Maternal Healthcare Services Along Indo-Bangladesh Bordering Districts: Exploring Effects of Social Determinants on Access to Maternal Healthcare Services.

Author(s):  
Nayan Jyoti Nath ◽  
Bedanga Talukdar ◽  
Tanu Shukla ◽  
Sangeeta Sharma

Abstract Background Regardless of government efforts toward ameliorating easy access and utilization of healthcare services, the disparity in Maternal Mortality Rate (MMR) is significantly higher across states of India. Post-Sustainable Development Goals (SDGs), equity in healthcare largely remain in the health policy discourse. The policy implementation's effectiveness remained confined to the central geographical location, remotely reaching the peripheral region. The study seeks to assess socio-demographic and household wealth's effect on the access and utilization of healthcare services among women. A cross-sectional study was conducted among 355 women aged 15–49 years in three Indian districts of Assam that share an international border with Bangladesh. Results The study's findings reported that utilization and accessibility are primarily influenced by households' wealth and women's age. Education qualification has no significant effect on healthcare utilization. Younger women from wealthier households are more likely to utilize government healthcare services in India's borderline regions. Conclusion Besides educating women, the availability of healthcare resources and empowering the livelihood resources in the peripheral region should be prioritized. In these fragile areas, efforts to empower women and their families to seek healthcare should be strengthened, which shall enhance well-being.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sajad Vahedi ◽  
Amin Torabipour ◽  
Amirhossein Takian ◽  
Saeed Mohammadpur ◽  
Alireza Olyaeemanesh ◽  
...  

Abstract Background Unmet need is a critical indicator of access to healthcare services. Despite concrete evidence about unmet need in Iran’s health system, no recent evidence of this negative outcome is available. This study aimed to measure the subjective unmet need (SUN), the factors associated with it and various reasons behind it in Iran. Methods We used the data of 13,005 respondents over the age of 15 from the Iranian Utilization of Healthcare Services Survey in 2016. SUN was defined as citizens whose needs were not sought through formal healthcare services, while they did not show a history of self-medication. The reasons for SUN were categorized into availability, accessibility, responsibility and acceptability of the health system. The multivariable logistic regression was used to determine significant predictors of SUN and associated major reasons. Results About 17% of the respondents (N = 2217) had unmet need for outpatient services. Nearly 40% of the respondents chose only accessibility, 4% selected only availability, 78% chose only responsibility, and 13% selected only acceptability as the main reasons for their unmet need. Higher outpatient needs was the only factor that significantly increased SUN, responsibility-related SUN and acceptability-related SUN. Low education was associated with higher SUN and responsibility-related SUN, while it could also reduce acceptability-related SUN. While SUN and responsibility-related SUN were prevalent among lower economic quintiles, having a complementary insurance was associated with decreased SUN and responsibility-related SUN. The people with basic insurance had lower chances to face with responsibility-related SUN, while employed individuals were at risk to experience SUN. Although the middle-aged group had higher odds to experience SUN, the responsibility-related SUN were prevalent among elderly, while higher age groups had significant chance to be exposed to acceptability-related SUN. Conclusion It seems that Iran is still suffering from unmet need for outpatient services, most of which emerges from its health system performance. The majority of the unmet health needs could be addressed through improving financial as well as organizational policies. Special attention is needed to address the unmet need among individuals with poor health status.


2021 ◽  
Vol 7 ◽  
pp. 237796082110643
Author(s):  
Zebene M. Assefa ◽  
Tariku G. Haile ◽  
Deribachew H. Wazema ◽  
Wubishet T. Tafese ◽  
Fantahun W. Berrie ◽  
...  

