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International Journal for Equity in Health

Wenzhe Qin, Lingzhong Xu, Jiajia Li, Long Sun, Gan Ding, Hui Shao, Ningze Xu
BACKGROUND: Government health subsidy (GHS) is an effective tool to improve population health in China. Ensuring an equitable allocation of GHS, particularly among the poorer socio-economic groups, is a major goal of China's healthcare reform. The paper aims to explore how GHS was allocated across different socioeconomic groups, and how well the overall health system was performing in terms of the allocation of subsidy for different types of health services. METHODS: Data from China's National Health Services Survey (NHSS) in 2013 were used...
May 18, 2018: International Journal for Equity in Health
Amanda Jayakody, Erin Passmore, Christopher Oldmeadow, Jamie Bryant, Mariko Carey, Eunice Simons, Aaron Cashmore, Louise Maher, Kiel Hennessey, Jacinta Bunfield, Maurice Terare, Andrew Milat, Rob Sanson-Fisher
BACKGROUND: Chronic diseases are more prevalent and occur at a much younger age in Aboriginal people in Australia compared with non-Aboriginal people. Aboriginal people also have higher rates of unplanned hospital readmissions and emergency department presentations. There is a paucity of research on the effectiveness of follow up programs after discharge from hospital in Aboriginal populations. This study aimed to assess the impact of a telephone follow up program, 48 Hour Follow Up, on rates of unplanned hospital readmissions, unplanned emergency department presentations and mortality within 28 days of discharge among Aboriginal people with chronic disease...
May 18, 2018: International Journal for Equity in Health
Anna Brydsten, Anne Hammarström, Miguel San Sebastian
BACKGROUND: Even though population health is strongly influenced by employment and working conditions, public health research has to a lesser extent explored the social determinants of health inequalities between people in different positions on the labour market, and whether these social determinants vary across the life course. This study analyses mental health inequalities between unemployed and employed in three age groups (youth, adulthood and mid-life), and identifies the extent to which social determinants explain the mental health gap between employed and unemployed in northern Sweden...
May 16, 2018: International Journal for Equity in Health
Takondwa Mwase, Stephan Brenner, Jacob Mazalale, Julia Lohmann, Saidou Hamadou, Serge M A Somda, Valery Ridde, Manuela De Allegri
BACKGROUND: Poor and marginalized segments of society often display the worst health status due to limited access to health enhancing interventions. It follows that in order to enhance the health status of entire populations, inequities in access to health care services need to be addressed as an inherent element of any effort targeting Universal Health Coverage. In line with this observation and the need to generate evidence on the equity status quo in sub-Saharan Africa, we assessed the magnitude of the inequities and their determinants in coverage of maternal health services in Burkina Faso...
May 11, 2018: International Journal for Equity in Health
Kai Liu, Chunling Lu
BACKGROUND: Ensuring equal access to care and providing financial risk protection are at the center of the global health agenda. While Rwanda has made impressive progress in improving health outcomes, inequalities in medical care utilization and household catastrophic health spending (HCHS) between the impoverished and non-impoverished populations persist. Decomposing inequalities will help us understand the factors contributing to inequalities and design effective policy instruments in reducing inequalities...
May 10, 2018: International Journal for Equity in Health
Esther E Idehen, Päivikki Koponen, Tommi Härkänen, Mari Kangasniemi, Anna-Maija Pietilä, Tellervo Korhonen
BACKGROUND: Cervical cancer is currently ranked as the fourth commonly diagnosed cancer in women globally. A higher incidence has been reported in low- and-middle-income countries, and the disease poses significant public health challenges. Evidence suggests that this disease is preventable by means of regular screening using the Papanicolaou (Pap) test. However, limited knowledge exists about disparities in cervical screening participation among immigrants compared with non-immigrants, in countries with universal cervical screening programmes...
