Determinants and levels of cervical Cancer screening uptake among women of reproductive age in South Africa: evidence from South Africa Demographic and health survey data, 2016

Background Cervical cancer (CC) is the cancer with the most incidents and the leading cause of cancer mortality among women in South Africa. CC screening is one of the most cost-effective control approaches for the disease burden. This study assessed the determinants and individual-level indicators of cervical cancer screening uptake among women of reproductive age in South Africa. Methods We analyzed data from the 2016 South Africa Demographic Health Survey. Our analysis focused on 5903 women (15–49 years). We conducted Chi-square test for bivariate analysis, and multivariate binary logistics regression was used to analyze independent association between individual-level factors and women who have had Pap smear testing. Statistical significance was set at p < 0.05. Results The mean age at cervical cancer screening uptake among women in South Africa was 40.8 years (SD 18.6, range 15–95 years). A majority of the women (39.3%) were aged 45 years and above and 54.6% of them resides in urban settlements. About 35.4% of women (n = 2098) have had a Pap smear test, with 66.5% of them who had a Pap smear test resides in Western Cape province. The proportion of women who had a Pap smear test was significantly higher among those with higher educational attainment (68.7%, p = 0.000), in the rich wealth index (50.1%, p = 0.000), and those with health insurance cover (60.3%, p = 0.000). Pap smear testing was found to be more prevalent among women aged 45+ years, were in the white population group, had higher education, were divorced, and had health insurance cover. The predominance of Pap smear test was 14% higher among women who are working in the professional/formal sector (AOR; 1.38, 95% CI; 1.14–1.69). The uptake of Pap smear test was also higher among women aged 35–44 years. Conclusions The prevalence of cervical cancer uptake is substantially low among women aged 15–24 years in South Africa and shows a degree of between-provinces differences. Therefore, heath educational interventions aimed at increasing the uptake of cervical cancer screening services in South Africa are critically needed.

The Legal Challenges of Insuring Against a Pandemic

COVID-19 has raised, and continues to raise, questions about the traditional approach to insurance cover. For instance, business interruption insurance covering “pandemics” under all risks insurance policies are likely to be a thing of the past. With tensions between businesses and the insurance industry on the rise, what can be done to offer businesses some protection at a premium they can afford, without emptying insurers’ reserves? In this chapter we talk about legal challenges related to traditional insurance against the risk of losses caused by a pandemic, and whether parametric insurance is the solution.

Utilization of complementary and traditional medicine practitioners among middle-aged and older adults in India: results of a national survey in 2017–2018

Background Lack of information exists about the use of traditional and complementary medicine (TCM) use among middle-aged and older adults in India, which led to studying the estimates of past-12-month Ayurveda/Yoga/Naturopathy/Unani/Siddha/Homeopathy (AYUSH) practitioner and traditional health practitioner (THP) utilization in India. Methods The study included 72,262 individuals (45 years and older) from the cross-sectional 2017–2018 Longitudinal Ageing Study in India (LASI) Wave 1. Results The prevalence of past 12-month AYUSH practitioner utilization was 6.5%, THP use 7.0%, and AYUSH or THP use 13.0%. The rate of AYUSH practitioner utilization was determined by older age (≥60 years) (Adjusted Odds Ratio-AOR: 1.20, 95% Confidence Interval-CI: 1.07–1.34), having pain (AOR: 1.48, 95% CI: 1.29–1.69), any bone or joint diseases (AOR: 1.57, 95% CI: 1.35–1.82), current tobacco use (AOR: 1.30, 95% CI: 1.12–1.50), male sex (AOR: 0.76, 95% CI: 0.68–0.85), high subjective socioeconomic status (AOR: 0.72, 95% CI: 0.60–0.87), urban residence (AOR: 0.71, 95% CI: 0.57–0.88), diabetes (AOR: 0.66, 95% CI: 0.55–0.81), chronic heart disease (AOR: 0.52, 95% CI: 0.37–0.73), and having a health insurance cover (AOR: 0.36, 95% CI: 0.30–0.44). The rate of THP utilization was determined by depressive symptoms (AOR: 1.17, 95% CI: 1.01–1.35), sleep problems (AOR: 1.28, 95% CI: 1.08–1.51), having pain (AOR: 1.82, 95% CI: 1.55–2.15), current tobacco use (AOR: 1.35, 95% CI: 1.22–1.51), having health insurance cover (AOR: 0.41, 95% CI: 0.33–0.51), hypertension (AOR: 0.82, 95% CI: 0.71–0.95), diabetes (AOR: 0.50, 95% CI: 0.39–0.65), urban residence (AOR: 0.25, 95% CI: 0.19–0.34), and high subjective socioeconomic status (AOR: 0.70, 95% CI: 0.58–0.85). Conclusion A moderate prevalence of AYUSH practitioner and THP use among middle-aged and older adults in India was found and several factors associated with AYUSH practitioner and THP use were identified.

