The Correlation Between Self-Care Behavior with Application of Eastern Wisdom and Resilience Among Village Health Volunteers: A Cross-Sectional Study in Southern Thailand

The job of village health volunteers (VHVs) is to coordinate between Thai government departments and the public. Such work can lead to boredom, discouragement, and physical and mental exhaustion. Therefore, strengthening the positive ability of VHVs can help them cope with fatigue. It is essential to continue supporting VHVs; consequently, it is necessary to incorporate Eastern wisdom into healthcare provided for village health volunteers. Purposive sampling was used in this descriptive research to study the relationship between self-care behaviors by applying Eastern wisdom to support and enhance the mental strength of the VHVs. The sample consisted of 77 VHVs in Southern Thailand. Demographic data questionnaire, self-care behavior questionnaire by applying Eastern wisdom, and resilience questionnaire were used to collect data. Pearson’s correlation was used to analyze data. The relationship between self-care behavior by applying Eastern wisdom and resilience was found to have a statistically significant positive correlation (r = .246, p < .05). The relationship between self-care behavior by applying Eastern wisdom and resilience in this study was weak, but there was a positive correlation. Thus, health care providers should promote and integrate Eastern wisdom into self-care activities with VHVs.

Food Insecurity and Healthcare Utilization in Indonesia: Evidence from Indonesian National Household Surveys

Treatment for sicknesses in healthcare is a crucial determinant to improve health. In Indonesia, the unmet need for healthcare is common for people in the lower economic group. This study aims to examine how food insecurity affects outpatient care using the indicators of food insecurity to highlight individuals with high health risks and experiencing problems with limited resources. The data used in this study consisted of 159,236 individuals representing different age ranges from the 2017 National Socio-Economic Survey (SUSENAS) and the 2018 Village Potential Census (PODES). Data were analyzed using ivprobit to address bias due to the endogeneity in the food insecurity variables. The results indicate that a higher food insecurity score will increase the chances of not accessing modern healthcare for outpatient care when sick. Several variables like sex, types of residence, number of household members living together, access to healthcare, health insurance, social protection, and illness characteristic were also found to influence individual behavior in not utilizing modern healthcare for outpatient care. This study suggests that policymakers should pay attention to the utilization of modern healthcare, especially for outpatient care in groups experiencing food insecurity.

The Loneliness of Older Adults Associated with Various Types of Thai Families

The structures of Thai families have changed, and therefore increased the number of factors negatively affecting older adults. The most common is loneliness, which affects older adults and is closely related to mental state. The purpose of this research was to analyze and compare the level of loneliness of older adults in different family types and study the differences between personal factors, family factors, and social factors of the older adults toward the loneliness of the older adults within a variety of family types. The population was 346 older adults aged 60 years and over. The analysis found that 76% of older adults in the study have low levels of loneliness. The older adults in different family types had a statistically significant difference level of loneliness. The older adults who lived alone had a higher level of loneliness than others. Factors related to the moderate level of loneliness among the older adults within different family types were not participating in family activities of a parent-child family and income inadequacy in a three-generation family. The outcome of this research could be used to promote and improve care for older adults to reduce and prevent loneliness based on their specific family types.

Multi-Layered Catastrophic Health Spending of Inpatient Women by Broad Group of Diseases in India

Healthcare for Indian women needs prioritizing, as they continue to face social and economic discrimination over their healthcare, often with high out-of-pocket payments. The study examines the amount inpatient women have to pay for treatment of major diseases, re-classified into four groups as infectious, reproductive, non-communicable diseases (NCDs), and disabilities & injuries, across the country to comprehend the extent of catastrophic health spending (CHS) they experienced. The study is based on India’s 75th round of the National Sample Survey (NSS), i.e., Household Social Consumption: Health (2017-2018), consisting of 26,938 inpatient women aged 12 and above from India's urban and rural areas. We examine the prevalence of the four categories of diseases by individual, household, community, and healthcare characteristics. Expenditure estimates were derived from cross-tabulation, followed by binary logistic regression to assess the association between covariates and inpatient expenditures for the diseases. Indian women are more likely to be hospitalized for infectious diseases (43%), but the burden of CHS (overall) is highest for disabilities and injuries (INR 24,414), followed by NCDs (INR 23,053). Duration of hospitalization and possession of health insurance by women indicate maximum variation with medical spending. Almost 97% of women have incurred out-of-pocket expenditure on hospitalization, from which we identify three layers of CHS. A substantial proportion of women (23 to 50%) experienced CHS, i.e., up to 0-10%, 11-30%, and >30%, which varies distinctively by place of residence and across the six regions. Covariates like age, economic status, and healthcare are highly significant and associated with disease-wise CHS thresholds. Women in India face divergent financial hardships for healthcare. Given the heterogeneity of morbidities and socio-economic characteristics, the need for women-sensitive public health services and interventions are evident.

Under-Utilization of Maternal-Child Healthcare Services and Adverse Outcomes of Unwanted Pregnancies in Urban and Rural Areas of Indonesia

The study examines the association of unwanted pregnancy and the utilization of maternal-child health services, and the adverse health outcomes in urban and rural settings. The study employed data from the 2017 Indonesia Demographic Health Survey that included 13,806 live births; the mothers were not pregnant at the interview and were married participants. The multiple logistic regression analysis concerning residential areas was conducted separately to compare outcomes related to unwanted pregnancy. Non-standard antenatal care visits (adjusted odds ratio [AOR]=1.7; 95% confidence interval [CI]=1.2–2.4), prolonged labor (AOR=1.6; 95% CI=1.2–2.1), the absence of child’s birth documentation (AOR=1.3; 95% CI=1.0–1.6), and smaller baby size (AOR=1.2; 95% CI=1.0–1.4) are associated with unwanted pregnancy in urban areas. In rural settings, on the other hand, unwanted pregnancy is associated with non-standard antenatal care (AOR=1.6; 95% CI=1.2–2.2). Therefore, in Indonesia, urban areas lack maternal-child healthcare services utilization and higher adverse events due to unwanted pregnancy than rural areas. An adjustment approach is required in maternal-child health-related programs in both areas, particularly for women living in urban.

