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International Journal for Equity in Health

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https://www.readbyqxmd.com/read/29037209/understanding-the-effects-of-socioeconomic-status-along-the-breast-cancer-continuum-in-australian-women-a-systematic-review-of-evidence
#1
REVIEW
Greg Lyle, Gilly A Hendrie, Delia Hendrie
BACKGROUND: Globally, the provision of equitable outcomes for women with breast cancer is a priority for governments. However, there is growing evidence that a socioeconomic status (SES) gradient exists in outcomes across the breast cancer continuum - namely incidence, diagnosis, treatment, survival and mortality. This systematic review describes this evidence and, because of the importance of place in defining SES, findings are limited to the Australian experience. METHODS: An on-line search of PubMed and the Web of Science identified 44 studies published since 1995 which examined the influence of SES along the continuum...
October 16, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29025434/minimum-dietary-diversity-and-associated-factors-among-children-aged-6-23%C3%A2-months-in-addis-ababa-ethiopia
#2
Dagmawit Solomon, Zewdie Aderaw, Teketo Kassaw Tegegne
BACKGROUND: Dietary diversity has long been recognized as a key element of high quality diets. Minimum Dietary Diversity (MDD) is the consumption of four or more food groups from the seven food groups. Globally, only few children are receiving nutritionally adequate and diversified foods. More than two-thirds of malnutrition related child deaths are associated with inappropriate feeding practice during the first two years of life. In Ethiopia, only 7 % of children age 6-23 months had received the minimum acceptable diet...
October 12, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29017564/factors-influencing-risky-sexual-behaviour-among-mozambican-miners-a-socio-epidemiological-contribution-for-hiv-prevention-framework-in-mozambique
#3
Emilia Martins-Fonteyn, Osvaldo Loquiha, Cynthia Baltazar, Subash Thapa, Makini Boothe, Ines Raimundo, Niel Hens, Marc Aerts, Herman Meulemans, Olivier Degomme, Edwin Wouters
BACKGROUND: Information dealing with social and behavioural risk factors as well as their mechanisms among Mozambican migrants working in South African mines remains undocumented. This study aims to understand the various factors influencing HIV-related risk behaviours and the resulting HIV positive status of Mozambican miners employed by South African mines. This analysis was undertaken in order to inform a broader and more effective HIV preventive framework in Mozambique. METHOD: This study relied upon data sourced from the first Integrated Biological and Behavioural Survey among Mozambican miners earning their living in South African mines...
October 10, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29017542/financial-burden-of-healthcare-for-cancer-patients-with-social-medical-insurance-a-multi-centered-study-in-urban-china
#4
Wenhui Mao, Shenglan Tang, Ying Zhu, Zening Xie, Wen Chen
BACKGROUND: Cancer accounts for one-fifth of the total deaths in China and brings heavy financial burden to patients and their families. Chinese government has made strong commitment to develop three types of social medical insurance since 1997 and recently, more attempts were invested to provide better financial protection. To analyze health services utilization and financial burden of insured cancer patients, and identify the gaps of financial protection provided by insurance in urban China...
October 10, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28982362/the-scope-and-impact-of-mobile-health-clinics-in-the-united-states-a-literature-review
#5
REVIEW
Stephanie W Y Yu, Caterina Hill, Mariesa L Ricks, Jennifer Bennet, Nancy E Oriol
As the U.S. healthcare system transforms its care delivery model to increase healthcare accessibility and improve health outcomes, it is undergoing changes in the context of ever-increasing chronic disease burdens and healthcare costs. Many illnesses disproportionately affect certain populations, due to disparities in healthcare access and social determinants of health. These disparities represent a key area to target in order to better our nation's overall health and decrease healthcare expenditures. It is thus imperative for policymakers and health professionals to develop innovative interventions that sustainably manage chronic diseases, promote preventative health, and improve outcomes among communities disenfranchised from traditional healthcare as well as among the general population...
October 5, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28978328/anxiety-and-depression-in-older-patients-the-role-of-culture-and-acculturation
#6
Anna Zisberg
BACKGROUND: Anxiety and depression are major health concerns in general among older adults and especially during hospitalization, as they lead to numerous negative outcomes. There is currently no sufficient body of research examining the role of cultural background in patients' experience of these conditions. Better identifying patients at risk may help reduce inequity and provide patient-centered, culturally sensitive care. The current study explores the roles of culture and acculturation in anxiety and depression levels in recent and veteran Russian immigrants compared with native Israelis and veteran immigrants from Middle Eastern countries...
October 4, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28974255/comparison-of-patient-perceived-primary-care-quality-in-public-clinics-public-hospitals-and-private-clinics-in-rural-china
#7
Wenhua Wang, Elizabeth Maitland, Stephen Nicholas, Ekaterina Loban, Jeannie Haggerty
BACKGROUND: In rural China, patients have free choice of health facilities for outpatient services. Comparison studies exploring the attributes of different health facilities can help identify optimal primary care service models. Using a representative sample of Chinese provinces, this study aimed to compare patients' rating of three primary care service models used by rural residents (public clinics, public hospitals and private clinics) on a range of health care attributes related to responsiveness...
