scholarly journals Legal Status as a Life Course Determinant of Health: Parent Status, Adjudication Stages, and HIV Knowledge Among Highlanders in Thailand

2021 ◽  
Author(s):  
Stephanie M. Koning ◽  
Amanda Flaim ◽  
Leo Baldiga ◽  
David A. Feingold
Keyword(s):  
Public Health ◽  
Human Rights ◽  
Logistic Regression ◽  
Life Course ◽  
Ethnic Group ◽  
Protective Factor ◽  
Legal Status ◽  
Ordinal Logistic Regression ◽  
Hiv Knowledge ◽  
Cross Sectional

Abstract Background: Rising nativism and political volatility worldwide threaten to undermine hard-won achievements in human rights and public health. Risks are particularly acute for hundreds of millions of migrants, minorities, and Indigenous peoples, who face disproportionately high health burdens, including HIV/AIDS, and precarious legal status (LS). While LS is receiving increasing attention as a social determinant of health and HIV, understandings are still limited to select immigrant communities. Its effects on health among stateless communities, particularly in the Global South, remain largely unknown. Moreover, widespread limitations in census measures of LS reduce its complexity to a simplistic citizen/non-citizen binary or insufficient proxies. Thailand’s ethnolinguistically diverse highlander population experiences disproportionately high HIV prevalence and comprises one of the world’s largest and most protracted cases of statelessness, an acute condition of precarious LS. As such, analysis of LS and health outcomes among highlanders is both critically warranted, and useful as a case study outside of the migration paradigm.Methods: Drawing on the UNESCO Highland Peoples Survey II (2010), an unprecedented and unique cross-sectional census of highlanders in Thailand, we mobilize complex measures of LS in adjusted ordinal logistic regression models to assess how parent citizenship and LS adjudication over the early life course condition adult HIV knowledge—a key protective factor against transmission (n=8,079). Results: Adjusted ordinal logistic regression on knowledge scores reveal that parent citizenship predicts more complete knowledge by 32 to 88 percent, depending on ethnic group. This is partially explained by divergent stages of LS adjudication between birth and adulthood, including successful birth registration and adult citizenship acquisition, along with secondary school completion. Precisely how these factors contribute to HIV knowledge varies by ethnic group. Conclusions: This study advances knowledge of LS outside of the migration paradigm, reveals heretofore unexamined connections between LS and access to public health information, and elucidates how instabilities in LS adjudication stages underlie health inequalities over the life course. Findings indicate that securing success in public health and human rights agendas requires attention to how states deploy LS at birth, and beyond, to structure access and exclusion among migrant and non-migrant communities alike.

scholarly journals Legal status as a life course determinant of health: parent status, adjudication stages, and HIV knowledge among highlanders in Thailand

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephanie M. Koning ◽  
Amanda Flaim ◽  
Leo Baldiga ◽  
David A. Feingold
Keyword(s):  
Public Health ◽  
Human Rights ◽  
Logistic Regression ◽  
Life Course ◽  
Ethnic Group ◽  
Protective Factor ◽  
Legal Status ◽  
Ordinal Logistic Regression ◽  
Hiv Knowledge ◽  
The Life Course

