scholarly journals Inequality in the Utilization of Rehabilitation Services Among Urban and Rural Households in Iran: A Cross-Sectional Study

2020 ◽  
Vol 21 (3) ◽  
pp. 336-357
Author(s):  
Jafar Yahyavi Dizaj ◽  
◽  
Faroogh Na'emani ◽  
Mohsen Fateh ◽  
Manijeh Soleimanifar ◽  
...  

Objective: Demographic and epidemiological changes in the 21st century have created new challenges such as aging and the rising trend of non-communicable diseases. The high prevalence of disability (due to the growing aging population), non-communicable diseases, and accidents have increased the demand for rehabilitation services. However, there are not enough resources to meet all current needs in many parts of the world. The purpose of this study is to investigate the inequality in the utilization of rehabilitation services between Iranian households in urban and rural areas. Materials & Methods: This is a descriptive-analytical study with a cross-sectional design using the household expenditure, income survey data from the Statistics Center of Iran in 2018. The used instrument was a questionnaire surveying the expenditure and income of urban and rural households (social characteristics of household members, place of residence and main living facilities, food/non-food expenses, and household income), which was completed through interviewing the household head or a member over 15 years of age. The study samples were 18610 households in rural areas and 20348 households in urban areas. After extracting and refining the data, 38958 households were included in the study. Factors affecting their utilization of rehabilitation services and the inequality in utilization were analyzed using the Chi-square test and the concentration index (CI), respectively. Data were extracted in MS Access 2013 and MS Excel 2013 applications and were analyzed in STATA V.14.1 software. The geographic distribution of the service utilization was plotted using ArcGIS Map V. 10 software. Results: A total of 258 households (0.77%) used rehabilitation services. Of these, 226 (87%) had a male head, and 32 (13%) had a female head. About 60% had 3-4 members, and 239 (92%) had insurance coverage, and others (8%) had no insurance coverage. Also, 173 (67%) had an employed head. Finally, 55% were living in rural areas, and 45% in urban areas. Uninsured households had less use of rehabilitation services (P<0.05). Also, 1.32% of the fifth income quintile (highest income) used rehabilitation services, while this rate was 0.35% for households in the first quintile (P<0.001). Zanjan, Qazvin, Khuzestan, Isfahan, Lorestan, Bushehr, and Semnan provinces had the lowest service utilization rates in urban/rural areas and the whole country. Qom province had a better status regarding service utilization in urban areas, while East Azerbaijan, Mazandaran, Golestan, Yazd, Fars, and Hormozgan provinces had higher service utilization rates in rural areas. Overall, East Azerbaijan, Mazandaran, and Qom provinces had a higher rate of utilization. The CI value for the whole country was reported at 0.24 (95% CI: 0.17-0.30), indicating a higher inequality in utilization in favor of the rich. The CI values for rural and urban areas were 0.27 and 0.19, respectively (P<0.001). Conclusion: There is inequality in the utilization of rehabilitation services in favor of the rich households in Iran, and low-income households have lower access to these services. The inclusion of rehabilitation services in the primary health insurance package with appropriate pricing and population coverage, and fair distribution of rehabilitation services following the needs of public and private sectors, can increase the access and utilization of rehabilitation services.

Author(s):  
Riyaz Ahmad S. ◽  
Mohd Haroon Khan ◽  
M. Athar Ansari

Background: Non-communicable diseases (NCD) are now recognized as major cause of morbidity and mortality. All countries, irrespective of their stage of economic development or demographic and epidemiological transition, face an increasing burden of non-communicable diseases (NCDs). The objective of the study was to estimate the prevalence of risk factors associated with non-communicable diseases.Methods: This is a community based cross sectional study conducted at field practice areas of the urban and rural health training centers, Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh. 640 study subject’s age group 18-65 years. Systematic random sampling and proportionate to population size method (PPS). SPSS version 13 and Chi-square was used to analyse the data.Results: The age group for the present study was chosen to be 18-65 years of age. The study population consisted of 340 females and 300 males. 27.1% belong to younger age group (18-25 years), whereas in urban areas majority (27.3%) belongs to 26-35 years age group. Also, the study group comprised of higher percentage of females (53%) compared to males (47%).129 (20.2%) subjects were found to be current smokers. Only 4 (1.3%) women were smokers. The prevalence of smokeless tobacco use which was found to be 21.6% (28.3% in males and 15.6% in females). The prevalence of current alcohol use in our study to be 10.3% in males and 0.6% in females. The overall prevalence of alcohol use was 5.2%. Alcohol use showed inverse relation with socioeconomic class, About 87% of the respondents did not have sufficient intake of fruits and vegetables. The physical inactivity during work was more in males (30.7%) compared to females (15.5%. Mean body weight, BMI and waist circumference showed significant changes with age in both sexes.Conclusions: It can be concluded from our study that the burden of risk factors for non-communicable diseases (NCDs) among the rural and urban areas of Aligarh is quite high.


