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International Journal for Equity in Health

Carlijn B M Kamphuis, Joost Oude Groeniger, Frank J van Lenthe
BACKGROUND: The importance of culture for food consumption is widely acknowledged, as well as the fact that culture-based resources ("cultural capital") differ between educational groups. Since current explanations for educational inequalities in healthy and unhealthy food consumption (e.g. economic capital, social capital) are unable to fully explain this gradient, we aim to investigate a new explanation for educational inequalities in healthy food consumption, i.e. the role of cultural capital...
November 15, 2018: International Journal for Equity in Health
Seung Hyun Kang, Yeong Jun Ju, Hyo Jung Yoon, Sang Ah Lee, Woorim Kim, Eun-Cheol Park
OBJECTIVES: The objective of our study was to investigate the relationship between catastrophic health expenditure (CHE) and health-related quality of life (HRQoL) in general population. METHODS: We used Korean Health Panel Survey data from 2011 to 2013, which included data from 8850 baseline participants of 19 years of age or older. We defined CHE as total annual out-of-pocket health payment that was 40% greater than the household's capacity to pay. HRQoL was measured using the EuroQol-visual analogue scale (EQ-VAS)...
November 14, 2018: International Journal for Equity in Health
Mahamat Fayiz Abakar, Djimet Seli, Filippo Lechthaler, Esther Schelling, Nhan Tran, Jakob Zinsstag, Daniel Cobos Muñoz
BACKGROUND: Demand side barriers to vaccination among rural and hard-to-reach populations in Chad are not yet well understood. Although innovative approaches such as linking human and animal vaccination increase vaccination uptake among mobile pastoralist communities, vaccination coverage in these communities is still lower than for rural settled populations. We hypothesize that mobile pastoralists' communities in Chad face specific demand side barriers to access vaccination services...
November 14, 2018: International Journal for Equity in Health
Munjae Lee, Kichan Yoon, Kyu-Sung Lee
BACKGROUND: This study aimed to verify the mediating effect of using assistive devices as a factor that alleviates the relationship between multimorbidity and subjective health status. METHODS: This study used three-year data (2011-2013) from the Korea Health Panel (KHP). The data were jointly collected by the consortium of the National Health Insurance Service and Korea Institute for Health and Social Affairs. RESULTS: The mediating effect of using assistive devices was verified, but the direction of the effect was deteriorated subjective health...
November 12, 2018: International Journal for Equity in Health
Liming Lu, Jingchun Zeng
OBJECTIVES: This study identifies inequities in the provincial-level geographical distribution of traditional Chinese Medicine (TCM) hospital beds and doctors in China from 2004 to 2014. This provides policy implications of the optimal allocation of TCM health care resources. METHODS: Our study used province level data on TCM hospital beds and doctors from 2004 to 2014. These data were obtained from the China TCM Yearbook 2004-2014 and the China Statistical Yearbook 2004-2014...
November 12, 2018: International Journal for Equity in Health
Curtis Huffman, Edwin van Gameren
BACKGROUND: We analyze the effects of the Mexican universal health insurance program, Seguro Popular, on key variables associated with the provision of healthcare services. Given that the program was introduced gradually over a period that lasted more than a decade, the dynamics of the roll-out of the program and its reaction to the expansion of healthcare services it caused should be accounted for when evaluating the program. METHODS: We present a new semiparametric procedure to analyze time-varying continuous interventions...
November 8, 2018: International Journal for Equity in Health
Lidan Wang, Weizhen Dong, Yunqing Ou, Shuting Chen, Jingjing Chen, Qicheng Jiang
OBJECTIVE: Self-rated health represents a reliable and important health measure related to general health and quality of life. This study aimed to identify the differences of health states of rural residents in a lower middle income setting in China and its associated factors. METHODS: A descriptive study of a stratified random sample of 3870 individuals was conducted in rural Anhui during 2015. We investigated the influence of five independent variables: individual demographic characteristics, family factors, social capital traits, physical health conditions and healthy lifestyle habits of participants who self-related their health as good...
