The Influence of Universal Health Coverage on Life Expectancy at Birth (LEAB) and Healthy Life Expectancy (HALE): A Multi-Country Cross-Sectional Study

Abstract Background Reproductive and child health interventions are essential to improving population health in Africa. In Mozambique, although some progress on reproductive and child health has been made, knowledge of social inequalities in health and health care is lacking. Objective To investigate socio-economic and demographic inequalities in reproductive and child preventive health care as a way to monitor progress towards universal health coverage. Methods A cross-sectional study was conducted, using data collected from the 2015 Immunization, AIDS and Malaria Indicators Survey (IMASIDA) in Mozambique. The sample included 6946 women aged 15 to 49 years. Outcomes variables were the use of insecticide treated nets (ITN) for children under 5 years, full child immunization and modern contraception use, while independent variables included age, marital status, place of residence, region, education, occupation, and household wealth index. Prevalence ratios (PR) with 95% confidence intervals (95% CI) were calculated by log binomial regression to assess the relationship between the socio-economic and demographic characteristics and the three outcomes of interest. Results The percentage of mothers with at least one child under 5 years that did not use ITN was 51.01, 46.25% of women had children aged 1 to 4 years who were not fully immunized, and 74.28% of women were not using modern contraceptives. Non-educated mothers (PR = 1.33; 95% CI: 1.16–1.51) and those living in the Southern region (PR = 1.36; 95% CI: 1.17–1.59) had higher risk of not using ITN, while the poorest quintile (PR = 1.34; 95% CI: 1.04–1.71) was more likely to have children who were not fully immunized. Similarly, non-educated women (PR = 1.17; 95% CI: 1.10–1.25), non-working women (PR = 1.09; 95% CI: 1.04–1.16), and those in the poorest quintile (PR = 1.13; 95% CI: 1.04–1.24) had a higher risk of not using modern contraceptives. Conclusion Our study showed a low rate of ITN utilization, immunization coverage of children, and modern contraceptive use among women of reproductive age. Several socio-economic and demographics factors (region, education, occupation, and wealth) were associated with these preventive measures. We recommend an equity-oriented resource allocation across regions, knowledge dissemination on the importance of ITN and contraceptives use, and an expansion of immunization services to reach socio-economically disadvantaged families in order to achieve universal health coverage in Mozambique.

Download Full-text

Cancer Screening of Older Adults in Israel According to Life Expectancy: Cross Sectional Study

Journal of the American Geriatrics Society ◽

10.1111/jgs.15035 ◽

2017 ◽

Vol 65 (11) ◽

pp. 2539-2544 ◽

Cited By ~ 1

Author(s):

Ronen Bareket ◽

Mara A. Schonberg ◽

Doron Comaneshter ◽

Yochai Schonmann ◽

Michal Shani ◽

...

Keyword(s):

Older Adults ◽

Cancer Screening ◽

Life Expectancy ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

Download Full-text

Relationship between awareness and attitude with health and foodsafety among students of Urmia University, Urmia, Iran

Journal of Analytical Research in Clinical Medicine ◽

10.15171/jarcm.2019.002 ◽

2019 ◽

Vol 7 (1) ◽

pp. 7-11

Author(s):

Arezou Khezerlou ◽

Nasim Zolfaghari Firouzsalari ◽

Hajar Zolfaghari ◽

Mahmood Alizadeh sani ◽

Maryam Azizi-lalabadi ◽

...

Keyword(s):

Food Safety ◽

Training Programs ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Healthy Life ◽

Academic Level ◽

Freshmen Students ◽

Significant Difference ◽

Healthy Life Style

Introduction: Healthy life style and food safety are among the most crucial elements inpromoting community health. This cross-sectional study was conducted to assess the awarenessand attitudes of the students of Urmia University, Urmai, Iran, regarding health and food safety. Methods: The questionnaire used was designed in three parts (demographic, attitude, andawareness) and it was completed by 384 students. Data were analyzed using SPSS software.Results: Results showed that over 80% of the students had positive attitude towards health and foodsafety. In addition, almost 50% of the subjects had low awareness on the most appropriate plasticcontainers to keep food healthy. Findings indicated that there was a significant difference between thestudents' attitudes and their academic level (P = 0.008). No significant differences were found amongstudents' awareness and attitude considering gender and passing the food safety course. Cocnclusion: As the study findings revealed, training programs and workshops related to healthand food safety could be effective, specially for freshmen students.