Niepewność interpretacyjna zapisów ochrony ubezpieczeniowej konsumentów ubezpieczeń na życie oferowanych do kredytów mieszkaniowych na przykładzie wybranych ofert

Bundled package of home loans and insurance are a natural phenomenon. Banks treat insurance as the primary security for the credit. For the consumer–borrower can help in financial difficulty. The purpose of insurance added to the loan is to reduce the risk of inability of borrowers to pay back their loans to banks and to ensure the safety of the insured or beneficiary of the insurance policy Therefore, insurance added to the loans should effectively protect borrowers. However, bundled package entails the risk of mismatching the insurance cover with the individual policy-holder insurance needs. Consumer–borrower may not be aware of the scope of insurance protection, which results from the insurance contract and general insurance terms and conditions. Therefore, in order to properly understand the offer of insurance, it becomes necessary to familiarize the borrower–the consumer with the general insurance conditions. However, as research shows, there is a big problem on the insurance sector with unintelligible insurance policy. The purpose of the article/hypothesis: The aim of the article is to compare and assess the scope of insurance cover based on the provisions of the general conditions of life insurance added to home loans by the two largest banks in Poland. Methodology: The article uses a comparative analysis of the scope of insurance cover on the based on provisions of the general conditions of insurance. The following categories have been selected from the general conditions of insurance: subject of insurance, definitions of events covered by the liability of the insurer, nature of benefits, amount of insurance and exclusions and limitations of liability. Results of the research: the analysis of the scope of insurance cover at selected banks in the article shows that selected categories from the general terms and conditions of insurance limit the potential level of insurance cover. After reviewing the general terms and conditions of insurance, consumer–borrower is not sure whether he will get help from the insurer when he needs it.

Likelihood of Insurance Coverage on Damages Due to Level of Insecurity in Nigeria: Logistic Modeling Approach

Insurance serves as a protection against the unexpected and it is one of the most effective risk management tools that protect individuals from being bankrupt due to various contingencies. The binary logistic regression model approach was used to model the described dataset; the model so obtained was statistically significant. All the levels of education were statistically significant in predicting the odds of having insurance cover except for primary education level. Also, employment status and age were statistically significant in predicting the likelihood for insurance cover in Nigeria. The results showed that individuals who move from no formal education to obtain Higher education level are 21.66 times more likely to obtain insurance cover and individuals who move from no formal education to obtain Secondary education level are 2.63 times more likely to obtain insurance cover. The odd ratio is not significant for moving from no formal education to Primary education and therefore should not be interpreted. Further, individuals who move from being unemployed to being employed are more likely to obtain insurance cover. Education has the highest impact in predicting the likelihood for one to have insurance cover in Nigeria. This paper recommends overhauling of the educational system in order to revamp this sector.

Experiences of women undergoing assisted reproductive technology in Ghana: A qualitative analysis of their experiences

Objective The study aimed to explore the experiences of women undergoing Assisted Reproductive Technologies namely; Invitro Fertilization and Intracytoplasmic Sperm Injection at the Finney Hospital and Fertility Centre, New Bortianor, Ghana. Method A qualitative research design was employed to analyse and describe the experiences of the women seeking Assisted Reproductive Technologies. A total of 32 women were invited to take part in the interview, 15 of them accepted the invitation. However, saturation was reached before all interviews had been complete. Results Three themes emerged from the study: the women’s experiences, challenges and the roles and contributions of significant others. The women were anxious, stressed-up, exhausted and financially burdened. Spouses and health professionals played significant roles by providing social, emotional and financial support for these women. Significant others such as spouses and close relatives were supportive and provided encouragement to the women. Conclusion The experiences of women undergoing Assisted Reproductive Technologies are multi-dimensional. Thus, psychosocial interventions as part of ART services with health insurance cover may be client-centered and more appropriate for these group of women.