Abstract Background Rising nativism and political volatility worldwide threaten to undermine hard-won achievements in human rights and public health. Risks are particularly acute for hundreds of millions of migrants, minorities, and Indigenous peoples, who face disproportionately high health burdens, including HIV/AIDS, and precarious legal status (LS). While LS is receiving increasing attention as a social determinant of health and HIV, understandings are still limited to select immigrant communities. Its effects on health among stateless communities, particularly in the Global South, remain largely unknown. Moreover, widespread limitations in census measures of LS reduce its complexity to a simplistic citizen/non-citizen binary or insufficient proxies. Thailand’s ethnolinguistically diverse highlander population experiences disproportionately high HIV prevalence and comprises one of the world’s largest and most protracted cases of statelessness, an acute condition of precarious LS. As such, analysis of LS and health outcomes among highlanders is both critically warranted, and useful as a case study outside of the migration paradigm. Methods Drawing on the UNESCO Highland Peoples Survey II (2010), an unprecedented and unique cross-sectional census of highlanders in Thailand, we mobilize complex measures of LS in adjusted ordinal logistic regression models to assess how parent citizenship and LS adjudication over the early life course condition adult HIV knowledge—a key protective factor against transmission (n = 8079). Results Adjusted ordinal logistic regression on knowledge scores reveal that parent citizenship predicts odds of greater knowledge by 1.4- to 2.2-fold, depending on ethnic group. This is partially explained by divergent stages of LS adjudication between birth and adulthood, including successful birth registration and adult citizenship acquisition, along with secondary school completion. Precisely how these factors contribute to HIV knowledge varies by ethnic group. Conclusions This study advances knowledge of LS outside of the migration paradigm, reveals heretofore unexamined connections between LS and access to public health information, and elucidates how instabilities in LS adjudication stages underlie health inequalities over the life course. Findings indicate that securing success in public health and human rights agendas requires attention to how states adjudicate and deploy LS in multiple stages across the life course to structure access and exclusion among migrant and non-migrant communities alike.

scholarly journals Data-Driven Decision Making and Proactive Citizen–Scientist Communication: A Cross-Sectional Study on COVID-19 Vaccination Adherence

Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1384
Author(s):  
Emil Syundyukov ◽  
Martins Mednis ◽  
Linda Zaharenko ◽  
Eva Pildegovica ◽  
Ieva Danovska ◽  
...  
Keyword(s):  
Public Health ◽  
Logistic Regression ◽  
Exploratory Study ◽  
Large Scale ◽  
Severe Disease ◽  
Data Driven ◽  
Personal Factors ◽  
Cross Sectional ◽  
Digital Platform ◽  
Factors Associated

Due to the severe impact of COVID-19 on public health, rollout of the vaccines must be large-scale. Current solutions are not intended to promote an active collaboration between communities and public health researchers. We aimed to develop a digital platform for communication between scientists and the general population, and to use it for an exploratory study on factors associated with vaccination readiness. The digital platform was developed in Latvia and was equipped with dynamic consent management. During a period of six weeks 467 participants were enrolled in the population-based cross-sectional exploratory study using this platform. We assessed demographics, COVID-19-related behavioral and personal factors, and reasons for vaccination. Logistic regression models adjusted for the level of education, anxiety, factors affecting the motivation to vaccinate, and risk of infection/severe disease were built to investigate their association with vaccination readiness. In the fully adjusted multiple logistic regression model, factors associated with vaccination readiness were anxiety (odds ratio, OR = 3.09 [95% confidence interval 1.88; 5.09]), feelings of social responsibility (OR = 1.61 [1.16; 2.22]), and trust in pharmaceutical companies (OR = 1.53 [1.03; 2.27]). The assessment of a large number of participants in a six-week period show the potential of a digital platform to create a data-driven dialogue on vaccination readiness.

scholarly journals Predictors to HIV testing among youth women in Ethiopia: 2016 Ethiopian Demographic and Health Survey

2019 ◽  
Author(s):  
Gedefaw Diress ◽  
Mohammed Ahmed ◽  
Seteamlak Adane ◽  
Melese Linger ◽  
Birhan Aleminew
Keyword(s):  
Logistic Regression ◽  
Hiv Testing ◽  
Health Survey ◽  
Multivariate Logistic Regression Analysis ◽  
Demographic And Health Survey ◽  
Outcome Variable ◽  
Hiv Knowledge ◽  
Cross Sectional ◽  
Infected People ◽  
Treatment Cascade