Download Full-text

Dermatoses among patients aged 60 years and above attending a tertiary referral center: A cross-sectional study from North Kerala

Journal of Skin and Sexually Transmitted Diseases ◽

10.25259/jsstd_52_2020 ◽

2021 ◽

Vol 0 ◽

pp. 1-7

Author(s):

Muhammed Kutty Simin ◽

Sarita Sasidharanpillai ◽

Uma Rajan ◽

Najeeba Riyaz

Keyword(s):

Fungal Infections ◽

Significant Proportion ◽

The Elderly ◽

Cross Sectional Study ◽

Sectional Study ◽

Tertiary Referral ◽

Cross Sectional ◽

Tertiary Referral Center ◽

Referral Center ◽

Life Expectancy At Birth

Objectives: With the rise in life expectancy at birth, geriatric population contributes to a significant proportion of those seeking medical aid. Skin problems in the elderly are very common and vary according to region and ethnicity. It is essential for dermatologists to have a better understanding of the pathophysiology of geriatric skin disorders to formulate quality management guidelines. This study was undertaken to document the frequency and the clinical pattern of various physiological and pathological changes in the elderly skin. Materials and Methods: A cross-sectional study was carried out in 200 consecutive patients aged 60 years and above and who attended the Dermatology outpatient clinic of a tertiary referral center in North Kerala. A pre-set pro forma was used to document the patient characteristics, the comorbidities, the medications used, and the clinical findings. Results: All the study participants (100%) had one or more dermatoses. The age of the study population ranged from 60 to 89 years (mean 67.7 ± 6.2 years). This was a female preponderant study with a female to male ratio of 1.4:1. Hypertension (36%), hyperlipidemia (27%) and diabetes mellitus (26%) were the common comorbidities observed. Graying of hair was the most common physiological change, followed by wrinkling. Pruritus was the most common presenting complaint (136, 68%). Statistically significant association was noted between xerosis and generalized pruritus. Fungal infections (30.5%) outnumbered other infections and infestations. Changes of severe photoaging were less frequent. One patient had skin malignancy (basal cell carcinoma). Significant association was noted between photoaging and male sex, smoking, and sun exposure. Limitations: Study conducted in a tertiary referral center not reflecting the status in the community was the major limitation. Conclusion: Photoaging and skin cancers are less frequent in darker skin type. Healthy lifestyle, nutritious diet, frequent application of emollient, better skin care, and judicious use of sunscreen can delay the process of cutaneous aging. More prospective studies in different population groups may go a long way in improving the current knowledge about the less known aspects of geriatric dermatoses.

Download Full-text

Equity in access to non-communicable disease medicines: a cross-sectional study in Kenya

BMJ Global Health ◽

10.1136/bmjgh-2018-000828 ◽

2018 ◽

Vol 3 (3) ◽

pp. e000828 ◽

Cited By ~ 2

Author(s):

Peter C Rockers ◽

Richard O Laing ◽

Veronika J Wirtz

Keyword(s):

Health Facility ◽

Universal Health Coverage ◽

Access To Medicines ◽

Household Wealth ◽

Health Coverage ◽

Cross Sectional ◽

Household Asset ◽

Equity In Access ◽

The Relationship ◽

Universal Health

IntroductionWealth-based inequity in access to medicines is an impediment to achieving universal health coverage in many low-income and middle-income countries. We explored the relationship between household wealth and access to medicines for non-communicable diseases (NCDs) in Kenya.MethodsWe administered a cross-sectional survey to a sample of patients prescribed medicines for hypertension, diabetes or asthma. Data were collected on medicines available in the home, including the location and cost of purchase. Household asset information was used to construct an indicator of wealth. We analysed the relationship between household wealth and various aspects of access, including the probability of having NCD medicines at home and price paid.ResultsAmong 639 patients interviewed, hypertension was the most prevalent NCD (69.6%), followed by diabetes (22.2%) and asthma (20.2%). There was a positive and statistically significant association between wealth and having medicines for patients with hypertension (p=0.020) and asthma (p=0.016), but not for diabetes (p=0.160). Poorer patients lived farther from their nearest health facility (p=0.050). There was no relationship between household wealth and the probability that the nearest public or non-profit health facility had key NCD medicines in stock, though less poor patients were significantly more likely to purchase medicines at better stocked private outlets. The relationship between wealth and median price paid for metformin by patients with diabetes was strongly u-shaped, with the middle quintile paying the lowest prices and the poorest and least poor paying higher prices. Patients with asthma in the poorest wealth quintile paid more for salbutamol than those in all other quintiles.ConclusionThe poorest in Kenya appear to face increased barriers to accessing NCD medicines as compared with the less poor. To achieve universal health coverage, the country will need to consider pro-poor policies for improving equity in access.