Negotiating Religiosity in a Secular Society: A Study of Indonesian Muslim Female Migrant Workers in Hong Kong

This study examined how Indonesian Muslim female migrant workers in Hong Kong, the majority of whom work in the domestic sector, negotiate their religiosity in a secular society. As a method of investigation, qualitative exploratory research was used. Observation and in-depth semi-structured interviews were used to collect data with eight Indonesian Muslim female workers in Hong Kong. The findings show that: 1) despite workplace restrictions, these workers adhered to their religious rites; 2) they utilized the most viable solutions to enable them to conduct their job obligations that were incompatible with their religion; 3) they established halaqas [religious study groups] in several mosques throughout Hong Kong and met regularly; and 4) the migrant workers gained strength from their faith, while the religious study groups greatly assisted them in overcoming and resolving life’s challenges. The researchers concluded that while it is critical for many workers to live according to their religion, many employers are unaware of their employees’ religion and religious values. There should be better dialogue and agreement on how workers and employers can negotiate their rights and obligations. In response to the study’s findings, several recommendations are made.

Changes in Physical Activity Among University Students in Indonesia from Before to During the COVID-19 Pandemic: A Retrospective Cohort Study

University life is an important phase for forming healthy physical activity habits among university students. However, little is known about the change in physical activity level during the COVID-19 pandemic among university students in Indonesia, which has a low stringency index. A retrospective cohort study was conducted among students of Universitas Gadjah Mada (n=153) from October to November 2020, where there were asked to recall their physical activity level and type of physical activity engaged in at four points of time: before the pandemic, early pandemic, Ramadan period, and relaxation period. Then, we conducted three-way mixed analyses of variance followed by Bonferroni’s post hoc comparisons tests to compare the mean difference of total moderate-vigorous physical activity with a subject over time and between subgroups in a similar time. Containment measures during the pandemic resulted in a 69.4-minute drop (95% confidence interval: 40.1 to 98.7 minutes, p<.001) of total moderate-vigorous physical activity. While the relaxation of containment measures could restore non-health natural science students’ physical activity to the pre-pandemic amount, it did not influence health science students’ physical activity. Our findings provide evidence that pandemic situations in a low stringency index country also affected physical activity behavior among university students. More efforts are needed to increase university students’ physical activity during the COVID-19 pandemic, particularly among health science students.

The Impact of Educational Assortative Mating on Income Inequality: Evidence from Argentina

This paper seeks to quantify the impact of educational assortative mating on income inequality among households in Argentina. We use microdata from two household surveys conducted by the National Institute of Statistics and Census: The Permanent Household Survey and the National Survey of Risk Factors. We construct contingency tables and perform a regression analysis to study the existence of educational assortative mating. We also present counterfactual simulations of random re-matching of observations. The results show that a sizeable proportion of couples are educationally homogamous (45%). Comparing the Gini coefficients calculated in the real matching and the simulated scenarios, we observe a reduction of up to 4 points. Thus, the educational assortative mating represents a relevant dimension to explain income inequality. Our results recommend considering this matching pattern when defining optimal income taxes; this is, if there is a high positive covariance between the income of both members of the couple, it seems appropriate, from a redistributive point of view, to define income taxes at the household level and not at the individual level (as is currently the case in most countries, including Argentina).

On Prevention of Diarrheal Disease: Assessing the Factors of Effective Handwashing Facilities in Bangladesh

People in Bangladesh usually do not utilize handwashing facilities properly, which makes it challenging to implement hygiene practices of handwashing to reduce diarrhea and other health risks. Against this backdrop, this research attempts to assess the factors associated with Effective Handwashing Facilities (EHFs) in Bangladesh utilizing the Multiple Indicator Cluster Survey 2019. This study utilizes descriptive statistics techniques and also bivariate and multivariable logistic regression methods by representing odd ratios to identify the relationship between associated factors and EHF in Bangladesh. The descriptive statistics show that about 74.22% of the households in Bangladesh have EHFs. Gender, education, ethnicity, male-head households, household wealth status, source of water, sanitation status, sharing toilet facility are identified as the potential determinants of EHF. As a result, we recommend that all levels of society in Bangladesh have continuous access to handwashing equipment and facilities to reduce hygiene-related illnesses especially diarrheal disease.

Interpersonal Ties and Health Care: Examining the Social Networks of Filipino Migrant Domestic Workers in Hong Kong

This paper explores the relationship between the social networks of Filipino migrant domestic workers (FMDWs) in Hong Kong and the accessibility of health resources, especially for migrant women. This study primarily draws evidence from ethnographic interviews with 20 FMDWs in Hong Kong. Likewise, this analysis also relied on field notes from participant observations during formal meetings and informal activities. This paper reveals that FMDWs strategically use their strong and weak ties in managing risks and accessing resources for their health and well-being by deciding among their social network who and what to share regarding health concerns. They conscientiously negotiate their rights and opportunities with their employers, who can also provide access to social and institutional resources. Finally, FMDWs participate in conversations and discourses on health-related policies of their home and host countries with their social network. By focusing on the social networks of FMDWs in Hong Kong, this paper conceptually and empirically broadens conversations about how migration becomes a social determinant of health. Moreover, it illustrates how migrant social networks are organized, activated, and mobilized around discourses on state-crafted health policies towards migrant women.