Author(s):  
Alireza Javidmehr ◽  
Yagoob Garedaghi ◽  
Amir Babak Sioufi

Introduction: Cryptosporidiosis is a worldwide zoonotic disease that is caused by Cryptosporidium species and leads to acute or chronic diarrhea and vomiting in patients. Due to the suitable conditions of East Azerbaijan province for parasite transmission, the present study was performed to evaluate the prevalence of Cryptosporidium infection in patients with gastroenteritis referred to hospitals and reference laboratories of East Azerbaijan province during 2018-2019. Methods: A descriptive cross-sectional study was performed on patients with diarrhea who referred to hospitals and reference laboratories of East Azerbaijan province during 2018-2019. In this study, 180 fecal samples were collected from patients with gastroenteritis by cluster-random sampling. Stool samples were stored in 10% formalin and transferred to a parasitology laboratory and examined for parasite contamination by modified acid-fast staining (Modified Ziehl-Neelsen) method. Data were analyzed by chi-square test using SPSS. Results: Out of 180 samples, the highest number of diarrhea samples belonged to the age group over 40 years (35.5%) and the lowest belonged to the age group of 10-20 years (7.7%). Additionally, 56% of subjects were male and 44% were female. Of these patients, 57.7% lived in urban areas and 42.3% in rural areas. Cryptosporidium was observed in 1.6% (3 cases) of patients with gastroenteritis. There was a statistically significant relationship between Cryptosporidium infection and the age of patients with diarrhea (P<0.05). Conclusion: In the present study, a lower prevalence of cryptosporidiosis has been determined in comparison with previous studies in East Azerbaijan province. However, Cryptosporidium and other parasitic infections in the feces of patients with diarrhea referred to hospitals or reference laboratories need to be carefully diagnosed by appropriate parasitological methods.


Author(s):  
Ajibola Idowu ◽  
Adesegun O. Fatusi ◽  
Folakemi O. Olajide

Abstract Background: Non-communicable diseases (NCDs) have become the leading cause of deaths globally and the key associated risk factors – alcohol abuse, physical inactivity, cigarette smoking and poor dietary patterns – are often initiated in adolescence. Co-existence of these risk factors further increase the risk for NCDs. Yet, very little is known about the pattern of co-occurrence of behavioural risk factors for NCDs among Nigerian adolescents, especially those in rural areas. This study aimed to assess the prevalence and determinants of clustering patterns of behavioural risk factors for NCDs among in-school adolescents in rural areas of Osun State, Nigeria. Methods: This cross-sectional study involved 476 adolescents recruited through multi-stage sampling across Osun State. Data were collected through a facilitated self-administered questionnaire with questions adapted from the Global School-Based Health Survey (GSHS) instrument. Data were analysed using Stata, with binary logistic regression used to identify determinants. Results: The mean age of the respondents was 14.7±2.0 years and females constituted 50.2% of them. Among the respondents, 36.1% had reported consuming alcoholic drinks but no one met the criteria for harmful alcohol use, while 8.8% had ever smoked cigarettes and only one respondent (0.2%) was a current smoker. The prevalence of poor diet (89.5%) and physical inactivity (85.9%) was, however, high. Poor diet and physical inactivity co-occurred in 369 (77.5%) respondents, while one respondent (0.2%) had three risk factors (poor diet, physical inactivity and current smoking). Being in a senior secondary school class (odds ratio, OR=1.6; 95% confidence interval, C.I.=1.04–2.39) and living with parents (OR=0.53; 0.33–0.90) were significantly associated with clustering of NCD behavioural risk factors. Conclusion: The prevalence of clustering of modifiable risk factors for NCDs was high among rural-based in-school adolescents in south-west Nigeria, and there is a need to mount effective interventions. Findings from this study have the potential to inform effective school-based NCD control programmes.


Author(s):  
Bhatt, Y. ◽  
Kulshrestha, K.

