scholarly journals Spatial Analysis of the Tuberculosis Cure in Primary Care in Rio de Janeiro, Brazil

2020 ◽  
Author(s):  
José Carlos Prado Junior ◽  
Roberto de Andrade Medronho
Keyword(s):  
Spatial Analysis ◽  
Health Services ◽  
Rio De Janeiro ◽  
Additive Model ◽  
Family Health ◽  
World Health ◽  
Health Coverage ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Socioeconomic Variables

Abstract Background: Tuberculosis (TB) presents a high burden of disease and is considered a global emergency by the World Health Organization (WHO), consisting of the most important cause of death from infectious disease in adults. It is related directly to access to health services and socioeconomic factors. Primary health care provides greater linking people to health services and greater medication adherence in some chronic diseases. Also, it provides supervised treatment and the search for more effective contacts. Objective: This paper aims to compare the tuberculosis cure among the areas covered and not covered by the family health teams from 2012 to 2014. Methods: A cross-sectional study was carried out in Rio de Janeiro. The variables were obtained from the Notifiable Diseases Information System for Tuberculosis (SINAN-TB) and the socioeconomic variables from the 2010 national census. The socioeconomic variables were selected from the multivariate analysis using principal factors analysis techniques. For the spatial analysis was used a generalized additive model (GAM). Results: Association was found between TB cure and education, alcoholism, contacts search, serology for HIV and the elderly. People with family health coverage between 35 and 41 months had 1,64 more chance of cure when compared to people without coverage (95% CI 1.07 to 2.51). Conclusion: From the spatial analysis, it was possible to identify areas with less chance of cure for tuberculosis in the municipality.

scholarly journals Spatial analysis of the cure rate for tuberculosis in primary health care in the municipality of Rio de Janeiro between 2012 and 2014

2018 ◽  
Author(s):  
José Carlos Prado Junior ◽  
Roberto de Andrade Medronho
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Spatial Analysis ◽  
Health Services ◽  
Rio De Janeiro ◽  
World Health ◽  
Access To Health Services ◽  
Socioeconomic Variables ◽  
Primary Health ◽  
Access To Health

AbstractBackgroundTuberculosis (TB) has a high disease burden and the World Health Organization (WHO) states it is a global emergency. TB is the most important cause of death from infectious disease in adults. It is directly related to access to health services and socioeconomic factors. Primary health care (PHC) provides greater linkage of people to health services and greater medication adherence in some chronic diseases. It also provides supervised treatment and more effective search for contactants. The PHC Reform started in 2009 in Rio de Janeiro, increasing coverage from 7% to 46.16% in 2015.Methodology/Principal findingsThis paper aims to evaluate the spatial distribution of new TB cases closed with a cure outcome in dwellers of Rio de Janeiro in the period 2012-2014, according to PHC coverage, controlling socioeconomic, demographic and epidemiological factors. Variables were obtained from the Notifiable Diseases Information System for Tuberculosis (SINAN-TB) and the socioeconomic variables from the 2010 national census at census tract level. The socioeconomic variables were selected from multivariate analysis using main factors analysis technique. The generalized additive model (GAM) was used for the spatial analysis. Association was found between TB cure and variables education, alcoholism, contacts search, HIV serology and elderly. People with family health coverage between 35 and 41 months were 1.64 more likely of cure when compared to people without coverage (95% CI 1.07-2.51). Spatial analysis identified areas with less probability of cure for tuberculosis in the municipality of Rio de Janeiro.Author SummaryTuberculosis is associated to social and demographic conditions. Lack of access to healthcare contributes to delay in diagnosis and in the beginning of the treatment. Primary health care improve access and adherence to treatment. This study can be useful as a public health policy, since it is possible to prioritize the region in the map to improve TB cure. We found association between tuberculosis cure and the duration of implantation of the primary health care teams. This finding corroborates the importance of treating tuberculosis in this level of care. The spatial analysis of cases of tuberculosis cure showed a significant spatial association with the cure of tuberculosis. The results of this study can contribute reinforcing the policy makers for developing primary health care to improve the access to health services and to reach better TB cure rates. Spatial analysis may be an useful tool for identifying the areas where to prioritize efforts for reaching better results.