May 4, 2018: International Journal for Equity in Health
Zhong Li, Jian Yang, Yue Wu, Zijin Pan, Xiaoqun He, Boyang Li, Liang Zhang
BACKGROUND: China's rapid transition in healthcare service system has posed considerable challenges for the primary care system. Little is known regarding the capacity of township hospitals (THs) to deliver surgical care in rural China with over 600 million lives. We aimed to ascertain its current performance, barriers, and summary lessons for its re-building in central China. METHODS: This study was conducted in four counties from two provinces in central China...
May 2, 2018: International Journal for Equity in Health
Rao Chen, Ning-Xiu Li, Xiang Liu
BACKGROUND: The equity of medical services utilization for elderly individuals enrolled in different basic social medical insurance systems holds significant meaning for social harmony against a background of demographic aging and a growing wealth gap in China. This study is to explore the equity of the three medical insurance systems in southwest China with the aim of providing recommendations for relevant policy. METHODS: A total of 9600 elderly people insured through basic social medical insurance were selected and interviewed with a questionnaire...
May 2, 2018: International Journal for Equity in Health
Stella M Umuhoza, John E Ataguba
BACKGROUND: Socioeconomic inequalities in health have been documented in many countries including those in the Southern African Development Community (SADC). However, a comprehensive assessment of health inequalities and inequalities in the distribution of health risk factors is scarce. This study specifically investigates inequalities both in poor self-assessed health (SAH) and in the distribution of selected risk factors of ill-health among the adult populations in six SADC countries...
April 27, 2018: International Journal for Equity in Health
Sayem Ahmed, Sylvia Szabo, Kristine Nilsen
BACKGROUND: Universal health coverage implies that people obtain the health services they need without experiencing financial hardship. While the factors contributing to catastrophic health expenditure (CHE) among households are well understood, few studies have examined this relationship in the context of environmentally vulnerable regions, such as tropical deltas. This study aims to examine the disparities in the prevalence of CHE and impoverishment due to out-of-pocket (OOP) healthcare payments in the Mekong Delta in comparison with rest of Vietnam...
April 27, 2018: International Journal for Equity in Health
Chenwen Zhong, Li Kuang, Lina Li, Yuan Liang, Jie Mei, Li Li
BACKGROUND: The equity of rural-to-urban migrants' health care utilization is already on China's agenda. The Chinese government has been embarking on efforts to improve the financial and geographical accessibility of health care for migrants by strengthening primary care services and providing universal coverage. Patient experiences are equally vital to migrants' health care utilization. To our knowledge, no studies have focused on equity in the patient experiences between migrants and locals...
April 27, 2018: International Journal for Equity in Health
Nirali M Chakraborty, Andrea Sprockett
BACKGROUND: A key component of universal health coverage is the ability to access quality healthcare without financial hardship. Poorer individuals are less likely to receive care than wealthier individuals, leading to important differences in health outcomes, and a needed focus on equity. To improve access to healthcare while minimizing financial hardships or inequitable service delivery we need to understand where individuals of different wealth seek care. To ensure progress toward SDG 3, we need to specifically understand where individuals seek reproductive, maternal, and child health services...
April 24, 2018: International Journal for Equity in Health
Bernadette Pauly, Wanda Martin, Kathleen Perkin, Thea van Roode, Albert Kwan, Tobie Patterson, Samantha Tong, Cheryl Prescott, Bruce Wallace, Trevor Hancock, Marjorie MacDonald
BACKGROUND: Promoting health equity within health systems is a priority and challenge worldwide. Health equity tools have been identified as one strategy for integrating health equity considerations into health systems. Although there has been a proliferation of health equity tools, there has been limited attention to evaluating these tools for their practicality and thus their likelihood for uptake. METHODS: Within the context of a large program of research, the Equity Lens in Public Health (ELPH), we conducted a concept mapping study to identify key elements and themes related to public health leaders and practitioners' views about what makes a health equity tool practical and useful...
April 23, 2018: International Journal for Equity in Health
Hongwei Hu, Jiamin Gao, Haochen Jiang, Pingnan Xing
BACKGROUND: Children who suffer from parental migration have been manifested to exhibit physical and mental impairments at higher rates. This current study aims to explore unintentional injury disparity among schooling left-behind children, migrant children and residential children in China, and to examine the risk factors of unintentional injury among the three types of children based on a multi-level system framework. This study will fill the gaps of this topic for China and contribute to the world literature in the context of countries with frequent population migration...