October 3, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28974223/ageing-under-unequal-circumstances-a-cross-sectional-analysis-of-the-gender-and-socioeconomic-patterning-of-functional-limitations-among-the-southern-european-elderly
#8
Manuel Serrano-Alarcón, Julian Perelman
BACKGROUND: In a context of population ageing, it is a priority for planning and prevention to understand the socioeconomic (SE) patterning of functional limitations and its consequences on healthcare needs. This paper aims at measuring the gender and SE inequalities in functional limitations and their age of onset among the Southern European elderly; then, we evaluate how functional status is linked to formal and informal care use. METHODS: We used Portuguese, Italian and Spanish data from the Survey of Health, Ageing and Retirement in Europe (SHARE) of 2011 (n = 9233)...
October 3, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28962656/equity-in-health-financing-of-guangxi-after-china-s-universal-health-coverage-evidence-based-on-health-expenditure-comparison-in-rural-guangxi-zhuang-autonomous-region-from-2009-to-2013
#9
Xianjing Qin, Hongye Luo, Jun Feng, Yanning Li, Bo Wei, Qiming Feng
BACKGROUND: Healthcare financing should be equitable. Fairness in financial contribution and protection against financial risk is based on the notion that every household should pay a fair share. Health policy makers have long been concerned with protecting people from the possibility that ill health will lead to catastrophic financial payments and subsequent impoverishment. A number of studies on health care financing equity have been conducted in some provinces of China, but in Guangxi, we found such observation is not enough...
September 29, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28950875/different-indicators-of-socioeconomic-status-and-their-relative-importance-as-determinants-of-health-in-old-age
#10
Alexander Darin-Mattsson, Stefan Fors, Ingemar Kåreholt
BACKGROUND: Socioeconomic status has been operationalised in a variety of ways, most commonly as education, social class, or income. In this study, we also use occupational complexity and a SES-index as alternative measures of socioeconomic status. Studies show that in analyses of health inequalities in the general population, the choice of indicators influence the magnitude of the observed inequalities. Less is known about the influence of indicator choice in studies of older adults...
September 26, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28923069/perceived-barriers-and-enablers-to-participation-in-a-community-tailored-physical-activity-program-with-indigenous-australians-in-a-regional-and-rural-setting-a-qualitative-study
#11
Ashleigh Sushames, Terry Engelberg, Klaus Gebel
BACKGROUND: Aboriginal and Torres Strait Islander people have higher rates of chronic disease and a lower life expectancy than non-Indigenous Australians. In non-urban areas these health disparities are even larger. The aim of this qualitative study was to explore perceived barriers and enablers to attending an eight-week physical activity program in a rural and regional setting which aimed to improve health outcomes, but had a low attendance rate. METHODS: Thirty-four Indigenous Australians participated in the intervention from the rural (n = 12) and the regional (n = 22) community...
September 18, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28911338/organisational-culture-and-trust-as-influences-over-the-implementation-of-equity-oriented-policy-in-two-south-african-case-study-hospitals
#12
Ermin Erasmus, Lucy Gilson, Veloshnee Govender, Moremi Nkosi
BACKGROUND: This paper uses the concepts of organisational culture and organisational trust to explore the implementation of equity-oriented policies - the Uniform Patient Fee Schedule (UPFS) and Patients' Rights Charter (PRC) - in two South African district hospitals. It contributes to the small literatures on organisational culture and trust in low- and middle-income country health systems, and broader work on health systems' people-centeredness and "software". METHODS: The research entailed semi-structured interviews (Hospital A n = 115, Hospital B n = 80) with provincial, regional, district and hospital managers, as well as clinical and non-clinical hospital staff, hospital board members, and patients; observations of policy implementation, organisational functioning, staff interactions and patient-provider interactions; and structured surveys operationalising the Competing Values Framework for measuring organisational culture (Hospital A n = 155, Hospital B n = 77) and Organisational Trust Inventory (Hospital A n = 185, Hospital B n = 92) for assessing staff-manager trust...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28911337/postings-and-transfers-in-the-ghanaian-health-system-a-study-of-health-workforce-governance
#13
Aku Kwamie, Miriam Asiamah, Marta Schaaf, Irene Akua Agyepong
BACKGROUND: Decision-making on postings and transfers - that is, the geographic deployment of the health workforce - is a key element of health workforce governance. When poorly managed, postings and transfers result in maldistribution, absenteeism, and low morale. At stake is managing the balance between organisational (i.e., health system) and individual (i.e., staff preference) needs. The negotiation of this potential convergence or divergence of interests provides a window on practices of postings and transfers, and on the micro-practices of governance in health systems more generally...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28911332/-we-are-toothless-and-hanging-but-optimistic-sub-county-managers-experiences-of-rapid-devolution-in-coastal-kenya
#14
Mary M Nyikuri, Benjamin Tsofa, Philip Okoth, Edwine W Barasa, Sassy Molyneux