DETERMINANTS OF MALNUTRITION AMONG CHILDREN IN RURAL FARM HOUSEHOLDS IN OGUN STATE, NIGERIA

2021 ◽  
Vol 4 (4) ◽  
pp. 90-95
Author(s):  
Maria Ogunnaike ◽  
Mojisola Kehinde ◽  
Olubunmi Olabode
Keyword(s):  
Health Services ◽  
Household Head ◽  
World Health ◽  
Farm Households ◽  
Farm Size ◽  
Anthropometric Measurement ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Safe Water ◽  
Ogun State

Malnutrition in children is one of the most serious public health problems in Nigeria and also in the world. Therefore, the objective of the study was to measure the prevalence of stunting, wasting and underweight and to assess the socio economic factors that influence the anthropometric indicators among children residing in rural farm households of Ogun State Nigeria.  A cross sectional study was employed and 206 farm households were interviewed using a structured, personally administered questionnaire consisting of socio-demographic factors, maternal characteristics, farm production characteristics and anthropometric measurement was used to gather data for 100 children. Nutri-survey, SPSS and Stata software was used to perform descriptive statistics and logistic regression analyses. The summary statistics of nutritional status of children in the study area revealed that the prevalence of stunting, underweight and wasting was 70%, 25 % and 8%, respectively. In view of World Health Organisation recommendation into two age disaggregated groups, male children were found to be more stunted and wasted than females in the study area. Age(p<0.05) and sex of the child(p<0.05), Farm size(p<0.01), household size(p<0.05), access to safe water(p<0.05), years of formal education of the household head (p<0.05) and access to health services (p<0.01) are factors that significantly affect the incidence of stunting, underweight and wasting in the study area. Thus, efforts should be made to improve the health services and also provision of safe water to farm households for reducing malnutrition among children.

scholarly journals Active ageing among elderly community members: structural equation modeling analysis

2020 ◽  
Vol 73 (suppl 3) ◽  
Author(s):  
Nayara Gomes Nunes Oliveira ◽  
Darlene Mara dos Santos Tavares
Keyword(s):  
Structural Equation Modeling ◽  
Health Services ◽  
Structural Equation ◽  
Structural Model ◽  
World Health ◽  
Equation Modeling ◽  
Active Ageing ◽  
Access To Health Services ◽  
Community Members ◽  
Cross Sectional

ABSTRACT Objective: to propose a structural model of active ageing among elderly community members based on the World Health Organization’s theoretical framework and to identify the most relevant determinants of active ageing to the proposed model. Methods: a cross-sectional and analytical study conducted with 957 elderly community members. Confirmatory factor analysis and structural equation modeling were performed. Results: the final measurement model was composed of the six determinants of active ageing: behavioral (R²=0.66); personal (R²=0.74); physical environment (R²=0.70); social (R²=0.77); economic (R²=0.44); and social and health services (R²=0.95). The last one showed good quality of adjustment: χ2/gl=3.50; GFI=0.94; CFI=0.92; TLI=0.90; RMSEA=0.05. By analyzing the trajectories between determinants and active ageing, the most representative was social and health services active ageing (λ=0.97; p<0.001). Conclusion: satisfaction with access to health services and positive self-assessment of health status were the factors that most contributed to active ageing in this population.

scholarly journals Inequalities Between Migrants and Non-Migrants in Accessing and Using Health Services in Greece During an Era of Economic Hardship