Abstract Background HIV testing is the critical first step in identifying and linking HIV infected people to the treatment cascade and it also provides an important opportunity to reinforce HIV prevention among the negatives. The aim of this study was examine factors associated with HIV testing among youth women. Methods A community-based cross-sectional study design was used and a nationally representative secondary data analysis was done on the 2016 Ethiopian Demographic and Health Survey(EDHS). A total of 6401 youth women were eligible in the study. The data were analyzed by SPSS version 20. Frequencies and weighted percentage of the variables were calculated. Chi-square tests and logistic regression models were used to assess predictors of HIV testing. Multivariate logistic regression analysis was conducted to control confounders and to identify the independent contribution of each variable to the outcome variable. Result A total of 6401 youth women aged 15 to 24 years of age were included. Only 37.7% (95% CI:(33.6-39.1%)) of participants were ever tested for HIV in their life. In the final multivariable model age, marital status, level of educational, media access, number of sexual partner, STIs in Past 12 months and comprehensive knowledge to HIV, were significantly associated with ever been tested for HIV. Youth women who were in the age group between 20 to 24 (AOR=2.18; 95CI:(1.800-2.652), who were married (AOR=4.70; 95% CI:(3.674-6.008)), were divorced (AOR=6.16; 95% CI (3.976-9.541)), who had no access to media (AOR = 0.69; 95 CI %: (0.540-0.870)), who had no comprehensive HIV knowledge (AOR = 0.68; 65% CI: (0.530-0.861)) and having one or more sexual partners (AOR=2.48; 95% CI:(1.350-4.551)) were significantly associated with ever been tested for HIV.

scholarly journals Infrastructural Challenges Lead to Delay of Curative Radiotherapy in Nigeria

2020 ◽  
pp. 269-276 ◽  
Author(s):  
Jim Leng ◽  
Atara I. Ntekim ◽  
Abiola Ibraheem ◽  
Chidinma P. Anakwenze ◽  
Daniel W. Golden ◽  
...  
Keyword(s):  
Health Care ◽  
Logistic Regression ◽  
Treatment Initiation ◽  
Cross Sectional Study ◽  
Ordinal Logistic Regression ◽  
Sociocultural Factors ◽  
College Hospital ◽  
Energy Agency ◽  
Cross Sectional ◽  
Curative Radiotherapy

PURPOSE In low- and middle-income countries, there has been an exponential increase in cancer incidence. According to the International Atomic Energy Agency, the biggest gap in radiotherapy availability and need is in Nigeria, where each machine serves an estimated 25.7 million people. This study aimed to characterize the barriers to radiotherapy and to identify areas for intervention. METHODS This was a cross-sectional study conducted at the University College Hospital in Ibadan, Nigeria, from June 2017 to August 2017. Demographic, sociocultural, and infrastructural factors relating to radiotherapy were collected through a questionnaire (N = 186). Ordinal logistic regression was used to identify the factors leading to delays in referral and delays in treatment initiation. RESULTS Patients traveled from 20 of Nigeria’s 36 states. The median age was 50 years (range, 19-79 years). The most common cancers treated were breast (37.5%), cervical (16.3%), head and neck (11.9%), and prostate (10.9%). In ordinal logistic regression, sociocultural factors, including the inability to pay (odds ratio [OR], 1.99; P = .034), a bad hospital experience (OR, 7.05; P = .001), and travel time (OR, 1.36; P = .001), increased the odds of referral delay to radiotherapy. In contrast, there was no significant relationship between time to treatment initiation and sociocultural factors including age, education, and inability to pay. Infrastructural barriers, including machine breakdown (OR, 2.92; P = .001), worker strikes (OR, 2.64; P = .001), and power outages (OR, 2.81; P = .022), increased the odds of treatment delay. CONCLUSION Although delays caused by patient factors are reported extensively, patients overcame these barriers in the hopes of curative treatment. However, staff and equipment malfunctions prevented patients from receiving timely radiotherapy. Policies aimed at addressing machine maintenance, health care worker satisfaction, and the aging power grid in Nigeria must be implemented in the future to strengthen the health care system to care for patients with cancer.

