scholarly journals Equity and accessibility in health? Out-of-pocket expenditures on health care in middle income countries: evidence from Mexico

2008 ◽  
Vol 24 (12) ◽  
pp. 2819-2826 ◽  
Author(s):  
Armando Arredondo ◽  
Patricia Nájera
Keyword(s):  
Health Care ◽  
National Health Survey ◽  
Private Institutions ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public And Private ◽  
Middle Income ◽  
Middle Income Countries ◽  
Study Population ◽  
Type Of Institution

This study analyzes the results of a cross-sectional survey which set out to determine the costs to patients of searching for and receiving health care in public and private institutions. The information analyzed was obtained from the study population of the Mexican National Health Survey. The dependent variable was the out-of-pocket users' costs and the independent variables were the insurance conditions, type of institution and income. The empirical findings suggest that there is a need for a more detailed analysis of user costs in middle income countries in general, where the health system is based on social security, public assistance and private institutions. This study shows that the out of pocket costs faced by users are inequitable and fall disproportionately upon socially and economically marginalized populations.

scholarly journals Psychosocial Factors, Smoke-Free Restrictions, and Media Exposure in Relation to Smoking-Related Attitudes and Behaviors among Adults in Armenia and Georgia

2021 ◽  
Vol 18 (8) ◽  
pp. 4013
Author(s):  
Christina N. Wysota ◽  
Marina Topuridze ◽  
Zhanna Sargsyan ◽  
Ana Dekanosidze ◽  
Lela Sturua ◽  
...  
Keyword(s):  
Smoking Status ◽  
Media Exposure ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Quit Attempts ◽  
Multivariable Regression ◽  
Readiness To Quit ◽  
Perceived Harm

Background: Perceived harm, social influences, smoke-free policies, and media exposure have been understudied in relation to tobacco-related attitudes/behaviors in aggregate or in low and middle-income countries; thus, this study examined these factors collectively in relation to smoking-related outcomes among Armenian and Georgian adults. Methods: Using 2018 cross-sectional survey data (n = 1456), multivariable regression analyses examined these factors in relation to smoking status, perceived harm among nonsmokers, and readiness to quit and past-year quit attempts among smokers. Results: Significant predictors (p < 0.05) of current smoking (27.3%) included lower perceived harm, more smoking friends, and fewer home and vehicle restrictions. Among nonsmokers, more home and restaurant/bar restrictions, fewer vehicle restrictions, greater anti-tobacco media exposure, and less pro-tobacco media exposure predicted greater perceived harm. Among smokers, greater perceived social acceptability of smoking, less anti-tobacco media exposure, and greater pro-tobacco media exposure predicted readiness to quit (12.7% of smokers). More smoking friends, more home restrictions, less anti-tobacco media exposure, and greater pro-tobacco media exposure predicted past-year quit attempts (19.2%). Conclusions: Findings support the importance of smoke-free policies but were counterintuitive regarding the roles of social and media influences, underscoring the need to better understand how to address these influences, particularly in countries with high smoking rates.

scholarly journals Assessing Factors Associated with TB Awareness in Nepal: A National and Subnational Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5124
Author(s):  
Yoko Iwaki ◽  
Santosh Kumar Rauniyar ◽  
Shuhei Nomura ◽  
Michael C. Huang
Keyword(s):  
Socioeconomic Factors ◽  
Influential Factors ◽  
Regional Level ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Factors Associated ◽  
Middle Income Countries ◽  
Information And Communication ◽  
High Level

Tuberculosis (TB) has still remained a serious global health threat in low- and middle-income countries in recent years. As of 2021, Nepal is one of the high TB burden countries, with an increasing prevalence of cases. This study evaluates factors associated with TB awareness in Nepal. This study uses data from the Nepal Demographic and Health Survey, a cross-sectional survey carried out from June 2016 to January 2017. Multilevel logistic regression is performed to examine the association of demographic and socioeconomic factors with TB awareness. Our findings show a high level of TB awareness in all seven provinces of Nepal. Province 5 has the highest level of awareness (98.1%) among all provinces, followed by provinces 3 and 4, while province 6 has the lowest awareness level (93.2%) compared to others. Socioeconomic factors such as wealth, education and owning a mobile phone are significantly associated with TB awareness. Socioeconomic determinants are influential factors associated with TB awareness in Nepal. The wide variation in the proportion of awareness at a regional level emphasizes the importance of formulating tailored strategies to increase TB awareness. For instance, the use of mobile phones could be an effective strategy to promote TB awareness at a regional level. This study provides valuable evidence to support further research on the contribution of information and communication technology (ICT) usage to improving TB awareness in Nepal.