Download Full-text

Life expectancy and healthy life expectancy at birth

Health at a Glance: Europe 2014 - Health at a Glance: Europe ◽

10.1787/health_glance_eur-2014-4-en ◽

2014 ◽

pp. 16-17

Keyword(s):

Life Expectancy ◽

Healthy Life Expectancy ◽

Healthy Life ◽

Life Expectancy At Birth

Download Full-text

Factors related to excessive out-of-pocket expenditures among the ultra-poor after discontinuity of PBF: a cross-sectional study in Burkina Faso

Health Economics Review ◽

10.1186/s13561-020-00293-w ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Yvonne Beaugé ◽

Valéry Ridde ◽

Emmanuel Bonnet ◽

Sidibé Souleymane ◽

Naasegnibe Kuunibe ◽

...

Keyword(s):

Burkina Faso ◽

Financial Risk ◽

Healthcare Services ◽

Cross Sectional Study ◽

Service Utilisation ◽

Health Coverage ◽

Sectional Study ◽

Financial Risk Protection ◽

Cross Sectional ◽

Risk Protection

Abstract Background Measuring progress towards financial risk protection for the poorest is essential within the framework of Universal Health Coverage. The study assessed the level of out-of-pocket expenditure and factors associated with excessive out-of-pocket expenditure among the ultra-poor who had been targeted and exempted within the context of the performance-based financing intervention in Burkina Faso. Ultra-poor were selected based on a community-based approach and provided with an exemption card allowing them to access healthcare services free of charge. Methods We performed a descriptive analysis of the level of out-of-pocket expenditure on formal healthcare services using data from a cross-sectional study conducted in Diébougou district. Multivariate logistic regression was performed to investigate the factors related to excessive out-of-pocket expenditure among the ultra-poor. The analysis was restricted to individuals who reported formal health service utilisation for an illness-episode within the last six months. Excessive spending was defined as having expenditure greater than or equal to two times the median out-of-pocket expenditure. Results Exemption card ownership was reported by 83.64% of the respondents. With an average of FCFA 23051.62 (USD 39.18), the ultra-poor had to supplement a significant amount of out-of-pocket expenditure to receive formal healthcare services at public health facilities which were supposed to be free. The probability of incurring excessive out-of-pocket expenditure was negatively associated with being female (β = − 2.072, p = 0.00, ME = − 0.324; p = 0.000) and having an exemption card (β = − 1.787, p = 0.025; ME = − 0.279, p = 0.014). Conclusions User fee exemptions are associated with reduced out-of-pocket expenditure for the ultra-poor. Our results demonstrate the importance of free care and better implementation of existing exemption policies. The ultra-poor’s elevated risk due to multi-morbidities and severity of illness need to be considered when allocating resources to better address existing inequalities and improve financial risk protection.

Download Full-text

Nurses' knowledge of universal health coverage for inclusive and sustainable elderly care services

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.1152.2670 ◽

2016 ◽

Vol 24 (0) ◽

Author(s):

Fabian Ling Ngai Tung ◽

Vincent Chun Man Yan ◽

Winnie Ling Yin Tai ◽

Jing Han Chen ◽

Joanne Wai-yee Chung ◽

...

Keyword(s):

Universal Health Coverage ◽

Elderly Care ◽

Healthcare Policy ◽

Health Coverage ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Convenience Sample ◽

Care Services ◽

Universal Health ◽

Nurses Knowledge

Objectives: to explore nurses' knowledge of universal health coverage (UHC) for inclusive and sustainable development of elderly care services. Method: this was a cross-sectional survey. A convenience sample of 326 currently practicing enrolled nurses (EN) or registered nurses (RN) was recruited. Respondents completed a questionnaire which was based on the implementation strategies advocated by the WHO Global Forum for Governmental Chief Nursing Officers and Midwives (GCNOMs). Questions covered the government initiative, healthcare financing policy, human resources policy, and the respondents' perception of importance and contribution of nurses in achieving UHC in elderly care services. Results: the knowledge of nurses about UHC in elderly care services was fairly satisfactory. Nurses in both clinical practice and management perceived themselves as having more contribution and importance than those in education. They were relatively indifferent to healthcare policy and politics. Conclusion: the survey uncovered a considerable knowledge gap in nurses' knowledge of UHC in elderly care services, and shed light on the need for nurses to be more attuned to healthcare policy. The educational curriculum for nurses should be strengthened to include studies in public policy and advocacy. Nurses can make a difference through their participation in the development and implementation of UHC in healthcare services.

Download Full-text