BACKGROUND: In March 2013, Kenya transitioned from a centralized to a devolved system of governance. Within the health sector, this entailed the transfer of service provision functions to 47 newly formed semi-autonomous counties, while policy and regulatory functions were retained at the national level. The devolution process was rapid rather than progressive. METHODS: We conducted qualitative research within one county to examine the early experiences of devolution in the health sector...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28911328/devolution-and-its-effects-on-health-workforce-and-commodities-management-early-implementation-experiences-in-kilifi-county-kenya
#15
Benjamin Tsofa, Catherine Goodman, Lucy Gilson, Sassy Molyneux
BACKGROUND: Decentralisation is argued to promote community participation, accountability, technical efficiency, and equity in the management of resources, and has been a recurring theme in health system reforms for several decades. In 2010, Kenya passed a new constitution that introduced 47 semi-autonomous county governments, with substantial transfer of responsibility for health service delivery from the central government to these counties. Focusing on two key elements of the health system, Human Resources for Health (HRH) and Essential Medicines and Medical Supplies (EMMS) management, we analysed the early implementation experiences of this major governance reform at county level...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28911327/negotiating-power-relations-gender-equality-and-collective-agency-are-village-health-committees-transformative-social-spaces-in-northern-india
#16
Kerry Scott, Asha S George, Steven A Harvey, Shinjini Mondal, Gupteswar Patel, Kabir Sheikh
BACKGROUND: Participatory health initiatives ideally support progressive social change and stronger collective agency for marginalized groups. However, this empowering potential is often limited by inequalities within communities and between communities and outside actors (i.e. government officials, policymakers). We examined how the participatory initiative of Village Health, Sanitation, and Nutrition Committees (VHSNCs) can enable and hinder the renegotiation of power in rural north India...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28911325/how-does-decentralisation-affect-health-sector-planning-and-financial-management-a-case-study-of-early-effects-of-devolution-in-kilifi-county-kenya
#17
Benjamin Tsofa, Sassy Molyneux, Lucy Gilson, Catherine Goodman
BACKGROUND: A common challenge for health sector planning and budgeting has been the misalignment between policies, technical planning and budgetary allocation; and inadequate community involvement in priority setting. Health system decentralisation has often been promoted to address health sector planning and budgeting challenges through promoting community participation, accountability, and technical efficiency in resource management. In 2010, Kenya passed a new constitution that introduced 47 semi-autonomous devolved county governments, and a substantial transfer of responsibility for healthcare from the central government to these counties...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28911324/leadership-and-governance-of-community-health-worker-programmes-at-scale-a-cross-case-analysis-of-provincial-implementation-in-south-africa
#18
Helen Schneider, Nonhlanhla Nxumalo
BACKGROUND: National community health worker (CHW) programmes are returning to favour as an integral part of primary health care systems, often on the back of pre-existing community based initiatives. There are significant challenges to the integration and support of such programmes, and they require coordination and stewardship at all levels of the health system. This paper explores the leadership and governance tasks of large-scale CHW programmes at sub-national level, through the case of national reforms to South Africa's community based sector, referred to as the Ward Based Outreach Team (WBOT) strategy...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28911323/exploring-how-different-modes-of-governance-act-across-health-system-levels-to-influence-primary-healthcare-facility-managers-use-of-information-in-decision-making-experience-from-cape-town-south-africa
#19
Vera Scott, Lucy Gilson
BACKGROUND: Governance, which includes decision-making at all levels of the health system, and information have been identified as key, interacting levers of health system strengthening. However there is an extensive literature detailing the challenges of supporting health managers to use formal information from health information systems (HISs) in their decision-making. While health information needs differ across levels of the health system there has been surprisingly little empirical work considering what information is actually used by primary healthcare facility managers in managing, and making decisions about, service delivery...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28911320/practicing-governance-towards-equity-in-health-systems-lmic-perspectives-and-experience
#20
EDITORIAL
Lucy Gilson, Uta Lehmann, Helen Schneider
The unifying theme of the papers in this series is a concern for understanding the everyday practice of governance in low- and middle-income country (LMIC) health systems. Rather than seeing governance as a normative health system goal addressed through the architecture and design of accountability and regulatory frameworks, these papers provide insights into the real-world decision-making of health policy and system actors. Their multiple, routine decisions translate policy intentions into practice - and are filtered through relationships, underpinned by values and norms, influenced by organizational structures and resources, and embedded in historical and socio-political contexts...
September 15, 2017: International Journal for Equity in Health
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