by Gwat Tchongla Nazah and Ernest Molua
Original Research
Malaria remains the most important cause of mortality of persons, especially children and pregnant women in Africa. Health Insurance is a way to pay for health care. It protects persons from paying the full costs of medical services when they are injured or sick. The overall objective of this study is to evaluate the importance and effectiveness of Health Insurance in facilitating the payment of malaria bills in the Bamenda Health District. This is a cross sectional study in which questionnaires were administered to 202 respondents. Secondary data was obtained from hospital registers of four health facilities in Bamenda Health District. The data was analysed to show that there is a less than 1% coverage and enrolment in health insurance schemes in the Bamenda Mutual Health Organisation (BMHO), which is very low. Therefore people still cover their entire cost for malaria treatment, and are not opportune to save some money from their total expenditure on malaria bills. In addition, the knowledge of Health Insurance among persons in Bamenda Health District is 90.09%, which is good, but there is less enrolment, making the scheme, not very effective when it comes to covering malaria treatment bills. Finally, with the estimated cost of about 20,434 Francs CFA (US$ 35) monthly on malaria, uninsured persons are likely to save less than insured persons as about 75% of the bill is covered for insured persons. This is a serious economic burden on patients, which pushes them to borrow money to cover cost always, use traditional medicine and road side medicine as a way to evade cost of hospital treatment.
American Journal of Public Health Research. 2019, 7(3), 118-125. DOI: 10.12691/ajphr-7-3-5
Pub. Date: July 10, 2019
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by Chinedu John-Camillus IGBOANUSI, Kabir SABITU, Abdulrazaq Abdullahi GOBIR, Awawu Grace NMADU and Istifanus Anekoson JOSHUA
Original Research
Globally, more than 830 women die daily from pregnancy or childbirth-related complications especially in developing countries. Despite its importance, utilization of postnatal care services in Nigeria is very low due to various factors. This study assessed and compared the factors affecting the utilization of postnatal care services in primary health care facilities in urban and rural settlements in Kaduna State, Nigeria. The study was a cross-sectional, community-based and mixed method study carried out in Sabon Gari (an urban) and Giwa (a rural) Local Government Areas in July 2017. Multistage sampling technique was used to select 410 households in each study area where structured questionnaires were administered. The data was analysed using SPSS®version 20.0. Results were presented in charts and tables. Postnatal care services utilization was 73.7% and 61.4% in the urban and rural settlements respectively. Multivariate analysis identified antenatal attendance, large baby, poorest wealth quintile, transportation problems to the health facilities, and maternal age as predictors of postnatal care services utilization in the urban settings. In the rural settings the predictors were antenatal service attendance, hospital waiting time, family and financial problems. However, focus group discussion findings showed that there were not many differences in urban and rural areas. There were different predictors of postnatal services utilization in both urban and rural study areas. The state public health authorities need to take steps to address the various factors that deterred utilization of postnatal care services.
American Journal of Public Health Research. 2019, 7(3), 111-117. DOI: 10.12691/ajphr-7-3-4
Pub. Date: July 05, 2019
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by Rogers A. Ajeh, Jackson Jr. Ndenkeh, Akindeh Mbuh Nji, Adebola Adedimeji and Habakkuk A. Yumo
Original Research
Introduction: The size of the elderly population continues to increase rapidly in developing countries. Unfortunately, these countries are often least prepared to meet the health challenges of rapidly ageing population. The old are characterized by chronic non-communicable disease burden and disability, thus requiring opportunities for regular health care. Yet these older persons are believed to lack access to even basic healthcare services. The objective of this study was to identify the determinants of access of the elderly to healthcare services in Cameroon. Methods: We carried out a cross sectional study on 316 elderly persons using a cluster sampling method in two Health Districts chosen conveniently to represent the rural and urban contexts of Cameroon. Factors associated with access to primary health care services were evaluated using Chi squared test and logistic regression. Significance level was set at 5%. Results: Amongst the participants, 45.9%, reported to have gone for medical care within the past year. Almost half of the study population could not remember when they had their last blood sugar test (54.4%) and blood pressure test (43.0%). As concerns HIV testing, 67.5% had ever done an HIV test in their entire life. Furthermore, 26.1% of women and 20.0% of men have at least once done a breast cancer and prostate cancer screening respectively, with the rates being significantly higher for the urban setting (42.3% vs 32.9%, p<0.001). Lastly, accessibility to primary health care services was significantly associated with employment category and availability of a person to accompany the elderly to the hospital. Conclusion:This study showed that more than half of elderly lacked access to basic primary healthcare services. Employment category and availability of person to accompany elderly to the hospital were associated with access to healthcare services, while the setting (urban/rural) was associated with access to prostate and breast cancer screening. There is thus a need to improve access to primary healthcare services for elderly in Cameroon and the aforementioned factors should be considered when designing strategies to improve their accessibility. Larger scaled studies are needed to underscore other factors associated with access that could not be identified by this study.
