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International Journal for Equity in Health

Juliane Tetzlaff, Jelena Epping, Stefanie Sperlich, Sveja Eberhard, Jona Theodor Stahmeyer, Siegfried Geyer
BACKGROUND: Previous research has produced evidence for social inequalities in multimorbidity, but little is known on how these disparities change over time. Our study investigates the development of social inequalities in multimorbidity among the middle-aged and older working population. Special attention is paid to whether differing time trends between socio-economic status (SES) groups have taken place, increasing or decreasing inequalities in multimorbidity. METHODS: The analyses are based on claims data of a German statutory health insurance company covering an observation period from 2005 to 2015...
July 16, 2018: International Journal for Equity in Health
Katia M S Figueiredo, Gleice A A Gonçalves, Hermes M T Batista, Marco Akerman, Woneska R Pinheiro, Vânia B Nascimento
BACKGROUND: Maternal mortality is a global public health problem. Statistics show that in 2013, 289,000 women died from complications during pregnancy, childbirth or the postpartum period worldwide. Between 2010 and 2015, there were 10,075 maternal deaths in Brazil, 3,522of which occurred in the Northeast region. The aim of this study was to investigate the actions taken by primary health care (PHC) professionals to reduce maternal mortality. METHOD: This was a cross-sectional, descriptive field study with a qualitative approach...
July 16, 2018: International Journal for Equity in Health
Paola A Mosquera, Miguel San Sebastian, Anneli Ivarsson, Per E Gustafsson
BACKGROUND: Socioeconomic inequalities in cardiovascular disease seem to widen or endure in Sweden. However, research on inequalities in antecedent cardiovascular risk factors (CVRFs), and particularly what underpins them, is scarce. The present study aimed 1) to estimate income-related inequalities in eight biological cardiovascular risk factors in Swedish middle-aged women and men; and 2) to examine the contribution of demographic, socioeconomic, behavioural and psychosocial determinants to the observed inequalities...
July 13, 2018: International Journal for Equity in Health
Nan Zhang
BACKGROUND: China has seen rapid socio-economic changes and epidemiological transitions in the last few decades. Previous studies often fail to examine how wider macro-level forces contribute to changes in health inequality among its population in China. This study aims to examine urban/rural inequalities in cardiovascular (CVD) risks biomarkers among Chinese adolescents in two decades from 1991 to 2011 during the process of China's rapid urbanisation. METHODS: Data were drawn from a nationwide longitudinal dataset of the China Health and Nutrition Survey (CHNS) (Sweeps 1991, 1993, 1997, 2000, 2004, 2006, 2009 and 2011)...
July 11, 2018: International Journal for Equity in Health
Alexander Kailembo, Raman Preet, Jennifer Stewart Williams
BACKGROUND: The 2015 Global Burden of Disease Study estimated that oral conditions affect 3.5 billion people worldwide with a higher burden among older adults and those who are socially and economically disadvantaged. Studies of inequalities in the use of oral health services by those in need have been conducted in high-income countries but evidence from low- and middle-income countries (LMICs) is limited. This study measures and describes socioeconomic inequality in self-reported unmet need for oral health services in adults aged 50 years and over, in China, Ghana and India...
July 11, 2018: International Journal for Equity in Health
Benjamin Uzochukwu, Emmanuel Onwujekwe, Chinyere Mbachu, Chinyere Okeke, Sassy Molyneux, Lucy Gilson
BACKGROUND: The Nigerian National Health Act proposes a radical shift in health financing in Nigeria through the establishment of a fund - Basic Healthcare Provision Fund, (BHCPF). This Fund is intended to improve the functioning of primary health care in Nigeria. Key stakeholders at national, sub-national and local levels have raised concerns over the management of the BHCPF with respect to the roles of various stakeholders in ensuring accountability for its use, and the readiness of the implementers to manage this fund and achieve its objectives...
July 11, 2018: International Journal for Equity in Health
Joe Varghese, Anneline Blankenhorn, Prasanna Saligram, John Porter, Kabir Sheikh
BACKGROUND: Current policy priorities to strengthen the nursing sector in India have focused on increasing the number of nurses in the health system. However, the nursing sector is afflicted by other, significant problems including the low status of nurses in the hierarchy of health care professionals, low salaries, and out-dated systems of professional governance, all affecting nurses' leadership potential and ability to perform. Stronger nurse leadership has the potential to support the achievement of health system goals, especially for strengthening of primary health care, which has been recognised and addressed in several other country contexts...