scholarly journals Obstetric Violence in Spain (Part I): Women’s Perception and Interterritorial Differences

2020 ◽  
Vol 17 (21) ◽  
pp. 7726 ◽  
Author(s):  
Desirée Mena-Tudela ◽  
Susana Iglesias-Casás ◽  
Víctor Manuel González-Chordá ◽  
Águeda Cervera-Gasch ◽  
Laura Andreu-Pejó ◽  
...  
Keyword(s):  
Public Health ◽  
Human Rights ◽  
Informed Consent ◽  
Maternity Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Autonomous Communities ◽  
Obstetric Violence ◽  
The Mean

The decentralization of health systems can have direct repercussions on maternity care. Some inequalities can be noted in outcomes, like neonatal and child mortality in Spain. This study aimed to make the presence of obstetric violence in Spain visible as an interterritorial equity criterion. A descriptive, restrospective and cross-sectional study was conducted between January 2018 and June 2019. The sample comprised 17,541 questionnaires, which represented all Spanish Autonomous Communities. Of our sample, 38.3% perceived having suffered obstetric violence; 44.4% perceived that they had undergone unnecessary and/or painful procedures, of whom 83.4% were not requested to provide informed consent. The mean satisfaction with the attention women received obtained 6.94 points in the general sample and 4.85 points for those women who viewed themselves as victims of obstetric violence. Spain seems to have a serious problem with public health and respecting human rights in obstetric violence. Offering information to women and requesting their informed consent are barely practiced in the healthcare system, so it is necessary to profoundly reflect on obstetric practices with, and request informed consent from, women in Spain.

scholarly journals Prevalence of Anemia and its Associated Factors among Chinese 9-, 12-, and 14-Year-Old Children: Results from 2014 Chinese National Survey on Students Constitution and Health

2020 ◽  
Vol 17 (5) ◽  
pp. 1474
Author(s):  
Zhaogeng Yang ◽  
Yanhui Li ◽  
Peijin Hu ◽  
Jun Ma ◽  
Yi Song
Keyword(s):  
Logistic Regression ◽  
Rural Areas ◽  
Lower Risk ◽  
Associated Factors ◽  
Protective Factor ◽  
Mixed Effects ◽  
Daily Consumption ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Prevalence Of Anemia

Background: Anemia has been one of the main nutritional challenges around the world. Not enough attention has been paid to this issue in children and adolescents in China. In this study, we aimed to estimate the prevalence of anemia among 9-, 12-, and 14-year old Chinese children and investigate the associated factors of anemia. Methods: Data come from a cross-sectional survey conducted in 26 provinces and 4 municipalities in mainland China. A total of 48,537 children aged 9, 12, and 14 years old were included in data analyses. Anthropometric measurements were conducted to obtain information about height and weight. Capillary blood was collected from the fingertip, and hemoglobin concentration was tested by HemoCue201+. Information about sleep duration, daily consumption of eggs, milk, and breakfast were obtained from a self-administrated questionnaire. The mixed-effects logistic regression model was applied to estimate the association between selected variables and risk of anemia. Results: A total of 8.4% of participants were identified as being anemic; and the prevalence was higher in girls and rural children. Mixed-effects logistic regression analysis showed that children who were overweight, obese, and consumed eggs and milk every day had a lower risk of anemia. Spermarche, overweight/obesity, and having milk every day were associated with lower risk of anemia in boys, while menarche was found to be a risk factor and eating eggs every day to be a protective factor of anemia in girls. Conclusions: Anemia among 9-, 12-, and 14-year-old children is still high. Intervention programs of adding egg and milk into school daily diet might contribute to reducing anemia in Chinese school aged children, especially for those living in rural areas or girls with menarche.

scholarly journals Reproductive health at conflict borders: a cross-sectional survey of human rights violations and perinatal outcomes at the Thai-Myanmar border