Introduction Coronavirus disease 2019 (COVID-19) outbreak originated in Wuhan, Hubei Province, China, at the end of 2019. The COVID-19 incidence of new cases and fatality has continued to fast-track. The mental state and well-being of entire societies are severely suffering from this crisis and are a precedence to be immediately addressed. Objective To assess mental health disorders during the COVID-19 pandemic among university students, Southwest, Ethiopia, 2020/2021. Method Institutional-based cross-sectional study was conducted. Pretested self-administered a structured questionnaire was used. Depression, anxiety, and stress were measured by depression, anxiety, stress Scale-21 (DASS-21). Data were arrived by Epi Data version 3.1 and exported to SPSS version 25 for analysis. Bivariate and multivariate analyses were applied. In multivariate logistic regression; p-value < .05 at 95% CI was declared as significant. Results Seven hundred ten university students with 95.6% of the response rate participated in the study. Of the participants, 91.3% were between the ages of 18 and 24 years, and 57.2% were male. The magnitude of anxiety, depression, and stress was 35.1%, 30.0%, and 38.2%, respectively. In this study, age [Formula: see text] 25years, easy access to handwashing facilities, relative death due to COVID-19, wearing a face mask, a program of education, marital status, worried about academic activities, and family psychiatric history were predictors for mental health disorders and insomnia was a predictor of both anxiety and depression during COVID-19 pandemic. Conclusion In this study, the prevalence of depression, anxiety, and stress was above one-third, which was higher than the previous studies done in the country. Therefore, the continuing increase in new cases of disease infectivity and fatality throughout the country, providing psychological counseling, and developing coping strategies to predictors are important to prevent mental health impacts of the COVID-19 pandemic.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e043590
Author(s):  
Rajiv Raman ◽  
Ramachandran Rajalakshmi ◽  
Janani Surya ◽  
Radha Ramakrishnan ◽  
Sobha Sivaprasad ◽  
...  

IntroductionThe COVID-19 pandemic resulted in a national lockdown in India from midnight on 25 March 2020, with conditional relaxation by phases and zones from 20 April. We evaluated the impact of the lockdown in terms of healthcare provisions, physical health, mental health and social well-being within a multicentre cross-sectional study in India.MethodsThe SMART India study is an ongoing house-to-house survey conducted across 20 regions including 11 states and 1 union territory in India to study diabetes and its complications in the community. During the lockdown, we developed an online questionnaire and delivered it in English and seven popular Indian languages (Hindi, Tamil, Marathi, Telegu, Kannada, Bengali, Malayalam) to random samples of SMART-India participants in two rounds from 5 May 2020 to 24 May 2020. We used multivariable logistic regression to evaluate the overall impact on health and healthcare provision in phases 3 and 4 of lockdown in red and non-red zones and their interactions.ResultsA total of 2003 participants completed this multicentre survey. The bivariate relationships between the outcomes and lockdown showed significant negative associations. In the multivariable analyses, the interactions between the red zones and lockdown showed that all five dimensions of healthcare provision were negatively affected (non-affordability: OR 1.917 (95% CI 1.126 to 3.264), non-accessibility: OR 2.458 (95% CI 1.549 to 3.902), inadequacy: OR 3.015 (95% CI 1.616 to 5.625), inappropriateness: OR 2.225 (95% CI 1.200 to 4.126) and discontinuity of care: OR 6.756 (95% CI 3.79 to 12.042)) and associated depression and social loneliness.ConclusionThe impact of COVID-19 pandemic and lockdown on health and healthcare was negative. The exaggeration of income inequality during lockdown can be expected to extend the negative impacts beyond the lockdown.


BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e051148
Author(s):  
Seblewongel Gebretsadik Sertsewold ◽  
Ayal Debie ◽  
Demiss Mulatu Geberu

ObjectiveThis study aimed to analyse the prevalence and factors associated with continuum of maternal healthcare services among women who gave birth in Siyadebirena Wayu district, Central Ethiopia.DesignCommunity-based cross-sectional study.SettingAt eight Kebeles in Central Ethiopia.ParticipantsThe study was done on 614 women aged 15–49 years using interviewer-administered structured questionnaire. Following proportional allocation of the sample, we used simple random sampling technique to select study participants.MethodsBinary logistic regression model was fitted to identify the factors associated with the outcome. Variables with p<0.2 in the bivariable analysis were the candidates for multivariable analysis. A p<0.05 and adjusted OR (AOR) with 95% CI were taken to declare the factors and the strengths of association with continuum of maternal healthcare utilisation.OutcomeContinuum of maternal healthcare utilisation.ResultsOnly 16.1% (95% CI 13.3% to 19.0%) of the women had used a complete continuum of maternal health services. Variables, such as contraceptive use (AOR 4.95; 95% CI 1.61 to 15.20), autonomy (AOR 4.45; 95% CI 1.69 to 11.60), urban residence (AOR 3.91; 95% CI 1.06 to 14.39), educated women (AOR 5.36; 95% CI 1.15 to 25.06), took less than 30 min to reach a health facility (AOR 3.17; 95% CI 1.38 to 7.25), use public transportation (AOR 2.48; 95% CI 1.12 to 5.52) and good knowledge (AOR 9.88; 95% CI 3.89 to 25.0) were positively associated with continuum of maternal healthcare. In the contrary, women who had third child birth order (AOR 0.22; 95% CI 0.06 to 0.8) was negatively associated.ConclusionsOverall, the level of the continuum of maternal healthcare services utilisation was low compared with the national and global targets. Therefore, programme planners and implementer had better conduct health education to enhance the awareness of women about continuum of maternal healthcare services. Healthcare sector policy-makers and managers shall also scale up healthcare facilities to improve access to maternal healthcare services.