April 23, 2018: International Journal for Equity in Health
Nele van der Wielen, Jane Falkingham, Andrew Amos Channon
BACKGROUND: Ghana is currently undergoing a profound demographic transition, with large increases in the number of older adults in the population. Older adults require greater levels of healthcare as illness and disability increase with age. Ghana therefore provides an important and timely case study of policy implementation aimed at improving equal access to healthcare in the context of population ageing. This paper examines the determinants of National Health Insurance (NHIS) enrolment in Ghana, using two different surveys and distinguishing between younger and older adults...
April 23, 2018: International Journal for Equity in Health
Marya Gwadz, Noelle R Leonard, Sylvie Honig, Robert Freeman, Alexandra Kutnick, Amanda S Ritchie
BACKGROUND: Annual HIV testing is recommended for populations at-risk for HIV in the United States, including heterosexuals geographically connected to urban high-risk areas (HRA) with elevated rates of HIV prevalence and poverty, who are primarily African American/Black or Hispanic. Yet this subpopulation of "individuals residing in HRA" (IR-HRA) evidence low rates of regular HIV testing. HIV stigma is a recognized primary barrier to testing, in part due to its interaction with other stigmatized social identities...
April 20, 2018: International Journal for Equity in Health
Ambepitiyawaduge Pubudu De Silva, Sudirikku Hennadige Padmal De Silva, Rashan Haniffa, Isurujith Kongala Liyanage, Saroj Jayasinghe, Prasad Katulanda, Chandrika Neelakanthi Wijeratne, Sumedha Wijeratne, Lalini Chandika Rajapaksa
BACKGROUND: Explorations into quantifying the inequalities for diabetes mellitus (DM) and its risk factors are scarce in low and lower middle income countries (LICs/LMICs). The aims of this study were to assess the inequalities of DM and its risk factors in a suburban district of Sri Lanka. METHODS: A sample of 1300 participants, (aged 35-64 years) randomly selected using a stratified multi-stage cluster sampling method, were studied employing a cross sectional descriptive design...
April 17, 2018: International Journal for Equity in Health
Vahid Yazdi-Feyzabadi, Mina Bahrampour, Arash Rashidian, Ali-Akbar Haghdoost, Mohammadreza Akbari Javar, Mohammad Hossein Mehrolhassani
BACKGROUND: Households exposure to catastrophic health expenditure is a valuable measure to monitor financial protection in health sector payments. The present study had two aims: first, to estimate the prevalence and intensity of catastrophic health expenditures (CHE) in Iran. Second, to investigate main factors that influence the probability of CHE. METHODS: CHE is defined as an occasion in which a household's out-of-pocket (OOP) spending exceeds 40% of the total income that remains after subtraction of living expenses...
April 13, 2018: International Journal for Equity in Health
Amaila De La Torre, Zlatko Nikoloski, Elias Mossialos
BACKGROUND: Reducing maternal mortality is a top priority in Latin American countries. Despite the progress in maternal mortality reduction, Brazil and Colombia still lag behind countries at similar levels of development. METHODS: Using data from the Demographic Health Survey, this study quantified and compared, by means of concentration indices, the socioeconomic-related inequity in access to four key maternal health interventions in Brazil and Colombia. Decomposition analysis of the concentration index was used for two indicators - skilled attendance at birth and postnatal care in Brazil...
April 11, 2018: International Journal for Equity in Health
Madelene Barboza, Asli Kulane, Bo Burström, Anneli Marttila
BACKGROUND: Health inequities among children in Sweden persist despite the country's well-developed welfare system and near universal access to the national child health care programme. A multisectoral extended home visiting intervention, based on the principles of proportionate universalism, has been carried out in a disadvantaged area since 2013. The present study investigates the content of the meetings between families and professionals during the home visits to gain a deeper understanding of how it relates to a health equity perspective on early childhood development...
April 10, 2018: International Journal for Equity in Health
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