2020 ◽  
Vol 50 (4) ◽  
pp. 444-457
Author(s):  
Daphne Kaitelidou ◽  
Petros Galanis ◽  
Charalambos Economou ◽  
Philipa Mladovsky ◽  
Olga Siskou ◽  
...  
Keyword(s):  
Health Status ◽  
Health Services ◽  
Unmet Needs ◽  
Occupational Status ◽  
Cross Sectional Study ◽  
Undocumented Migrants ◽  
Health Coverage ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Study Population

A cross-sectional study was conducted from April 2013 until March 2014 to explore the existence of inequalities in access to and utilization of health services by migrants compared to non-migrants in Greece and to test the influence of various factors on these disparities. Also, we investigated the influence of several socioeconomic and demographic characteristics. Study population included 1,152 migrants and 702 non-migrants. Migrants, participants suffering from a chronic disease, those without health insurance, and patients who assessed their health status as not at all good/a little good/moderate were statistically more likely to report unmet needs in getting their medication. Uninsured participants, females, those unemployed or without a permanent occupational status, and those who assessed their health status as not at all good/a little good/moderate were statistically more likely to report unmet needs in access to health services during the last year. Regarding the use of health services, those with health coverage, non-migrants, and females were statistically more likely to go for a blood test as a hospital outpatient. Greece, despite administrative delays and barriers, provided full coverage to the uninsured, asylum seekers, and migrants, even many groups of undocumented migrants.

scholarly journals The Quest to Extend Health Services to Vulnerable Substance Users in Rio de Janeiro, Brazil in the Context of an Unfolding Economic Crisis

2016 ◽  
Vol 47 (3) ◽  
pp. 477-488 ◽  
Author(s):  
Noa Krawczyk ◽  
Deanna Kerrigan ◽  
Francisco Inácio Bastos
Keyword(s):  
Health Services ◽  
Health System ◽  
Economic Crisis ◽  
Rio De Janeiro ◽  
Crack Cocaine ◽  
Access To Health Services ◽  
Government Programs ◽  
Substance Users ◽  
Unified Health System ◽  
Harsh Criticism

Calls to address crack-cocaine use in Brazil among homeless and street-frequenting populations who are in urgent need of health services have questioned the capacity of the Brazilian Unified Health System to attend to the nation’s most marginalized citizens. In recent years, Brazil has launched several actions to escalate care for substance users, yet many obstacles hindering accessibility and effectiveness of services remain. Paradoxically, these actions have been implemented in the context of a growing economic crisis, and expanding services for a population of poor and stigmatized substance users while cutting other government programs tends to elicit harsh criticism from citizens. In consequence of such prospects, this commentary aims to discuss barriers marginalized substance users face in accessing health services that are at risk of worsening with government cutbacks. Using Rio de Janeiro as an example, we explore two primary issues: the resource-strained, under-staffed and decentralized nature of the Brazilian Unified Health System and the pervading stigma that bars vulnerable citizens from official structures and services. Abandoning initiated government efforts to increase access to health services would risk maintaining vulnerable citizens at the margins of public structures, inhibiting the opportunity to offer this population humane and urgently needed treatment and care.

Trends in access to health services and financial protection in China between 2003 and 2011: a cross-sectional study

The Lancet ◽  
2012 ◽  
Vol 379 (9818) ◽  
pp. 805-814 ◽  
Author(s):  
Qun Meng ◽  
Ling Xu ◽  
Yaoguang Zhang ◽  
Juncheng Qian ◽  
Min Cai ◽  
...  
Keyword(s):  
Health Services ◽  
Cross Sectional Study ◽  
Financial Protection ◽  
Sectional Study ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Access To Health

Challenges and Opportunities for Person Centered Integrated Care Through the Life Course

2016 ◽  
Vol 6 (2) ◽  
pp. 79-82
Author(s):  
C. Ruth Wilson ◽  
James Appleyard ◽  
Juan E. Mezzich ◽  
Mohammed Abou-Saleh ◽  
Cal Gutkin ◽  
...  
Keyword(s):  
Health Services ◽  
Health Professional ◽  
Life Course ◽  
Integrated Care ◽  
Professional Education ◽  
Transitions Of Care ◽  
World Health ◽  
Health Coverage ◽  
Challenges And Opportunities ◽  
The Life Course

