scholarly journals Factors that Influence Teenage Antenatal Care Utilization in John Taolo Gaetsewe (JTG) District of Northern Cape Province, South Africa: Underscoring the Need for Tackling Social Determinants of Health

2016 ◽  
Vol 5 (2) ◽  
pp. 134-145
Author(s):  
Eshetu Bekele Worku, PhD ◽  
Selamawit Alemu Woldesenbet, PhD
Keyword(s):  
South Africa ◽  
Antenatal Care ◽  
Social Determinants Of Health ◽  
Health Facility ◽  
Adolescent Mothers ◽  
Social Determinants ◽  
Teenage Pregnancy ◽  
Determinants Of Health ◽  
Care Utilization ◽  
Reproductive Health Services

Background and Objectives: In resource-limited settings, the uptake of antenatal care visits among women, especially teenage pregnant women, is disturbingly low. Factors that infl uence the uptake of ANC services among teenage women is largely understudied and poorly understood in John Taolo Gaetsewe (JTG), a predominantly rural and poor district of South Africa. The aim of this study was to determine the factors that infl uence uptake of ANC services among teenage mothers in JTG district. Methods: A cross-sectional health facility-based study utilising mixed method was conducted in all public health facilities (n=44) at JTG district. Mother-infant pairs (n=383) who brought their infants for six-week first DPT immunisation during the study period were enrolled in the study. Structured questionnaires were used to collect data on demographic, socio-economic and uptake of ANC indicators. Results: Out of 272 respondent mothers, 18.68% were adolescent mothers (13-19 years). The logistic regression analysis shows that mother’s age (OR=2.11; 95%CI = 1.04 - 4.27); distance to the nearest health facility (OR=3.38; 95%CI = 1.45-7.87); and client service satisfaction (OR=8.58; 95%CI =2.10-34.95 are significantly associated with poor uptake of ANC services. Conclusion and Global Health Implications: There is a need to improve the quality of adolescent reproductive health services tailored to their health and developmental needs. Moreover, addressing the social determinants of health that affect individual’s healthy life style and health seeking behavior is critical. Key words: Antenatal Care Visits • Teenage Pregnancy • Social Determinants of Health • John Taolo Gaetsewe Copyright © 2016 Worku and Woldesenbet. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Impact of COVID-19 on social determinants of health for adults with cystic fibrosis

2021 ◽  
Vol 15 ◽  
pp. 175346662110374
Author(s):  
Dana Albon ◽  
Heather Bruschwein ◽  
Morgan Soper ◽  
Rhonda List ◽  
Deirdre Jennings ◽  
...  
Keyword(s):  
Health Care ◽  
Cystic Fibrosis ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Issues ◽  
Determinants Of Health ◽  
Care Utilization ◽  
Health Questionnaire ◽  
Improvement Project ◽  
The Impact

Introduction: Outcomes in cystic fibrosis are influenced by multiple factors, including social determinants of health. Low socioeconomic status has been shown to be associated with lung function decline, increased exacerbation rates, increased health care utilization, and decreased survival in cystic fibrosis. The COVID-19 pandemic disrupted the US economy, placing people with cystic fibrosis at risk for negative impacts due to changes in social determinants of health. Methods: To characterize the impact of COVID-19-related changes in social determinants of health in the adult cystic fibrosis population, a social determinants of health questionnaire was designed and distributed to patients as part of a quality improvement project. Results: Of 132 patients contacted, 76 (57.6%) responses were received. Of these responses, 22 (28.9%) answered yes to at least one question that indicated an undesired change in social determinants of health. Patients with stable employment prior to COVID-19 were more likely to endorse undesired change in all domains of the questionnaire, and the undesired changes were most likely to be related to employment, insurance security, and access to medications. Patients receiving disability were more likely to report hardship related to utilities and food security compared with patients previously employed or unemployed. Of patients endorsing risk of socioeconomic hardship, 21 (95.5%) were contacted by a social worker and provided resources. Conclusion: Utilizing a social determinants of health questionnaire to screen for social instability in the context of COVID-19 is feasible and beneficial for patients with cystic fibrosis. Identifying social issues early during the pandemic and implementing processes to provide resources may help patients with cystic fibrosis mitigate social hardship and maintain access to health care and medications.

