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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Journal of Health Management and Informatics
- نوع مقاله: Journal Article
- کلمات کلیدی:
- چکیده:
- چکیده انگلیسی: Introduction: The financial burden of health care costs in Nigeria is borne almost entirely by the individuals and household members as health care financing is still mostly from out of pocket (OOP) payments. OOP payments can lead households into poverty. This study aimed to estimate the contribution of household health care expenditure to poverty in rural and urban communities in Oyo state, Nigeria.Method: This is a comparative cross-sectional study using a tested and adapted version of the Living Standard Survey questionnaire to collect data on 5,696 household members from 1,434 household representatives. Representatives were selected using a multistage sampling method. Information was collected from 714(49.8%) and 720(50.2%) households in the urban and rural Local Government Area (LGA), respectively. International poverty line of $1.25 per day was used. Poverty level was measured with and without household health expenditure. An exact McNemar’s test was used to determine the difference in the proportion of poor, gross and net payment for health care services. SPSS software was used for data analysis.Results: Health care was utilised by 1,006 (70.2%) of the 1,434 households studied. Of urban and rural households, 637(89.2%) and 369(51.3%) utilized health care services, respectively. Only 513(29.8%) were poor while 1519(88.2%) were poor after considering the cost of utilising health care. Increase in poverty of 66.2% occurred because of health care utilisation (p<0.001).Conclusion: Health care expenditure increased the proportion of household members living below poverty line. To protect against poverty free basic health care services is required in Nigeria.Keywords: Cost, Out of Pocket, Poverty, Expenditure
- انتشار مقاله: 10-04-1396
- نویسندگان: Olayinka Stephen Ilesanmi,Akindele Olupelumi Adebiyi,Akinola Ayoola Fatiregun
- مشاهده
- جایگاه : پژوهشی
- مجله: International Journal of Health Policy and Management
- نوع مقاله: Journal Article
- کلمات کلیدی: Chronic disease,quality improvement,Governance,Executive Leadership,Systems Change,Healthcare Improvement
- چکیده:
- چکیده انگلیسی: The Atlantic Healthcare Collaboration for Innovation and Improvement in Chronic Disease (AHC) Quality Improvement Collaborative (QIC) in Eastern Canada provided an approach to spur system-level reform across multiple health systems for patients and families living with chronic disease. Developed and led by senior executives with a unique governance approach and involving clinical front-line teams, the AHC serves as a practical example of leadership creating and driving momentum for achieving success in collaborative health system improvements.
- انتشار مقاله: 24-09-1395
- نویسندگان: Meghan Rossiter,Jennifer Verma,Jean-Louis Denis,Stephen Samis,Richard Wedge,Chris Power
- مشاهده
- جایگاه : پژوهشی
- مجله: International Journal of Health Policy and Management
- نوع مقاله: Journal Article
- کلمات کلیدی: Cost,Households,Healthcare Utilization,National Health Insurance Scheme (NHIS),Catastrophic Health Expenditure (CHE),Wealth Quintiles
- چکیده:
- چکیده انگلیسی: Background
The major objective of the National Health Insurance Scheme (NHIS) in Nigeria is to protect families from the financial hardship of large medical bills. Catastrophic Health Expenditure (CHE) is rampart in Nigeria despite the take-off of the NHIS. This study aimed to determine if households enrolled in the NHIS were protected from having CHE.
Methods
The study took place among 714 households in urban communities of Oyo State. CHE was measured using a threshold of 40% of monthly non-food expenditure. Descriptive statistics were done, Principal Component Analysis was used to divide households into wealth quintiles. Chi-square test and binary logistic regression were done.
Results
The mean age of household respondent was 33.5 years. The median household income was 43,500 naira (290 US dollars) and the range was 7,000–680,000 naira (46.7–4,533 US dollars) in 2012. The overall median household healthcare cost was 890 naira (5.9 US dollars) and the range was 10-17,700 naira (0.1–118 US dollars) in 2012. In all, 67 (9.4%) households were enrolled in NHIS scheme. Healthcare services was utilized by 637 (82.9%) and CHE occurred in 42 (6.6%) households. CHE occurred in 14 (10.9%) of the households in the lowest quintile compared to 3 (2.5%) in the highest wealth quintile (P= 0.004). The odds of CHE among households in lowest wealth quintile is about 5 times. They had Crude OR (CI): 4.7 (1.3–16.8), P= 0.022. Non enrolled households were two times likely to have CHE, though not significant
Conclusion
Households in the lowest wealth quintiles were at higher risk of CHE. Universal coverage of health insurance in Nigeria should be fast-tracked to give the expected financial risk protection and decreased incidence of CHE.- انتشار مقاله: 13-11-1392
- نویسندگان: Olayinka Stephen Ilesanmi,Akindele Adebiyi,Akinola Ayoola Fatiregun
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: Radical Neck Dissection,Modified Radical Neck Dissection,shoulder function,Muscle Energy Techniques,Active Range of Motion exercise
- چکیده:
- چکیده انگلیسی: Purpose: Shoulder and cervical pain, reduced mobility and disability are some of the major complications associated with surgeries of head and neck cancers affecting several domains of quality of life. In the present study we aimed to compare the effectiveness of Muscle Ener-gy Techniques (METS) and Active Range of Motion Exercises in reducing pain, improving shoulder mobility and function in patients post Modified Radical Neck Dissection (MRND). Methods: Forty eight subjects were randomly assigned to two groups. Group A received active range of motion (AROM) exercises and group B received Muscle energy techniques (METS). Both the groups were treated for a period of 10 consecutive days starting from the 3rd to 5th postoperative day. Data was collected on the 1st and 10th day of intervention. Results: Both groups showed highly significant improvements in shoulder range of motion , decrease in pain and better Global Rating Change cores(GRCS) (p=0.005). GRCS and shoul-der abduction showed significant improvement in group B when compared to group A, sug-gesting better clinical outcomes in those treated with Muscle Energy Techniques. Conclusion: This study showed that both METs and AROM exercises were effective in im-proving shoulder range of motion, function and reducing pain in patients post MRND but-Muscle Energy Techniques were more effective when compared to AROM exercises.