The impact of COVID-19 on oncologists: Experience from Egyptian physicians.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13514-e13514
Author(s):  
Abeid Mohamed Athman Omar ◽  
Marwa Ramadan ◽  
Yomna Khamis ◽  
Abdelsalam A. Ismail
Keyword(s):  
Family Support ◽  
Occupational Safety ◽  
Family Members ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Burnout Rate ◽  
Almost All ◽  
The Impact

e13514 Background: The unprecedented emergence of coronavirus disease (COVID-19) has disrupted the patients' and physicians' daily activities, including cancer care. However, little is known on how COVID-19 has impacted oncologists from low and middle-income countries. Methods: We conducted a cross-sectional survey among eighty-eight practicing oncologists in Alexandria governorate, Egypt. An electronic, anonymized self-reporting survey was distributed in February 2020 to collect information on occupational safety measures, the prevalence of COVID-19 among respondents, workload, and family support during the pandemic Results: Out of 88 contacted oncologists, 75% completed the survey (n=66). Nearly half (45%) of respondents were residents, 36% were specialists, and 18% were consultants. The mean age of respondents was 34.79 years (SD ±10.42). More than half of the respondents were not comfortable managing cancer patients during the pandemic (56%) and did not feel well-protected at the workplace (58%). However, most (79%) had managed a cancer patient with COVID-19 more than once. Furthermore, almost all participants (98%) have worked with an infected colleague. Nevertheless, to more than half (54%), it made no difference working with a colleague who was previously infected. Most physicians (79%) felt overwhelmed with workload than the pre-pandemic period. Despite being COVID-19 negative, nearly half reported their family members had reduced contact with them due to the fear of being infected. In contrast, 24% are now getting more family support, whereas 27% are experiencing the same contact level as before the COVID-19 era. Physicians lacking family support had a significantly higher burnout rate than those who had family support (p=0.038). However, the burnout rate was similar regardless of doctors' rank, or treating COVID-19 patients, or feeling protected at work. The majority of the participants (75%) had experienced COVID-19 like symptoms, and one third (n=21) were confirmed COVID-19 infected: residents - 52%, specialists - 33%, and consultants - 14%. Nevertheless, we found no association between the rank and being infected with COVID-19 (p=0.632). Most participants thought they were infected at the hospital (38% by patients; 24% by colleagues), and 14% by family members. However, there was no significant association between being infected and feeling protected at work (p=0.823). Most of the infected physicians (61%) received moral support from both the family and colleagues, and 33% received family support only. There was no association between burnout rate and being COVID-19 infected (p=0.719). Conclusions: One-third of the oncologists were COVID-19 positive. Besides, most oncologists feel overwhelmed with workload and experience more burnout than before the COVID-19 era, and it worsens if one lacks family support.

Breast cancer biomolecular profile in 909 patients of a lower-incomes province in Argentina.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e11538-e11538
Author(s):  
Silvia Holgado ◽  
Adriana del Carmen Elias ◽  
Juan Jose Zarba ◽  
Raul Audi ◽  
Ana Vinuales ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Utility ◽  
Statistical Study ◽  
Triple Negative ◽  
Molecular Profile ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Study Population ◽  
Molecular Expression