November 8, 2018: International Journal for Equity in Health
Kathleen A Culhane-Pera, Luis Martin Ortega, Mai See Thao, Shannon L Pergament, Andrew M Pattock, Lynne S Ogawa, Michael Scandrett, David J Satin
BACKGROUND: Quality metrics, pay for performance (P4P), and value-based payments are prominent aspects of the current and future American healthcare system. However, linking clinic payment to clinic quality measures may financially disadvantage safety-net clinics and their patient population because safety-net clinics often have worse quality metric scores than non-safety net clinics. The Minnesota Safety Net Coalition's Quality Measurement Enhancement Project sought to collect data from primary care providers' (PCPs) experiences, which could assist Minnesota policymakers and state agencies as they create a new P4P system...
November 7, 2018: International Journal for Equity in Health
Jens Klein, Olaf von dem Knesebeck
BACKGROUND: Despite the growing number of people with migrant background in Germany, a systematic review about their utilization of health care and differences to the non-migrant population is lacking. By covering various sectors of health care and migrant populations, the review aimed at giving a general overview and identifying special areas of potential intervention. METHODS: A systematic review was conducted in PubMed database including records that were published until 1st of June 2017...
November 1, 2018: International Journal for Equity in Health
Liz Croot, Melanie Rimmer, Sarah Salway, Chris Hatton, Emma Dowse, Jacquie Lavin, Sarah E Bennett, Janet Harris, Alicia O'Cathain
BACKGROUND: People with intellectual disabilities (ID) may not be able to access and respond to uniformly delivered health interventions. Public bodies have a legal duty to make 'reasonable adjustments' to policies and practices to provide fair access and treatment for people with ID. This study aimed to identify adjustments to the Slimming World weight management programme to improve accessibility and assess acceptability and feasibility for this population. METHODS: This user-centred qualitative study was carried out with a steering group of people with ID (n = 4)...
October 22, 2018: International Journal for Equity in Health
Xiaodong Guan, Huajie Hu, Chunxia Man, Luwen Shi
BACKGROUND: Essential medicines are those drugs that satisfy the priority health care needs of the population and help with functioning healthcare systems. Although many countries have formulated an essential medicine list, almost half of the global population still lack regular access to essential medicines. Research about the initiation of National Essential Medicines Policy in Chinese secondary and tertiary hospitals is inadequate, and the long-term effect on access after the reform is still unknown...
October 19, 2018: International Journal for Equity in Health
Luyang He, Hao Yu, Lizheng Shi, Yao He, Jingsong Geng, Yan Wei, Hui Sun, Yingyao Chen
BACKGROUND: Distribution equity assessment of computed tomography (CT) and magnetic resonance imaging (MRI) scanners is an important dimension of access to health technology. However, limited studies on the subject have been done in China. This study aims to reveal the distribution status of CT and MRI scanners and assess their distribution equity of them in China. METHODS: Five provinces with 66 cities from China were selected as the study sites. Descriptive analysis was used for the absolute number and number per million population of CT and MRI scanners in the study sites...
October 5, 2018: International Journal for Equity in Health
Linda Mureithi, James Michael Burnett, Adam Bertscher, René English
BACKGROUND: The general practitioner contracting initiative (GPCI) is a health systems strengthening initiative piloted in the first phase of national health insurance (NHI) implementation in South Africa as it progresses towards universal health coverage (UHC). GPCI aimed to address the shortage of doctors in the public sector by contracting-in private sector general practitioners (GPs) to render services in public primary health care clinics. This paper explores the early inception and emergence of the GPCI...
October 5, 2018: International Journal for Equity in Health
Krishna D Rao, Ligia Paina, Marie-Gloriose Ingabire, Zubin C Shroff
BACKGROUND: Formal engagement with non-state providers (NSP) is an important strategy in many low-and-middle-income countries for extending coverage of publicly financed health services. The series of country studies reviewed in this paper - from Afghanistan, Bangladesh, Bosnia & Herzegovina, Ghana, South Africa, Tanzania and Uganda - provide a unique opportunity to understand the dynamics of NSP engagement in different contexts. METHODS: A standard template was developed and used to summarize the main findings from the country studies...