American Journal of Public Health Research. 2019, 7(3), 102-110. DOI: 10.12691/ajphr-7-3-3
Pub. Date: June 10, 2019
9563 Views1966 Downloads
by Siyan Yi, Pheak Chhoun, Navy Chann, Sovannary Tuot, Sok Chamreun Choub and Phalkun Mun
Original Research
Background: In Cambodia, behavioral risks and subsequent new HIV infections in key populations, including female entertainment workers (FEWs), continue to be of great national concerns. This National Integrated Behavioral and Biological Survey was conducted to determine the prevalence of HIV, syphilis, and related risk behaviors among FEWs in the country. Methods: This cross-sectional survey was conducted in 2016 among 3,151 venue-based and non-venue-based FEWs recruited from the capital city and 17 other provinces using a two-stage cluster sampling design for structured-questionnaire interviews and HIV/syphilis testing. Descriptive statistical analyses were performed. Results: The mean age of FEWs in this survey was 26.2 (SD= 5.7) years. The prevalence of HIV and syphilis was 3.2% (95% CI= 1.75-5.75) and 0.8% (95% CI= 0.36-1.70), respectively. Only 25.1% of the respondents reported always using condoms with non-commercial partners, and 80.6% reported always using condoms with commercial partners in the past three months. About one-fifth (20.2%) reported having had at least one STI symptom in the past three months. Regarding substance use, 7.6% reported having used some form of illicit drugs in the past three months. The most common form of the drugs was amphetamine-type stimulants (86.1%), and 0.6% reported injecting drugs in the past three months. Of the total, 74.3% reported using some form of contraceptives, with condoms being the most common method (33.5%), and 33.7% reported having at least one induced abortion during the time working as an EW. Conclusions: This study surmises that the prevalence of HIV among FEWs in Cambodia remains stable, and these women remain at an increased risk of HIV infection. Sexual behaviors, notably inconsistent condom use and multiple partnership, may have exacerbated their vulnerability. These findings highlight the need for tailor-made interventions that focus on sexual and reproductive health education and access to needed services for this key population.
American Journal of Public Health Research. 2019, 7(3), 94-101. DOI: 10.12691/ajphr-7-3-2
Pub. Date: June 07, 2019
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by Ngo Huy Hoang, Joy Notter, Joy Hall, Malcom Hughes and Hoang Thi Kim Huyen
Original Research
In Vietnam, the national public healthcare services and statistics reveal problems with antibiotic use in the community with misunderstandings leading to the irrational and inappropriate use of these drugs resulting in bacterial resistance together with its consequences. There have been studies in Vietnam revealing a major problem in prescribing in the acute sector, but most antibiotics are prescribed in the community and there had been no studies exploring the situation in the community. This study was therefore an evaluation of the knowledge, skills and prescribing practice of those primarily responsible for administering antibiotics in the community, and was the first of its kind in Vietnam. The study used method triangulation to evaluate antibiotic use in the study location, a district in one province in North Vietnam. The district was chosen as it was typical of other rural areas in North Vietnam. The findings revealed a very high rate of antibiotic administration (79.8%) of which more than half (54%) were incorrectly prescribed for non-infectious conditions. Also, misunderstandings, limited knowledge and perceptions regarding the use of antibiotics, with staff having had little post basic training and education. It is further recommended that similar studies will be conducted along this line to verify the findings of the study.
American Journal of Public Health Research. 2019, 7(3), 87-93. DOI: 10.12691/ajphr-7-3-1
Pub. Date: June 02, 2019
9295 Views1850 Downloads