scholarly journals Dynamics of Health Among Adults in South Africa

2020 ◽  
Author(s):  
Usengimana Shadrack Mutembereza
Keyword(s):  
South Africa ◽  
Social Determinants Of Health ◽  
Health Inequality ◽  
Social Determinants ◽  
National Income ◽  
Determinants Of Health ◽  
Health Campaigns ◽  
Health Selection ◽  
Policy Makers ◽  
The Poor

Abstract BackgroundThis paper estimates trend of health mobility in South Africa using National Income Dynamic Study (NIDS) and investigate whether the patterns of health mobility differs within socioeconomic groups created by income and gender. Health is measured by SRHS, which correlates with mortality and morbidity; thus, it is the best measure of health. MethodsUsing five waves of NIDS and various econometric models, this research estimates health mobility in the period between 2007 and 2017. This study will use transition matrix as descriptive analysis of health mobility and Conditional Maximum Likelihood Estimations to analyse health mobility, trend of health mobility and relationship between health mobility and health inequality within NIDS. ResultsThe study shows that, among poor males, health mobility neither follows a health selection or health constraint mobility trend; the high health mobility with ambiguous trends has not decreased health inequality. Among the poor females, a negative health mobility trend is observed; this research also found that health inequality has not creased. Among the non-poor males, it is found that health mobility follows a gradient constraint trend which has decreased health inequality. Among non-poor females, it is found that health mobility follows a health selection trend which has not decreased health inequality. The results suggest that policy makers should target both social determinants of health and health campaigns to deal with health inequality among the poor males. ConclusionsThe trend of health mobility among poor females suggest that policy makers should target the social determinants of health to combat health inequality. The trend of health mobility among the non-poor males suggests that health mobility will eliminate health inequality. Lastly, the trend of health mobility suggests that policymakers should target health campaigns to deal with health inequality.

scholarly journals Factors Influencing Antenatal Care Utilization in the East Akim Municipality of Ghana

2020 ◽  
Author(s):  
Richard Dickson Amoako ◽  
Innocent Kwau Doku ◽  
Juliana Yartey Enos
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
First Trimester ◽  
Socioeconomic Background ◽  
Care Utilization ◽  
Reproductive Health Services ◽  
African Countries ◽  
Cross Sectional ◽  
Unintended Pregnancies ◽  
Factors Influencing

Abstract Background Maternal and neonatal mortality rates continue to be high in sub-Saharan African countries, including Ghana. Timely and regular antenatal care (ANC) during pregnancy are essential for early identification and management of potential risk factors associated with poor pregnancy outcomes. The purpose of this study was to investigate the uptake of ANC services in the East Akim Municipality of Ghana and identify factors influencing ANC utilization. Methods A cross-sectional study which employed stratified sampling methodology to select 310 women in their reproductive ages (15–49 years) in East Akim Municipality was conducted. A structured questionnaire was used to examine the determinants of ANC utilization among respondents. Data was managed using Microsoft Excel 2016 and analysed using Stata version 14. Descriptive, bivariate and multivariable logistic regression analyses were performed. Results ANC attendance, at least once during pregnancy, was almost universal (98.4%) with 83.5% making 4 + visits. However, only 58% of respondents made early ANC visits in the first trimester and 61% attended all regularly scheduled visits. Employment status, distance to health facility and pregnancy intention were significantly associated with regular ANC attendance. Self-employed women were 2.4 times more likely to attend ANC regularly (AOR: 2.42, 95%CI :1.20–4.88) than the unemployed; those who lived < 5 km to a health facility were 3.2 times more likely to attend ANC regularly than those who lived > 10 km (AOR: 3.24, 95%CI: 1.20, 8.72); and women with intended pregnancies were 2.5 times more likely to attend all ANC scheduled visits than those with unintended pregnancies (AOR: 2.46, 95%CI: 1.32, 4.57). Conclusion Although ANC utilization in East Akim Municipality is high, socioeconomically disadvantaged women who were unemployed; lived more than 10 km from a health facility; and those with unintended pregnancies did not attend ANC early and regularly. Interventions to ensure equitable access to quality reproductive health services at the community level for all women, irrespective of their socioeconomic background, is needed to improve timely and regular ANC utilization. These include strengthening of community-based health centers, provision of ANC through outreach services to poor women in remote, hard-to-reach locations and improvements in the socioeconomic conditions in which people live.