October 5, 2018: International Journal for Equity in Health
Ahmad Shah Salehi, Abdul Tawab Kawa Saljuqi, Nadia Akseer, Krishna Rao, Kathryn Coe
BACKGROUND: In 2002 Afghanistan's Ministry of Public Health (MoPH) and its development partners initiated a new paradigm for the health sector by electing to Contract-Out (CO) the Basic Package of Health Services (BPHS) to non-state providers (NSPs). This model is generally regarded as successful, but literature is scarce that examines the motivations underlying implementation and factors influencing program success. This paper uses relevant theories and qualitative data to describe how and why contracting out delivery of primary health care services to NSPs has been effective...
October 5, 2018: International Journal for Equity in Health
Stephen Maluka, Dereck Chitama, Esther Dungumaro, Crecensia Masawe, Krishna Rao, Zubin Shroff
BACKGROUND: Governments increasingly recognize the need to engage non-state providers (NSPs) in health systems in order to move successfully towards Universal Health Coverage (UHC). One common approach to engaging NSPs is to contract-out the delivery of primary health care services. Research on contracting arrangements has typically focused on their impact on health service delivery; less is known about the actual processes underlying the development and implementation of interventions and the contextual factors that influence these...
October 5, 2018: International Journal for Equity in Health
Zubin Cyrus Shroff, Krishna Dipankar Rao, Sara Bennett, Ligia Paina, Marie-Gloriose Ingabire, Abdul Ghaffar
This editorial provides an overview of the special issue "Moving towards UHC: engaging non-state providers". It begins by describing the rationale underlying the Alliance's choice of a research program addressing issues of non-state providers and briefly discusses the research process this entailed. This is followed by a summary of the findings and key messages of each of the eight articles included in the issue. The editorial concludes with a series of reflections regarding lessons learnt about the engagement of non-state providers, methodological challenges, areas for future research as well as the contribution of the research program towards efforts to build capacity and strengthen health systems towards universal health coverage...
October 5, 2018: International Journal for Equity in Health
Annabel Grieve, Jill Olivier
BACKGROUND: Faith-based non-profit (FBNP) providers have had a long-standing role as non-state, non-profit providers in the Ghanaian health system. They have historically been considered to be important in addressing the inequitable geographical distribution of health services and towards the achievement of universal health coverage (UHC), but in changing contexts, this contribution is being questioned. However, any assessment of contribution is hampered by the lack of basic information about their comparative presence and coverage in the Ghanaian health system...
October 5, 2018: International Journal for Equity in Health
Aloysius Ssennyonjo, Justine Namakula, Ronald Kasyaba, Sam Orach, Sara Bennett, Freddie Ssengooba
BACKGROUND: A case study was prepared examining government resource contributions (GRCs) to private-not-for-profit (PNFP) providers in Uganda. It focuses on Primary Health Care (PHC) grants to the largest non-profit provider network, the Uganda Catholic Medical Bureau (UCMB), from 1997 to 2015. The framework of complex adaptive systems was used to explain changes in resource contributions and the relationship between the Government and UCMB. METHODS: Documents and key informant interviews with the important actors provided the main sources of qualitative data...
October 5, 2018: International Journal for Equity in Health
Rubana Islam, Shahed Hossain, Farzana Bashar, Shaan Muberra Khan, Adel A S Sikder, Sifat Shahana Yusuf, Alayne M Adams
BACKGROUND: Contracting-out (CO) to non-state providers is used widely to increase access to health care, but it entails many implementation challenges. Using Bangladesh's two decades of experience with contracting out Urban Primary Health Care (UPHC), this paper identifies contextual, contractual, and actor-related factors that require consideration when implementing CO in Low- and Middle- Income Countries. METHODS: This qualitative case-study is based on 42 in-depth interviews with past and present stakeholders working with the government and the UPHC project, as well as a desk review of key project documents...
October 5, 2018: International Journal for Equity in Health
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