July 9, 2018: International Journal for Equity in Health
Panpan Zhao, Xiaoli Gu, Dongfu Qian, Fan Yang
BACKGROUND: Abdominal obesity has become an important public health issue in China. Socioeconomic disparities are thought to be closely related to the prevalence of abdominal obesity. Exploring socioeconomic disparities in abdominal obesity over the life course in China could inform the design of new interventions to prevent and control abdominal obesity. METHODS: The China Health and Nutrition Survey (CHNS) was a prospective household-based study involving seven rounds of surveys between 1993 and 2011...
July 5, 2018: International Journal for Equity in Health
A Relecom, B Arzel, T Perneger
BACKGROUND: Breast cancer stands as the leading cause of cancer related mortality in women worldwide. Mammography screening has the potential to improve prognosis by reducing stage at diagnosis. Socioeconomic inequalities in mammography cancer screening have been widely reported. The influence of organised programs on socioeconomic disparities regarding mammography screening is to date unclear. We aimed to investigate the impact of an organised regional screening program on socioeconomic inequalities in terms of the uptake, knowledge and attitudes towards mammography screening...
July 3, 2018: International Journal for Equity in Health
Yuqi Zhou, Xi Yao, Weiyan Jian
BACKGROUND: Beginning in 2010, China has endeavoured to expand health coverage and provide residents with fair access to primary health care with the intention of improving health equity. This study aims to measure changes in income-related health inequity in China between 2010 and 2014. METHODS: Data were extracted from the nationally representative annual survey of the China Family Panel Studies in 2010 and 2014 with a first wave of 31,743 respondents and a second wave of 32,006 respondents over age 15...
July 3, 2018: International Journal for Equity in Health
Luke Mondor, Deborah Cohen, Anum Irfan Khan, Walter P Wodchis
BACKGROUND: The burden of multimorbidity is a growing clinical and health system problem that is known to be associated with socioeconomic status, yet our understanding of the underlying determinants of inequalities in multimorbidity and longitudinal trends in measured disparities remains limited. METHODS: We included all adult respondents from four cycles of the Canadian Community Health Survey (CCHS) (between 2005 to 2011/12), linked at the individual-level to health administrative data in Ontario, Canada (pooled n = 113,627)...
June 26, 2018: International Journal for Equity in Health
Anika Winn, Erin Hetherington, Suzanne Tough
BACKGROUND: Female refugees can be a vulnerable population, often having suffered through traumatic events that pose risks to their health, especially during pregnancy. Pregnancy can be an entry point into the health care system, providing health care professionals the opportunity to gain women's trust, connect refugees with resources, and optimize the health of mother and child. Policies surrounding the provision and funding of health care services to refugees can impact access to and quality of care...
June 26, 2018: International Journal for Equity in Health
Bart Jacobs, Ashish Bajracharya, Jyotirmoy Saha, Chhorvann Chhea, Ben Bellows, Steffen Flessa, Adelio Fernandes Antunes
BACKGROUND: Following the introduction of user fees in Cambodia, Health Equity Funds (HEF) were developed to enable poor people access to public health services by paying public health providers on their behalf, including non-medical costs for hospitalised beneficiaries (HEFB). The national scheme covers 3.1 million pre-identified HEFB. Uptake of benefits, however, has been mixed and a substantial proportion of poor people still initiate care at private facilities where they incur considerable out-of-pocket costs...
June 25, 2018: International Journal for Equity in Health
Yudong Miao, Jianqin Gu, Liang Zhang, Ruibo He, Sandeep Sandeep, Jian Wu
BACKGROUND: China has set up a universal coverage social health insurance system since the 2009 healthcare reform. Due to the inadequate funds, the social health insurance system reimbursed the inpatient expenditures with much higher ratio than outpatient expenditure. The gap in reimbursement ratios resulted in a rapid rising hospitalization rate but poor health outcomes among the Chinese population. A redistribution of social health insurance funds has become one of the main challenges for the performance of Social Health Insurance...