2021 ◽  
Vol 12 ◽  
Author(s):  
Sami Ouanes ◽  
Hassen Al-Amin ◽  
Nurrunnazha Binti Hussein ◽  
Faisal Khan ◽  
Ahmad Al Shahrani ◽  
...  

Background: Many studies have shown a high prevalence of depression, anxiety, and stress symptoms in COVID-19 patients and the general population. However, very few studies directly examined the potential impact on the health-related quality of life (HRQoL), and none compared HRQoL in COVID-19 patients to the general population amid the pandemic.Methods: We carried out a cross-sectional study comparing HRQoL (as measured using the RAND Short Form 36 or SF-36 Health Survey) in randomly selected individuals from three different groups: hospitalized COVID-19 patients, quarantined COVID-19 patients, and controls from the general population in Qatar. We constructed a multivariate analysis of covariance (MANCOVA) to compare the SF-36 scores between the three groups and control for various covariates.Results: Our sample consisted of 141 COVID-19 inpatients, 99 COVID-19 quarantined patients, and 285 healthy controls. Surprisingly, we found that HRQoL was higher in COVID-19 hospitalized than in COVID-19 non-hospitalized patients than in controls. The main components where COVID-patients scored higher than controls were physical functioning and role limitations due to emotional problems. In COVID-19 patients, the female gender, older age, and past psychiatric history were associated with lower HRQoL.Conclusions: It seems that COVID-19 patient's HRQoL might be better than expected. Our results can be explained by social support from family and friends, easy access to mental health screening and care, and a possible change of perspectives after recovery from COVID-19, resulting in psychological growth and enhanced resilience.


2018 ◽  
Vol 17 (4) ◽  
pp. 545-555
Author(s):  
Akkur Chandra Das ◽  
Manik Nag

Background: Maternal health voucher scheme, providing financial support to poor women, is popularly known as subsidies in maternity care services including antenatal, delivery and postnatal care and also economic barriers while seeking treatment from qualified service providers. The aim of this study is to evaluate the association of voucher scheme on receiving maternal healthcare services among the rural women in Bangladesh.Methods: This is a cross sectional study where total sample size was (n=500) rural women who were selected by using convenience sampling method. Among them, 250 women were voucher scheme receivers and other 250 women were non-voucher scheme receivers. A structured questionnaire was adopted for data collection between November and December 2015. In the final analysis, cross tabular analysis and logistic regression model were used, and adjusted odds ratios (ORs) were reported.Results: The study found a strong relation between voucher scheme and maternal healthcare services among the rural women in Bangladesh where majority (88.4%) voucher scheme receivers received information or treatment of Reproductive Tract Infections (RTIs) and Sexually Transmitted Infections (STIs) while non-voucher scheme receivers received only 10%. Most of the respondents (93%) voucher scheme receivers received at least 3 times of antenatal care visit; but only 28% received non-voucher scheme receivers at least 3 times of antenatal care visit. Voucher scheme receivers received 17.127 times more likelihood to receive skilled birth attendance and 25.344 times more likelihood to receive institutional delivery services and positively significant (5 percent) compared to those who did not receive maternal heath voucher scheme. Moreover, 92.4% voucher receivers received transport cost and 73.2%, received safe home delivery services while 22.8% non-voucher scheme receivers received transport cost and only 20.4% received safe home delivery services. Majority (94%) voucher scheme receivers received long time birth control services while only 19.2% non-voucher scheme receivers received long time birth control services.Conclusion: Women who did not receive maternal health voucher scheme found the status of lower antenatal, delivery and postnatal care services receiving trends compared to the women who received the maternal health voucher scheme. It is recommended an effective monitoring system and necessary interventions getting overall developed health status in Bangladesh.Bangladesh Journal of Medical Science Vol.17(4) 2018 p.545-555


2020 ◽  
Author(s):  
Sajad Vahedi ◽  
Amin Torabipour ◽  
Amirhossein Takian ◽  
Saeed Mohammadpur ◽  
Alireza Oliaeemanesh ◽  
...  