scholarly journals Using ICD-10-based Social Determinants of Health Categories to Assess Patients Risk for Acute Care Utilization

2021 ◽  
Author(s):  
Peter H. Nguyen ◽  
James Wang ◽  
Pamela Garcia-Filion ◽  
Deborah Dominick ◽  
Hamed Abbaszadegan ◽  
...  
Keyword(s):  
Social Determinants Of Health ◽  
Social Services ◽  
Acute Care ◽  
Social Determinants ◽  
Hospital Admissions ◽  
Medical Center ◽  
Determinants Of Health ◽  
Care Utilization ◽  
Icd 10 ◽  
Acute Care Utilization

ABSTRACTObjectiveSocial determinants of health (SDoH) play a pivotal role in health care utilization and adverse health outcomes. However, the optimal method to identify SDoH remains debatable. We ascertained SDoH based on International Classification of Disease 10 (ICD-10) codes in patient electronic health records (EHR) to assess the correlation with acute care utilization, and determine if social services interventions reduced care utilization.MethodsWe analyzed retrospective data for active patients at a Department of Veterans Affairs Medical Center (VAMC) from 2015-2017. Eleven categories of SDoH were developed based on existing literature of the social determinants; the relevant ICD-10 codes were divided among these categories. Emergency Room (ER) visits, hospital admissions, and social work visits were determined for each patient in the cohort.ResultsIn a cohort of 44,401 patients, the presence of ICD-10 codes within the EHR in the 11 SDoH categories was positively correlated with increased acute care utilization. Veterans with at least one SDoH risk factor were 71% (95%CI: 68% - 75%) more likely to use the ED and 71% (95%CI: 65%-77%) more likely to be admitted to the hospital. Utilization decreased with social service interventions.ConclusionThis project demonstrates a potentially meaningful method to capture patient social risk profiles through existing EHR data in the form of ICD-10 codes, which can be used to identify the highest risk patients for intervention with the understanding that not all SDoH codes are uniformly used and some SDoHs may not be captured.

scholarly journals Development and testing of a composite index to monitor the continuum of maternal health service delivery at provincial and district level in South Africa

2020 ◽  
Author(s):  
Mamothena Carol Mothupi ◽  
Jeroen De Man ◽  
Hanani Tabana ◽  
Lucia Knight
Keyword(s):  
South Africa ◽  
Maternal Health ◽  
Service Delivery ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Composite Index ◽  
Health Service Delivery ◽  
Continuum Of Care ◽  
Determinants Of Health ◽  
The Continuum

Abstract Introduction: The continuum of care is a recommended framework for comprehensive health service delivery for maternal health, and it integrates health system and social determinants of health. There is a current lack of knowledge on a measurement approach to monitor performance on the framework. In this study we aim to develop and test a composite index for assessing the maternal health continuum in South Africa. Materials and Methods: The composite index was computed as a geometric mean of four dimensions of adequacy of the continuum of care. Data was sourced from the district health information system, household surveys and the census. The index formula was tested for robustness when alternative inputs for indicators and standardization methods were used. The index was used to assess performance in service delivery in the North West province of South Africa, as well as its four districts over a five-year period (2013-2017). The index was validated by assessing associations with maternal health and other outcomes. And factor analysis was used to assess the statistical dimensions of the index. Results: The provincial level index score increased from 62.3 in 2013 to 74 in 2017, showing general improvement in service delivery over time. The district level scores also improved over time, and our analysis identified areas for performance improvement. These include social determinants of health in some districts, and access and linkages to care in others. The provincial index was correlated with institutional maternal mortality rates (rs=-0.90, 90% CI = (-1.00, -0.25)) and the Human Development Index (r=0.97, 95% CI = (0.63, 0.99). It was robust to alternative approaches including z-score standardization of indicators. Factor analysis showed three groupings of indicators for the health system and social determinants of health. Conclusions: This study demonstrated the development and testing of a composite index to monitor and assess service delivery on the continuum of care for maternal health. The index was shown to be robust and valid, and identified potential areas for service improvement. A contextualised version can be tested in other settings within and outside of South Africa.

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