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Stephanie M. Koning ◽  
Kaylee Scott ◽  
James H. Conway ◽  
Mari Palta
Keyword(s):  
Human Rights ◽  
Migrant Workers ◽  
Legal Status ◽  
Perinatal Outcomes ◽  
Perinatal Health ◽  
Human Rights Violations ◽  
Residential Setting ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Precarious Legal Status

Abstract Background Human rights violations (HRVs) are common in conflict and displacement contexts. Women are especially vulnerable to HRVs in these contexts, and perinatal health is acutely sensitive to related stressors and health care barriers. However, how HRVs affect immediate and long-term perinatal health in chronic displacement settings has not been closely investigated. Furthermore, it remains unclear whether and how HRVs in these contexts are tied directly to displacement circumstances or other marginalizing factors affecting local migrant and minority populations generally. Methods We investigated these questions using novel survey data from 577 women at the northern Thai-Myanmar border, where thousands of people have fled conflict in Shan State, Myanmar, for refuge in a range of precarious settings in Thailand, including unofficial refugee camps, villages, and worksites. We compared HRV exposures by ethnicity, country of birth, legal documentation, and residential setting. We then analyzed perinatal outcomes associated with HRV frequency, timing, and type. Results Birth in Myanmar, and ethnic minority and precarious legal status more broadly, predicted higher HRV prevalence. HRV frequency significantly predicted unmet antenatal care and lower birth weight, along with HRVs related to labor exploitation and violence or conflict. HRVs timed closer to pregnancies were more adversely associated with perinatal outcomes. Resource/property deprivation was the strongest predictor of pregnancy complications. Conclusions Human rights must be urgently attended to, through expanded HRV screenings and responsive care, and policy changes to further protect migrant workers, displaced persons, and others in precarious legal status situations.

scholarly journals Antibiotic misuse among children with diarrhea in China: results from a national survey

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2668 ◽  
Author(s):  
Ruili Li ◽  
Feng Xiao ◽  
Xiaoguo Zheng ◽  
Huimin Yang ◽  
Lihong Wang ◽  
...  
Keyword(s):  
Public Health ◽  
Logistic Regression ◽  
Urban Areas ◽  
Health Knowledge ◽  
Reference Group ◽  
Average Rate ◽  
High Rate ◽  
Cluster Sampling ◽  
Multilevel Logistic Regression ◽  
Cross Sectional

BackgroundAntibiotic resistance is one of the world’s biggest public health issues, and the situation in China is particularly grave. The objective of this study is to investigate the antibiotics usage pattern among Chinese children and provide further insight in developing strategies for promoting public health education.MethodsThis is a cross-sectional study, in the study, participants are from 53,665 guardians of children aged 0–6 years, who were recruited with multistage stratified random cluster sampling in 2013/2014 from 46 community health centers in 14 provinces across China Mainland. Children’s guardians completed surveys on their previous experience on using antibiotics in treating diarrhea of their children without a prescription from any pediatrician. Odds ratios (ORs) and 95% confidential intervals (CIs) for the association between antibiotic use and its predictors were estimated using multilevel logistic regression models, with antibiotic rational use group as a reference group.ResultsThe prevalence of antibiotic misuse among children with diarrhea in the eastern, middle and western areas of China and associations between antibiotic misuse and its predictors were studied. The average rate of antibiotic misuse is 35.12%. Multilevel logistic regression revealed that living in urban areas (OR = 0.79 (0.76, 0.83)), female children (OR = 0.92 (0.88, 0.96)), guardians having higher education (OR = 0.60 (0.55, 0.66)), being raised by parents (OR = 0.90 (0.85, 0.94)), guardians having basic health knowledge (OR = 0.82 (0.79, 0.86)) are protective factors and children’s age (1–3 years OR = 1.62 (1.54, 1.71)); 4–6 years OR = 1.90 (1.77, 2.03)) is a risk factor of antibiotic misuse among children aged 0–6 years with diarrhea in China.ConclusionsOur findings confirmed that there has been a high rate of antibiotic misuse without a prescription in children with diarrhea in China, which requires considerable attention. Suitable regulations and interventions are needed to solve this problem.