- انتشار مقاله: 09-03-1399
- نویسندگان: Anmol Thomas,Cherishma D’Silva,Leah Mohandas,Sudeep M J Pais,Stephen Rajan Samuel
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: Awareness,cervical cancer screening,Willingness,Uptake,Women living with HIV
- چکیده:
- چکیده انگلیسی: Background: Cervical cancer is among the most prevalent cancer among women worldwide and women living with HIV are at increased risk, especially in a resource-limited environment. Objective: This study aimed to determine levels of awareness, knowledge, uptake, and willingness to screen for cervical cancer among women receiving care in an HIV clinic at Dodoma Regional Referral Hospital (DRRH), Tanzania. Methods: Data were collected for a period of three weeks from July 21 to August 11, 2017 using a mobile phone data collection App. A total of 421 Women aged 18-50 years old were included in the study. Results: Majority of the women interviewed (n=306, 73%) were aware of cervical cancer. Among those who were aware, 84% (n=257) did not recall ever being screened for cervical cancer, and majority had a poor knowledge of cervical cancer. Educational level completed (p=0.01), income per month (p=0.02), age group (p<0.0001), and area of residence (p<0.0001) were all significantly associated to awareness of cervical cancer. Most of the women who have never screened (n=231, 91%) expressed willingness to be screened. Prior uptake of cervical cancer screening was associated with number of live births (p=0.001) and area of residence (p=0.04). And Willingness to screen was significantly associated with age groups (p=0.03) and the number of live births (p=0.03). Moreover, we found that younger age and urban residence was positively associated with awareness and uptake of cervical cancer screening. Willingness was found to decrease as age increased. Conclusion: The study found that despite older women’s higher risk of cervical cancer, those who indicated willingness to screen were younger. Additional education, health promotion, and integration of cervical cancer screening services is needed to improve cervical cancer awareness and screening uptake at the HIV clinic.
- انتشار مقاله: 10-12-1398
- نویسندگان: Moses New-Aaron,Jane L Meza,Martha H Goedert,Stephen M Kibusi,Mkhoi L Mkhoi,Caroline Damian Mayengo,James Charles,Siraji Shabani,Kelsie M Musil,Anlan Cheney,Samwel Sumba
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: Indian Standard Population,age adjusted rate,Age Standardised Rate,NCDIR,National population
- چکیده:
- چکیده انگلیسی: Objective: Standardization adjusts for variations in population age-distribution and provides a summary measure for the comparison of populations and comparisons of time-trends in population. Globally, several standard population were used by many countries for comparison of rates. Segi World Standard Population (WSP) is suitable for international comparison. However, national standard population would be more appropriate for Intra-national comparison as the standard should be similar to the population of interest. This study aimed to develop Indian Standard Population (ISP) for estimating Age Adjusted Rate (AAR) and, to understand the outcome on the cancer incidence rate using ISP in Population Based Cancer Registries (PBCRs). Methods: The Indian Standard Population was estimated based on the average age structure of three Censuses (1991,2001 and 2011). Age Adjusted Rate has been estimated using two standard populations of WSP and ISP for magnitude of change and comparison between 15 PBCRs in India. Results: The implementation of ISP led to overall 20% reduction in AAR for all sites of cancers in both sexes and minor relative changes in the ranking among PBCRs. Time trends in cancer incidence rate showed same temporal pattern curve using both ISP and WSP, AARs. Conclusion: The ISP would be more representative of the age-structure of Indian registries population and this would give more realistic comparison across the different PBCRs in India.
- انتشار مقاله: 16-03-1398
- نویسندگان: SathishKumar K,Vaitheeswaran K,Stephen S,Sathya N,Prashant Mathur
- مشاهده