 Objective: To examine the opportunities and challenges in achieving person centered integrated care through the life course.  Methods: Critical literature review and evidence based analysis of person-centered integrated care through the life course, combined with expert consultation. The World Health Organization’s “Global Framework on Integrated People-Centred Health Services” is used as a basis.  Results: Using the approach of the life cycle allows connection of persons’ current health status to their sociocultural, biological, and psychological context. Person centered medicine has as its central precept the relationship between the health professional and person seeking care. This principle is the link to primary health care, which is built on a lasting relationship with individuals and populations in their social context.  The patient’s medical home provides one promising model of how health services can be organized to support the full achievement of person centered integrated care. Re-orientation of the health professional education towards generalism, and the development of metrics for measurement of person centered integrated care are required. In 2016 the global crisis in refugees is a particularly prominent challenge for the delivery of person centered integrated care.  Conclusion: Universal health coverage can provide equitable access to person centered integrated care throughout the life course. Specialized expertise and skills are important for caring for persons with specific conditions at particular times in the life course. When care is well-integrated, transitions of care are smooth and the critical paradigm of person-centeredness is retained.  

Reasons for Vaccine Rejection in 0 to 2 Years Old Children Registered to Family Health Centers in Konya

2021 ◽  
Vol 16 (02) ◽  
pp. 074-079
Author(s):  
Hasan Kucukkendirci ◽  
Fatih Kara ◽  
Gulsum Gulperi Turgut
Keyword(s):  
Health Personnel ◽  
Family Health ◽  
Cross Sectional Study ◽  
World Health ◽  
University Graduates ◽  
Cross Sectional ◽  
Vaccination Programs ◽  
Vaccine Preventable Diseases ◽  
Health Organization

AbstractObjective According to the 2017 report of the World Health Organization (WHO), ∼1.5 million people die from vaccine preventable diseases. The WHO is working to generate and popularize effective vaccination programs. However, the concept of “vaccine rejection,” which first started in Europe and United States, has started to make an impact in Turkey during the past 10 years. It is therefore seen as a growing danger in future. This study was conducted to determine, detect, and prevent the reasons of vaccine rejection that have increased in recent years.Methods A cross-sectional study was conducted between June and December at 2015. In all districts of Konya (n = 31), it was aimed to reach all 242 families who rejected vaccination to their 0 to 2 years old babies. Families having more than one child refused to vaccinate all of their children. A questionnaire consisting of 47 questions was prepared by the researchers, using the standard trainings of the Ministry of Health and the literature. A total of 172 families agreed to participate in this study. The questionnaire was applied to the parents using the telephone interview technique. Data were presented as mean ± standard deviation and percentage.Results About 41.3% (n = 71) of the mothers were high school graduates, 50.6% (n = 87) of their fathers were university graduates. About 82.6% (n = 142) of the participants received examination, treatment and follow-up services from family physicians and family health personnel. About 20.9% (n = 36) of the children were the only children of the family. About 55.8% (n = 96) of the families also refused the vaccination for other children. About 83.7% (n = 144) of the unvaccinated children had infants/children follow-up care. While all participants stated that vaccines had side effects, 31.4% (n = 54) of these believed that vaccines cause autism or paralysis in infants. About 62.2% (n = 107) of their mothers did not receive tetanus vaccine during pregnancy. The highest rate of nonvaccination was with the second dose of hepatitis A vaccine, which 96.5% (n = 166) refused. The most accepted vaccine was the first dose of hepatitis B vaccine, which was refused by 18.0% (n = 31). About 79.7% (n = 137) of the participants did not know the reason for the vaccination and 95.9% (n = 165) thought that the vaccines were not required. All participants received information from the health personnel about the vaccines. While 9.9% (n = 17) of the families thought that vaccines cause infertility, 44.8% (n = 77) did not receive vaccination because the vaccines were produced abroad.Conclusion A growing number of families refuse to have their babies vaccinated. The production of vaccines abroad is a major cause of insecurity. There are also beliefs that vaccines cause infertility. Vaccine production in Turkey should be accelerated and public education about vaccines should be reviewed. Training provided to families about vaccines should also be reviewed.