e11538 Background: Recent reports of the increasing incidence of BC in low and middle-income countries highlights the need to have a better understanding of prognostic biomarkers with clinical utility. The aims of this study were to analyze the biomolecular profile in a population with BC of Tucumán, Argentine. Methods: The study population consisted of 909 patients with primary or metastatic BC. The immunostainning results for hormones receptors (ER-PR) and Her2/neu protein expression in patients with histological breast diagnosis were assessed. The study design was cross sectional and the statistical study was exploratory. We compared the frequencies of patients with ER+/PR+/Her2-, ER+/PR-/Her2-, ER+/PR+/Her2+, ER+/PR-/Her2+, ER-/PR-/Her2+ and ER-/PR-/Her2- with those published in 2011 by St Gallen and relative variations were calculated to meet the relative percentages of the differences. Results: 893 were studied for all three. Molecular Expression (Population: 909): ER 58% (486/841); PR 48% (405/841); Her2 10% (85/893) Population Age: 21-89 years old (mean 58 yrs). Conclusions: The molecular profile in BC in our province seems to be different of the previously reported in western countries (St Gallen 2011), showing a more aggressive biomolecular profile with higher incidence of triple negative patients and lower incidence of Her2neu positive. With these results it is possible to assume that we are dealing with a population with particular characteristics. [Table: see text]

scholarly journals Gaps in Capacity in Primary Care in Low-Resource Settings for Implementation of Essential Noncommunicable Disease Interventions

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
S. Mendis ◽  
Igbal Al Bashir ◽  
Lanka Dissanayake ◽  
Cherian Varghese ◽  
Ibtihal Fadhil ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Information ◽  
Health Financing ◽  
Noncommunicable Disease ◽  
Noncommunicable Diseases ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Objective.The objective was to evaluate the capacity of primary care (PC) facilities to implement basic interventions for prevention and management of major noncommunicable diseases (NCDs), including cardiovascular diseases and diabetes.Methods.A cross-sectional survey was done in eight low- and middle-income countries (Benin, Bhutan, Eritrea, Sri Lanka, Sudan, Suriname, Syria, and Vietnam) in 90 PC facilities randomly selected. The survey included questions on the availability of human resources, equipment, infrastructure, medicines, utilization of services, financing, medical information, and referral systems.Results and Conclusions.Major deficits were identified in health financing, access to basic technologies and medicines, medical information systems, and the health workforce. The study has provided the foundation for strengthening PC to address noncommunicable diseases. There are important implications of the findings of this study for all low- and middle-income countries as capacity of PC is fundamental for equitable prevention and control of NCDs.

scholarly journals ASSESSING PHARMACY STUDENTS’ MIGRATION RELATED ATTITUDES AND INTENTION TO EMIGRATE FROM LITHUANIA

2017 ◽  
Vol 27 (3) ◽  
pp. 123-128
Author(s):  
Gvidas Urbonas ◽  
Indrė Venclovaitė ◽  
Aušra Urbonienė ◽  
Loreta Kubilienė
Keyword(s):  
Pharmacy Students ◽  
Self Report ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Middle Income ◽  
High Unemployment ◽  
Personal Attitude ◽  
Middle Income Countries ◽  
Path Analysis Approach

Lithuania among the middle-income countries is experiencing the brain drain situation when high-educated professionals, including health care specialists, migrate to high-income countries in search for better economic, social and cultural life. The objective of the study was to identify the potential reasons for migration from the perspective of pharmacy students that might come into consideration after they graduate university. A convenience sample (n = 196) of pharmacy students participated in the cross-sectional survey where they gave opinion on why people emigrate from Lithuania, also expressed personal attitude towards emigration, as well as intention to emigrate after the studies on self-report scales. The nonlinear Robust Path Analysis approach was employed for data analysis. The results revealed that high unemployment conceived as a reason to emigrate from Lithuania, as well as personal attitude towards emigration was significantly linked with intent to emigrate after studies. Family or friends living abroad, adverse cultural environment, and lack of entertainment options conceived as a reason to emigrate significantly affected students personal attitude towards emigration from Lithuania. High unemployment as a reason for emigration remained the main factor directly associated with the intention to emigrate. However, investment in social, cultural and human capital should be seen as the next step to reduce the attractiveness of emigration to the future pharmacists.

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