Insurance Sector Development and Economic Growth in Nigeria, 1980 –2014

This study was carried out to determine the effect of insurance sector development on the economic growth of Nigeria. Consequently, three hypotheses were designed to guide the researcher and data were drawn from the Central Bank of Nigeria (CBN) statistical bulletin which covered a thirty five (35) years period between 1980 to 2014. The hypotheses were tested using ordinary least square regression analysis and the econometrics co integration test and the result revealed that; there is a positive and significant relationship between insurance premium and economic growth in Nigeria; there is a positive and significant relationship between insurance claims and gross domestic product of Nigeria; there is a positive and significant relationship between insurance investments and economic growth in Nigeria. Based on the results, the researcher thus recommended the following amongst others; Government should Provide institutional improvements by making better laws and policies that will not only encourage fair play but also help to attract international players in the industry; Government should also provide information and education to the populace on the importance of acquiring insurance cover in order to be protected; Increasing efficiency, especially in risk management, and product development.

Health Insurance Uptake and Affordability of Care Among Patients with Hypertension in a Federal Teaching Hospital in Southwestern Nigeria

This study aims to assess health insurance uptake and affordability of care among patients with hypertension in a Federal Teaching Hospital in Southwestern Nigeria. This was a cross sectional study involving 138 hypertensive patient selected through systematic random sampling technique from the cardiology clinic of a Federal Teaching Hospital. A semi-structured, interviewer administered questionnaire was used to collect data. Analysis was done using Statistical Package for Social Sciences (SPSS) version 21. A significance level of 5% was used. The mean age (standard deviation) of the patients was 57.4 (12.8) years with median (interquartile range) monthly income of ₦46,500.00 (₦55,000.00) [US$129 (US$152.78)]. The health insurance uptake among them was 26.8%. Out of those who had no health insurance cover, 87.2% of them believed it could make their financial burden less and wish to be registered. Hypertensive patients enrolled under health insurance were significantly less likely to face financial difficulty when paying for drugs (p<0.001) and investigations (p<0.001). Additionally, these patients were significantly less likely to deny or defer project(s) in order to pay for their illness (p=0.004) and to have their source of livelihood being negatively affected by this illness (p=0.002). This study found a low health insurance uptake among hypertensive patients, even though most of the patients who had no health insurance cover were ready to enroll. Additionally, health insurance was identified to promote affordability of care among these patients. It is therefore crucial to put in place measures that will increase health insurance coverage among these patients.

Health Insurance Uptake and Affordability of Care Among Patients with Hypertension in a Federal Teaching Hospital in Southwestern Nigeria

This study aims to assess health insurance uptake and affordability of care among patients with hypertension in a Federal Teaching Hospital in Southwestern Nigeria. This was a cross sectional study involving 138 hypertensive patient selected through systematic random sampling technique from the cardiology clinic of a Federal Teaching Hospital. A semi-structured, interviewer administered questionnaire was used to collect data. Analysis was done using Statistical Package for Social Sciences (SPSS) version 21. A significance level of 5% was used. The mean age (standard deviation) of the patients was 57.4 (12.8) years with median (interquartile range) monthly income of ₦46,500.00 (₦55,000.00) [US$129 (US$152.78)]. The health insurance uptake among them was 26.8%. Out of those who had no health insurance cover, 87.2% of them believed it could make their financial burden less and wish to be registered. Hypertensive patients enrolled under health insurance were significantly less likely to face financial difficulty when paying for drugs (p&lt;0.001) and investigations (p&lt;0.001). Additionally, these patients were significantly less likely to deny or defer project(s) in order to pay for their illness (p=0.004) and to have their source of livelihood being negatively affected by this illness (p=0.002). This study found a low health insurance uptake among hypertensive patients, even though most of the patients who had no health insurance cover were ready to enroll. Additionally, health insurance was identified to promote affordability of care among these patients. It is therefore crucial to put in place measures that will increase health insurance coverage among these patients.