Globally, the burden of non-communicable diseases (NCDs) is rising. To assess the trends in the age of occurrence of non-communicable, age-related diseases this study was performed in the three districts of Uttarakhand, in both rural and the urban settings. The study comprised of both male and female subjects between the age group of 15 years to 55 onwards. The respondents were categorized into three age groups range as- 15-35 years, 36-55 years, and above 56 years. Starting from the age of 5 years, each age group is also categorized decade-wise e.g. age group of 56 years and above was divided into six decades starting from the age of five years.  The present study showed that the occurrence of age-related diseases, among the age group 56 years and above, was seen during their 40s while in the other two age groups, occurrence was recorded in the 30s itself. Comparing the third decade, i.e., the 30s of all the three age groups, none of the subjects was suffering from age-related disease among 56 years and above while among 36-55 years of age, 0.57 percent and among 15-35 years of age, 1.35 percent of subjects suffered from hypertension. The occurrence of these diseases was more in the urban areas as compared to rural areas. These results throw an insight onto the necessity for government bodies to focus on key factors leading to this trend, improving health care quality, and emphasis on a healthy lifestyle.


2020 ◽  
Author(s):  
Supa Pengpid ◽  
Karl Peltzer

Abstract Background Non-communicable diseases (NCDs) are on the rise in low- and middle-income countries. The aim of this study was to assess the prevalence and correlates of multiple NCD risk factors among adults in Sudan. Methods Cross-sectional nationally representative data were analysed from 7,722 18–69 year-old individuals (median age = 36 years) that took part in the “2016 Sudan STEPS survey.” Results The prevalence of individual NCD risk factors was 94.6% inadequate fruit and vegetable intake, followed by hypertension (31.6%), general overweight/obesity (28.0%), low physical activity (21.3%), current tobacco use (15.7%), raised total cholesterol (13.6%), diabetes (5.9%), and heavy episodic drinking (1.7%). In all, 34.2% had 0–1 NCD risk factor, 33.5% 2 risk factors, and 32.4% 3 or more NCD risk factors. In adjusted ordinal logistic regression analysis, compared to individuals 18–34 years old, persons 50–69 years old were 3.52 times (AOR: 3.52, 95% CI: 2.88–4.31) more likely to have multiple NCD risk factors. Men were 21% (AOR: 1.21, 95% CI: 1.00-1.46) more likely than women to have multiple NCD risk factors. Individuals residing in urban areas were 86% (AOR: 1.86, 95% CI: 1.49–2.32) more likely than individuals residing in rural areas to have multiple NCD risk factors, and compared to persons never married, married participants and persons separated, divorced or widowed persons were 51% (AOR: 1.51, 95% CI: 1.22–1.87) and 74% (AOR: 1.74, 95% CI: 1.22–2.47), respectively, more likely to have multiple NCD risk factors. Compared to persons with less than 500 pounds household income, persons with over 2000 pounds household income were 75% (AOR: 1.75, 95% CI: 1.28–2.38) more likely to have multiple NCD risk factors. Compared to women who cannot read or write, women who had more than primary education were 38% (AOR: 1.38, 95% CI: 1.06–1.80) more likely to have multiple NCD risk factors. Compared to men who were self-employed, engaged in non-paid work, were students or unemployed (able to work), government employees, non-government employees, retired or unemployed (unable to work) had a significantly higher odds of having multiple NCD risk factors. Conclusion Almost one in three participants had three or more NCD risk factors and several associated variables were identified that can facilitate in designing intervention programmes.


2021 ◽  
Vol 9 (E) ◽  
pp. 1233-1237
Author(s):  
Meri Neherta ◽  
Yonrizal Nurdin

Adolescence is when we still like to experiment and often develop bad habits which may lead to non-communicable diseases (NCDs) in the future. This study aimed to understand the lifestyle at risk of non-communicable diseases in adolescents that live in the urban and rural areas of Padang city. This research method is comparative descriptive with a descriptive-analytical approach, with a total sample of 788 people. The study was conducted from March 2019 to November 2019. Results: A total of 57.77% of respondents in urban areas and 69.54% of respondents in rural areas like to eat junk food. 45.35% urban respondents and 60.21% rural respondents like to consume high-sweetened beverages. 73.4% of urban respondents and 7.6% of rural respondents like to smoke. 80.6% of urban respondents and 87.8% of rural respondents lack physical activity. 59.9% of urban respondents and 49.05% of rural respondents do not like to exercise. 67% of urban respondents and 80.2% of rural respondents sleep late at night. Conclusion: The risk behavior of non-communicable diseases in rural adolescents is higher than in urban adolescents. It is recommended that parents, teachers, and health workers work together to carry out intervention activities for healthy lifestyles for all adolescents.