Effect of Behavior on the Utilization of KIA Books in Pregnant Women at the Lawe Sumur Public Public Health Center, Lawe Sumur Sub District, Aceh Tenggara District

2021 ◽  
Vol 1 (1) ◽  
pp. 1-8
Author(s):  
Wahyuni Wahyuni ◽  
Khoirotun Najihah ◽  
Marcella Chatarina
Keyword(s):  
Public Health ◽  
Logistic Regression ◽  
Pregnant Women ◽  
Health Center ◽  
Effective Means ◽  
P Value ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Public Health Center ◽  
Knowledge Variable

The KIA Handbook is a simple but effective means of communicating and recording the health of pregnant women as an information, education, and communication. According to data from Lawe Sumur Aceh Tenggara Public Health Center, there were 118 pregnant women where they had received the KIA book. The purpose of this study is to determine how they use the KIA books for the pregnant women at Lawe Sumur Public Public Health Center, Lawe Sumur Sub District, Aceh Tenggara District. This type of research is an analytic survey with a cross sectional design. Research location at Public Public Health Center Lawe Sumur. This study was held on October 2020. The research population is all of the pregnant woman reach 118 woman in Lawe Sumur Public Health Center territory. The sampling technique with cluster sampling for 54 people. The Data Analysis by using univariat, bivariat using chu-square test, and multivariate using multiple logistic regression test. The results of the research with logistic regression showed the p-value for the knowledge variable (p = 0.008) with the Exp (B) = 9,100, the attitude (p = 0.021) with the Exp (B) value = 0.021 and the action (p = 0.187) with the Exp (B) = 2.979. The conclusion of this study is that there is a significant effect of knowledge and attitudes on the use of the KIA handbook and there is no significant effect on the use of the KIA handbook. It is advisable for pregnant women to comply with ANC visits and to use the KIA handbook.

A Cross-Sectional Study on China’s Public Health Emergency Personnel’s Field Coping-Capacity: Need, Influencing Factors, and Improvement Options

2019 ◽  
Vol 14 (2) ◽  
pp. 192-200
Author(s):  
Miaomiao Zhao ◽  
Baohua Liu ◽  
Lan Wang ◽  
Qunhong Wu ◽  
Zheng Kang ◽  
...  
Keyword(s):  
Public Health ◽  
Logistic Regression ◽  
Emergency Response ◽  
Emergency Preparedness ◽  
Crisis Communication ◽  
Public Health Emergency ◽  
Personal Protection ◽  
Cross Sectional ◽  
Coping Capacity ◽  
Preparedness Planning

ABSTRACTObjective:This study aimed to identify the important capacities that were most urgently needed during emergency response and factors associated with the Centers for Disease Control and Prevention (CDC) professionals’ field coping-capacity for public health emergency.Methods:Professional workers (N = 1854) from 40 CDC institutions were chosen using the stratified cluster random sampling method in all 13 municipalities of Heilongjiang Province, China. Descriptive analysis and multivariate logistic regression were used.Results:Of 10 key capacities, the 3 that were most urgently needed during emergency response fieldwork as identified by respondents were crisis communication capacity, personal protection capacity, and laboratory detection capacity. Overall, 38.1% of respondents self-rated as “poor” on their coping-capacity. The logistic regression found that proficiency in emergency preparedness planning, more practical experiences in emergency response, effectiveness in training and drills, a higher education level, and a higher professional position were significantly associated with the individual’s field coping-capacity.Conclusion:This study identified CDC professionals’ most urgent capacity need and the obstructive factors and highlighted the importance of enhancing the capacity in crisis communication, personal protection, and laboratory detection. Intervention should be targeted at sufficient fund, formalized, and effective emergency training and drills, more operational technical guidance, and all-around supervision and evaluation.

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