scholarly journals Patient adherence to ischemic heart disease treatment

2017 ◽  
Vol 63 (3) ◽  
pp. 252-260 ◽  
Author(s):  
Moacyr Roberto Cuce Nobre ◽  
Rachel Zanetta de Lima Domingues
Keyword(s):  
Heart Disease ◽  
Health Services ◽  
Ischemic Heart Disease ◽  
Patient Adherence ◽  
Ischemic Heart ◽  
Sociocultural Factors ◽  
Multidisciplinary Teams ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Caregiver Support

Summary Introduction: The effectiveness of the treatment of chronic diseases depends on the participation of the patient, influenced by different sociocultural factors, which are not fully recognized by the treatment routine. Objective: To search for some of these factors that hinder or facilitate adherence to treatment and use of healthcare resources, approaching patients with ischemic heart disease. Method: A cross-sectional study was conducted using face-to-face interviews. We applied semi-structured questionnaires to 347 individuals and recorded 141 interviews for qualitative analysis. Descriptors were selected to identify eight categories of analyses. The quantitative data were submitted to descriptive analysis of frequency. Results: Only 2% had good medication adherence according to score on Morisky questionnaire. About 23% bought statins; the others obtained statin in the public health institution. Thirty-six speeches were selected and classified according to the following categories: knowledge about disease and medication, difficulty of acquisition, self management of treatment, difficulties of access to health services, side effect of statins, caregiver support, transportation to health services and concerns about the disease progression. However, it was noticed that about 1/3 of the care outside the research institution can be characterized as an attempt to bring rationalization to the health system. Conclusion: The improved adherence to chronic treatment of ischemic heart disease depends on the establishment of effective flows for referral and counter-referral from one care unit to another, relevant information and clarification of the questions for the patients and the attention of health professionals to the many social and cultural factors involved in treatment adherence. New research should be focused on educational groups by integrated multidisciplinary teams in order to share treatment decisions, thereby increasing the patient's commitment to his own health.

scholarly journals Equitable access to health services for children aged 5 to 9 in a medium city of northeasth of Brazil: a result of Family Health Strategy

2014 ◽  
Vol 17 (suppl 2) ◽  
pp. 39-52 ◽  
Author(s):  
Adriana Xavier de Santiago ◽  
Ivana Cristina de Holanda Cunha Barreto ◽  
Ana Cecília Silveira Lins Sucupira ◽  
José Wellington de Oliveira Lima ◽  
Luiz Odorico Monteiro de Andrade
Keyword(s):  
Health Services ◽  
Health System ◽  
Family Health ◽  
Northeastern Brazil ◽  
Local Health ◽  
Access To Health Services ◽  
Care Services ◽  
Health Strategy ◽  
Access To Health ◽  
Family Health Strategy

INTRODUCTION: The Brazilian National Health System may reduce inequalities in access to health services through strategies that can reach those most in need with no access to care services. OBJECTIVE: To identify factors associated with the use of health service by children aged 5 to 9 years in the city of Sobral, Ceará, northeastern Brazil. RESULTS: Only 558 (17.0%) children used health care services in the 30 days preceding this survey. Children with any health condition (OR = 3.90) who were frequent attenders of primary care strategy of organization (the Family Health Strategy, FHS) (OR = 1.81) and living in the city's urban area (OR = 1.51) were more likely to use health services. Almost 80% of children used FHS as their referral care service. Children from poorer families and with easier access to services were more likely to be FHS users. CONCLUSION: The study showed that access to health services has been relatively equitable through the FHS, a point of entry to the local health system.

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