Kumasi Metropolis. Methods: A cross-sectional study using semi-structured questionnaires was conducted with people with disabilities (with physical, hearing and visual impairments,) in the Kumasi Metropolis. The study used a multi-stage sampling involving cluster and simple random sampling to select 255 respondents split amongst the following five clusters of communities; Oforikrom, Subin, Asewase, Tafo and Asokwa. Data were analysed using STATA 14 and presented in descriptive and inferential statistics. Results: The study found that 71% of the respondents faced some form of discrimination including the use of derogatory remarks, frustration and unavailable required services on the basis of their disability, the type of services they need and the location. Women were 3.89 times more likely to face discrimination; Adjusted odds ratio (AOR) = 3.89 (95% confidence interval [CI]; 1.41, 10.76), and visually impaired was more likely to be discriminated at the facility compared with physical disability; AOR = 5.05 (95% CI; 1.44, 17.65). However, respondents with some educational qualification and those who stayed with their family members were less likely to face discrimination; AOR = 0.08 (95% CI; 0.01, 0.39). Conclusion: The study recommends the provision of in-service training for service providers to update their knowledge on disability issues and improve access to services for people with disabilities.

scholarly journals Evaluation Of Public Awareness, Knowledge And Attitudes Towards Basic Life Support Among Non-Medical, Adult Population In Muscat City, Oman: Cross-Sectional Study

2020 ◽  
Vol 5 (2) ◽  
pp. 1-8
Author(s):  
Aisha Aldhakhri ◽  
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Service Providers ◽  
Public Awareness ◽  
Adult Population ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Knowledge And Attitudes ◽  
Health Service Providers ◽  
Life Threatening

Life-threatening illnesses or injuries may occur at places where there are no health service providers, so it is imperative that laypeople are equipped with all necessary knowledge and skills to provide BLS.

scholarly journals Discrimination and Health: The Mediating Effect of Acculturative Stress

2021 ◽  
Vol 18 (10) ◽  
pp. 5312
Author(s):  
Alfonso Urzúa ◽  
Alejandra Caqueo-Urízar ◽  
Diego Henríquez ◽  
David R. Williams
Keyword(s):  
Mental Health ◽  
Racial Discrimination ◽  
Acculturative Stress ◽  
Short Form ◽  
Cross Sectional Study ◽  
Ethnic Discrimination ◽  
Mediating Effect ◽  
Physical And Mental Health ◽  
Negative Effects ◽  
Cross Sectional

There is not much evidence on the effects of south–south migration and its consequences on physical and mental health. Our objective was to examine the mediating role of Acculturative Stress in the association between ethnic discrimination and racial discrimination with physical and mental health. This research is a non-experimental, analytical, cross-sectional study. A total of 976 adult Colombian migrants living in Chile were interviewed. We used the Everyday Discrimination Scale, the acculturative stress scale, and the Medical Outcomes Study Short Form (SF-12) for health status; we found that racial and ethnic discrimination had a negative effect on physical and mental health. In the simultaneous presence of both types of discrimination, racial discrimination was completely absorbed by ethnic discrimination, the latter becoming a total mediator of the effect of racial discrimination on mental and physical health. Our findings are consistent with the literature, which suggests that there are various types of discrimination which, individually or in their intersectionality, can have negative effects on health.

scholarly journals Trends in social inequalities in breastfeeding and infant formulas in Latin American countries between the 1990 and 2010 decades

2021 ◽  
pp. 1-10
Author(s):  
Camila S Ferreira ◽  
Catarina M Azeredo ◽  
Ana Elisa M Rinaldi
Keyword(s):  
Dominican Republic ◽  
Social Inequality ◽  
Latin American ◽  
Low Income ◽  
Social Inequalities ◽  
Weighted Least Squares ◽  
Cross Sectional Study ◽  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Simultaneous Decrease

Abstract Objective: To analyse trends of social inequality in breastfeeding and infant formula (IF) use in Latin America between 1990 and 2010 decades. Design: Time-series cross-sectional study with data from Demographic and Health Surveys. We described the prevalence of exclusive breastfeeding (EBF), breastfeeding between 6 and 12 months (BF6-12) and IF for infants under 6 months (IF < 6) and between 6 and 12 months (IF6-12). Social inequalities were assessed using the slope index of inequality (SII) and concentration index (CIX). Trends in the prevalence of breastfeeding, IF and index of social inequality were analysed by a linear regression model with weighted least squares variance. Setting: Bolivia, Colombia, Dominican Republic, Guatemala, Haiti and Peru. Participants: 51·358 alive infants younger than 12 months. Results: Five countries showed an increasing trend for EBF and BF6-12, four increased for IF < 6 and six for IF6-12. Simultaneous decrease in IF < 6 (Colombia: −0·3/year; Haiti: −0·02/year) and increase in EBF (Colombia: +2·0/year; Haiti: +1·9/year) were observed only in two countries. EBF prevalence was high in the lowest income quintiles in five countries, and IF prevalence was high in the highest income quintiles in all countries and over the decades. For BF6-12, a decrease in inequality (prevalence increased in the highest quintile) was observed in Guatemala (SII1995 = −0·42; SII2015 = −0·28) and the Dominican Republic (SII1996 = −0·54; SII2013 = −0·26). Guatemala was the only country showing a decrease in inequality for BF (SII = −0·005; CIX = −0·0035) and an increase for IF (SII = 0·022; CIX = 0·01). Conclusions: The inequality in BF and IF remained over time. However, inequality in IF < 6 has decreased because low-income infants have increased use and high-income infants have decreased.

scholarly journals Acceptance of a COVID-19 Vaccine in Japan during the COVID-19 Pandemic

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 210
Author(s):  
Masaki Machida ◽  
Itaru Nakamura ◽  
Takako Kojima ◽  
Reiko Saito ◽  
Tomoki Nakaya ◽  
...  
Keyword(s):  
Low Income ◽  
Multiple Logistic Regression Analysis ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Internet Survey ◽  
Protective Measure ◽  
Attitudes And Beliefs ◽  
Perceived Effectiveness ◽  
Cross Sectional ◽  
Vaccine Acceptance

Vaccination could be a key protective measure against coronavirus disease 2019 (COVID-19), and it is important to understand the acceptability of the COVID-19 vaccine among the general public. However, there is no study on the acceptance of a COVID-19 vaccine in Japan. Therefore, this study aimed to describe the COVID-19 vaccine acceptance and hesitancy situation in Japan and assess the factors associated with such issues. This was a cross-sectional study based on an internet survey completed by 2956 people. Participants were asked to indicate how likely they were to get vaccinated for COVID-19. In addition, the participants responded to questions regarding sociodemographic factors, attitudes, and beliefs regarding COVID-19 infection and vaccination. The proportion of participants with a high likelihood of getting a COVID-19 vaccine was 62.1%. Multiple logistic regression analysis showed that vaccine acceptance was lower among several sociodemographic groups, such as women, adults aged 20–49 years, and those with a low-income level. Several psychological factors, especially the perceived effectiveness of the COVID-19 vaccine, and willingness to protect others by getting oneself vaccinated, were associated with vaccine acceptance. Our results indicate that the perceived effectiveness of the vaccine and willingness to protect others may play an important role in the acceptance of the COVID-19 vaccine.

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