June 25, 2018: International Journal for Equity in Health
Xinyi Zhang, Zerin Imam Syeda, Zhengyue Jing, Qiongqiong Xu, Long Sun, Lingzhong Xu, Chengchao Zhou
BACKGROUND: Compared with the Expanded Program on Immunization (EPI) vaccines, the coverage rate of the non-EPI vaccines is still low. The aim of this study is to explore the rural-urban disparity in category II vaccine and its determinants among children under 5 years old in China. METHODS: A cross-sectional study was conducted in 17 cities in Shandong province from August to October, 2013. A total of 1638 children were included in the analysis. Unadjusted and adjusted regression model were used to identify the rural-urban difference in vaccination of category II vaccine...
June 22, 2018: International Journal for Equity in Health
Vincent Dei, Miguel San Sebastian
BACKGROUND: There is a lack of focused research on the older population in Ghana and about issues pertaining to their access to healthcare services. Furthermore, information is lacking regarding the fairness in the access to these services. This study aimed to ascertain whether horizontal and vertical equity requirements were being met in the healthcare utilisation among older adults aged 50 years and above. METHODS: This study was based on a secondary cross-sectional data from the World Health Organization's Study on global AGEing (SAGE) and adult health wave 1 conducted from 2007 to 2008 in Ghana...
June 20, 2018: International Journal for Equity in Health
Fidelia A A Dake
BACKGROUND: Following years of out-of-pocket payment for healthcare, some countries in Africa including Ghana, Kenya and Rwanda have instituted social health protection programs through health insurance to provide access to quality and affordable healthcare especially for the poor. This paper examines equity in coverage under Ghana's National Health Insurance Scheme (NHIS). METHODS: Secondary data from the 2008 Ghana Demographic and Health Survey based on an analytical sample of 4821 females (15-49 years) and 4568 males (15-59 years) were analysed using descriptive, bivariate and multivariate methods...
June 18, 2018: International Journal for Equity in Health
Nicole Bergen, Abebe Mamo, Shifera Asfaw, Lakew Abebe, Jaameeta Kurji, Getachew Kiros, Muluemebet Abera, Gebeyehu Bulcha Duguma, Kunuz Haji Bedru, Manisha A Kulkarni, Ronald Labonté, Sudhakar Morankar
BACKGROUND: The Safe Motherhood Research Project studies the implementation and scale-up of maternal, newborn and child health (MNCH) initiatives in Jimma Zone, Ethiopia. This qualitative rapid assessment study was undertaken to explore community perceptions and experiences related to health, health inequality and other MNCH themes. METHODS: We conducted 12 focus group discussions and 24 in-depth interviews with community stakeholder groups (female and male community members, Health Extension Workers, members of the Women Development Army and Male Development Army, and religious leaders) across six rural sites in Jimma Zone...
June 18, 2018: International Journal for Equity in Health
Victoria Nkunu, Kevin J McLaughlin
BACKGROUND: Despite the reputation of Canada's healthcare system as being accessible to all Canadians, certain populations continue to face inequities within our healthcare system. In addition to promoting fairness, addressing healthcare inequities has the potential to reduce healthcare costs, which is increasingly important as healthcare costs continue to rise. Intentionally or otherwise, physicians are often leaders in healthcare teams, but there is a paucity of literature on physicians' perceptions of the problem of healthcare inequities and their potential role in addressing inequities...
June 15, 2018: International Journal for Equity in Health
Min Su, Yafei Si, Zhongliang Zhou, Chi Shen, Wanyue Dong, Xiaojing Fan, Xiao Wang, Xiaolin Wei
BACKGROUND: Hypertension has become a global health challenge given its high prevalence and but low awareness and detection. Whether the actual prevalence of hypertension has been estimated is important, especially for the poor. This study aimed to measure tested prevalence and self-reported prevalence of hypertension and compare the inequity between them in China. METHODS: Data were derived from China Health and Nutrition Survey (CHNS) conducted in 2011. By using the multistage, stratified, random sampling method, 12,168 respondents aged 18 or older were identified for analysis...
June 15, 2018: International Journal for Equity in Health
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