2019 ◽  
pp. 80-86
Author(s):  
Phuoc Thuoc Doan ◽  
Thi Huong Nguyen ◽  
Thi Thanh Nhan Tran ◽  
Thi Phuong Thao Nguyen ◽  
Thi Thuy Hang Nguyen ◽  
...  

Background: Non-communicable diseases seriously affect public health and socio-economic development of the country due to the high number of people suffering from diseases, being disabled and mortal. However, the proportion of people who recognized themselves a suffering from non-communicable diseases such as hypertension, diabetes and dyslipidemia is not high. For cases that their disease situations have been identified, there are not appropriate treatment and preventive behaviors. Objectives: 1) To determine the proportion of 25 - 84 years old peoplewho identified themselves as suffering from hypertension, diabetes and dyslipidemia. 2) To learn treatment and preventive behaviors in the group of people who identified themselves as suffering from diseases. Methods: A cross-sectional study was conducted with a randomly selected sample of 1600 residents in Thua Thien Hue province. Results: The proportion of people knowing that they are suffering from hypertension, diabetes and dyslipidemia was 29.4%; 3.2% and 7.8% respectively. Among them, the proportion of people who did not treat and treated irregularly accounted for 42.7%; 13.7% and 75.2% respectively; the proportion of people who did not change their lifestyles and dietary habits accounted for 50.1%; 5.9% and 56.8% respectively. Conclusions: The proportion of people who identified themselves as suffering from some non-communicable diseases without appropriate treatment and preventive behaviors is alarming. Interventions are needed to help people realize the importance of treatment and prevention effectively. Key words: Non-communicable diseases, hypertension, diabetes, dyslipidemia


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Vareda ◽  
T Garcia ◽  
J Rachadell

Abstract Background From disease prevention to health promotion, communication is key for Public Health (PH) practice and, according to the 9th Essential Public Health Operation its goal is to improve populations health literacy and capacity to access, understand and use information. Though social media is frequently presented as a potentially useful tool for PH communication, there is a lack of evidence about its effectiveness and impact on PH outcomes. This study researches Instagram® as a PH tool and aims to know who is using it, what content is shared on the platform and how much engagement there is. Methods This cross-sectional study regards information on 1000 Instagram® posts with the hashtags publichealth, publichealthpromotion, healthpromotion, publichealthmatters and publichealtheducation. Authors categorized post content and creators, and reviewed the number of likes and comments per post to determine engagement. Data analysis was performed on IBM SPSS® Statistics. Results The most common content categories were communicable diseases (n = 383), non-communicable diseases (n = 258) and healthy lifestyles (n = 143). Health professionals post more about communicable diseases (43,6%) and non-professionals about healthy lifestyles (36,1%). Non-professionals (n = 191) post about PH issues almost as much as health professionals (n = 220) and PH associations (n = 201). Most don't reference their sources (n = 821). Posts on communicable diseases have the most likes and comments per post (mean of 172 likes and 3,1 comments). Conclusions Half the Instagram® posts analysed in this study were made by health professionals or organizations. Communicable diseases, non-communicable diseases and healthy lifestyles were the most frequent content categories and had the most engagement. The majority of posts didn't reference their sources. Though Instagram® seems to be a potential PH communication tool, further research is needed to confirm its benefits for PH. Key messages Social media platforms like Instagram® are potentially powerful tools for PH communication. There is a need to understand the efficacy of social media as health promotion tools.


2016 ◽  
Vol 7 (2) ◽  
pp. 1-13 ◽  
Author(s):  
Mohammad Rashemdul Islam ◽  
Shamima Parvin Laskar ◽  
Darryl Macer

Non-communicable diseases (NCDs) disproportionately affect low and middle-income countries where nearly three quarters of NCD deaths occur. Bangladesh is also in NCD burden. This cross-sectional study was done on 50 health facilities centres at Gazipur district in Bangladesh from July 2015 to December 2015 to introduce SARA for better monitoring and evaluation of non-communicable diseases health service delivery. The General Service readiness index score was 61.52% refers to the fact that about 62% of all the facilities were ready to provide general services like basic amenities, basic equipment, standard precautions for infection prevention, and diagnostic capacity and essential medicines to the patients. But in case of non-communicable diseases, among all the health facilities 40% had chronic respiratory disease and cardiovascular diseases diagnosis/ management and only 32% had availability of diabetes diagnosis/management. Overall readiness score was 52% in chronic respiratory disease, 73% in cardiovascular disease and 70% in diabetes. Therefore, service availability and readiness of the health facilities to provide NCD related health services were not up to the mark for facing future targets.  A full-scale census survey of all the facilities of the study area would give a better understanding of the availability and service readiness.


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