Abstract Background: Unmet need is a critical indicator of access to healthcare services. Despite concrete evidence about unmet need in Iran’s health system, no recent evidence of this negative outcome is available. This study aimed to measure the subjective unmet need (SUN), the factors associated with it and various reasons behind it in Iran. Methods: We used the data of 13005 respondents over the age of 15 from the Iranian Utilization of Healthcare Services Survey in 2016. SUN was defined as citizens whose needs were not sought through formal healthcare services, while they did not show a history of self-medication. The reasons for SUN were categorized into availability, accessibility, responsibility and acceptability of the health system. The multivariate logistic regression was used to determine significant predictors of unmet need and associated major reasons. Results: About 17% of the respondents (N=2,217) had unmet need for outpatient services. Nearly 40% of the respondents chose only accessibility, 4% selected only availability, 78% chose only responsibility, and 13% selected only acceptability as the main reasons for their unmet need. Low education was associated with higher responsibility-related SUN, while it could also reduce acceptability-related SUN. While SUN and responsibility-related SUN were prevalent among lower economic quintiles and people with higher outpatient needs, having a complementary insurance was associated with decreased SUN and responsibility-related SUN. The elderly and those with basic insurance had lower chances to face with responsibility-related SUN, while employed individuals were at risk to experience SUN. Conclusion: It seems that Iran is still suffering from unmet need for outpatient services, most of which emerges from its health system performance. The majority of the unmet health needs could be addressed through improving financial as well as organizational policies. Special attention is needed to address the unmet need among individuals with poor health status.


GeroPsych ◽  
2017 ◽  
Vol 30 (2) ◽  
pp. 61-70 ◽  
Author(s):  
Lia Oberhauser ◽  
Andreas B. Neubauer ◽  
Eva-Marie Kessler

Abstract. Conflict avoidance increases across the adult lifespan. This cross-sectional study looks at conflict avoidance as part of a mechanism to regulate belongingness needs ( Sheldon, 2011 ). We assumed that older adults perceive more threats to their belongingness when they contemplate their future, and that they preventively react with avoidance coping. We set up a model predicting conflict avoidance that included perceptions of future nonbelonging, termed anticipated loneliness, and other predictors including sociodemographics, indicators of subjective well-being and perceived social support (N = 331, aged 40–87). Anticipated loneliness predicted conflict avoidance above all other predictors and partially mediated the age-association of conflict avoidance. Results suggest that belongingness regulation accounts may deepen our understanding of conflict avoidance in the second half of life.


2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Mory Sanoh

Introduction : A chronic condition like diabetes interferes with an individual's well-being, and if some of their needs are not met because of the disease, their quality of life is reduced. In this context, therapeutic education constitutes a basic element in the management of diabetes.Materials and Methods : A cross-sectional study by self-administered questionnaire and interviews which were carried out with all type 1 and type 2 diabetics, consultants at the level of the Tit Mélil Primary Health Care establishment, in 2019 and who benefited from or not therapeutic education, with or without complications.Result : The study included 50 diabetic patients, surveys show us that type 1 diabetic patients were 13 (26%). And type 2.37 (74%). Regarding the organization of care, 74% of patients say they are under treatment with oral antidiabetics, 10% oral antidiabetics and insulins, 6% insulin therapy and others under diet. Speaking of Food, 76.5% of diabetics know the importance and know what foods to avoid.Conclusion : TVE is possible, it will result in a change in the structure of programs and new educational training for caregivers.


2017 ◽  
Vol 8 (1) ◽  
pp. 10
Author(s):  
Narendra Kumar Singh ◽  
Nishant Goyal

Background: Schizophrenia is associated with a high familial, social and economic burden. Schizophrenia is also associated with a high level of disability which may create impediments on the social and economic areas of the patients as well as on their respective family networks. Families with schizophrenia may encounter problems such as impairment of health and well being of other family members, restriction of social activities of the family members and shrinking of support from the social network. Aims: The present study examined the difference in perceived social support and burden of care between the male and female caregivers of patients with schizophrenia. Methods: This was a cross-sectional study examining the difference in perceived social support and burden of care between the male and female caregivers of patients with schizophrenia. The sample consisted of 60 (30 male and 30 female) caregivers of the patients with the diagnosis of schizophrenia as per ICD-10-DCR. Results and Conclusion: This study revealed that male caregivers perceived more social support and less burden of care as compared to female caregivers. Key words: Gender, social support, burden


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