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International Journal for Equity in Health

Douglas C Dover, Ana Paula Belon
BACKGROUND: Despite the wealth of frameworks on social determinants of health (SDOH), two current limitations include the relative superficial description of factors affecting health and a lack of focus on measuring health equity. The Health Equity Measurement Framework (HEMF) addresses these gaps by providing a more encompassing view of the multitude of SDOH and drivers of health service utilisation and by guiding quantitative analysis for public health surveillance and policy development...
February 19, 2019: International Journal for Equity in Health
Kaley Butten, Newell W Johnson, Kerry K Hall, Maree Toombs, Neil King, Kerry-Ann F O'Grady
BACKGROUND: The oral health of a child not only impacts the physical well-being of the child, but can have quality of life implications for parents and families as they endeavour to provide care and support their child's oral health needs. Within Australia, Aboriginal and Torres Strait Islander children are thought to experience a disproportionate burden of poor oral heath compared to non-Indigenous children. Despite the prevalence of oral health challenges, there are limited qualitative studies investigating the oral health experiences of families...
February 18, 2019: International Journal for Equity in Health
Yolanda Eraso
BACKGROUND: Hormonal therapy is an integral component for breast cancer treatment in women with oestrogen receptor positive tumours in early-stage and advanced cases of the disease. Little is known about what factors influence oncologists' prescribing practices, especially non-biological factors, although this information may have important implications for understanding inequalities in health care quality and outcomes. This paper presents findings from research on factors influencing oncologists' prescribing hormonal therapy for women with early and advanced cases of breast cancer in the city of Córdoba, Argentina...
February 18, 2019: International Journal for Equity in Health
Sayem Ahmed, Md Tariqujjaman, Md Arafat Rahman, Md Zahid Hasan, Md Mehedi Hasan
BACKGROUND: In recent years, developing countries like Bangladesh are facing a higher burden of non-communicable diseases such as hypertension as a result of demographic transition. Prevalence of hypertension is often studied in this setting. However, evidence on undiagnosed hypertension is not widely available in the existing literature. Therefore, the current study focuses on inequalities in the prevalence of undiagnosed hypertension in Bangladesh. METHODS: A total of 8835 participants aged 35+ years were included in this study using nationally representative Bangladesh Demographic and Health Survey 2011 (BDHS)...
February 15, 2019: International Journal for Equity in Health
Emily Callander, Nicole Bates, Daniel Lindsay, Sarah Larkins, Stephanie M Topp, Joan Cunningham, Sabe Sabesan, Gail Garvey
BACKGROUND: Indigenous Australians diagnosed with cancer have poorer survival compared to non-Indigenous Australians. We aim to: 1) identify differences by Indigenous status in out-of-pocket expenditure for the first three-years post-diagnosis; 2) identify differences in the quantity and cost of healthcare services accessed; and 3) estimate the number of additional services required if access was equal between Indigenous and non-Indigenous people with cancer. METHODS: We used CancerCostMod, a model using linked administrative data...
February 12, 2019: International Journal for Equity in Health
María Luisa Granda, Wilson Giovanni Jimenez
No abstract text is available yet for this article.
February 8, 2019: International Journal for Equity in Health
Jorge L León-Cortés, Gustavo Leal Fernández, Héctor J Sánchez-Pérez
Adopting key mechanisms to restructure public policy in developing countries is a crucial political task. The strengthening of infrastructure of health services, care quality, monitoring and population health; all might contribute to assuring the functionality of a national system for health monitoring and care. Over the last decades, the Mexican government has launched wide-ranging political reforms aiming to overcome socioeconomic and environmental problems, namely health, education, finances, energy and pension...
February 7, 2019: International Journal for Equity in Health
Yanbing Zeng, Jiajing Li, Zhipeng Yuan, Ya Fang
BACKGROUND: The alarming progression of an increasingly aging population in China has attracted much attention within the country and abroad. In 2003, the Chinese central government launched the New Cooperative Medical Scheme (NCMS) to resolve problems of healthcare inequity in regions with inadequate infrastructure and relative poverty. The purpose of this study was to investigate the effect of NCMS on health expenditures by the Chinese rural elderly population. METHODS: The data were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which was conducted in 2005, 2008, 2011 and 2014...
February 6, 2019: International Journal for Equity in Health
Xuanxuan Wang, Jiaying Chen, Bo Burström, Kristina Burström
BACKGROUND: This study aimed to measure outpatients' general satisfaction with and experiences of different aspects of health care in Chinese public hospitals and to investigate to what extent general satisfaction could be explained by patients' experiences in public hospitals located at urban and rural areas. METHODS: Data on 4782 outpatients were derived from a patient survey in 9 city-level (urban) and 16 county-level (rural) public hospitals across China in 2016...
February 6, 2019: International Journal for Equity in Health
Ngianga-Bakwin Kandala, Bettina Shell-Duncan
BACKGROUND: Over the last several decades, global efforts to end female genital mutilation/cutting (FGM/C) have intensified through combined efforts of international and non-governmental organizations, governments, and religious and civil society groups. One question asked by donors, program implementers and observers alike is whether there is any evidence that FGM/C is declining. In the last two decades, reliable data have been generated in numerous countries through major household surveys, including repeat cross-sectional surveys...
January 30, 2019: International Journal for Equity in Health
Rosalind McCollum, Miriam Taegtmeyer, Lilian Otiso, Rachel Tolhurst, Maryline Mireku, Tim Martineau, Robinson Karuga, Sally Theobald
BACKGROUND: Power imbalances are a key driver of avoidable, unfair and unjust differences in health. Devolution shifts the balance of power in health systems. Intersectionality approaches can provide a 'lens' for analysing how power relations contribute to complex and multiple forms of health advantage and disadvantage. These approaches have not to date been widely used to analyse health systems reforms. While the stated objectives of devolution often include improved equity, efficiency and community participation, past evidence demonstrates that that there is a need to create space and capacity for people to transform existing power relations these within specific contexts...
January 30, 2019: International Journal for Equity in Health
Mulumebet Zenebe, Haldis Haukanes
BACKGROUND: In spite of increasing international commitment to young people's sexual and reproductive health, unintended pregnancies remain a major problem for young women worldwide. This article explores the issue of unintended pregnancies among Ethiopian university students and investigates narratives of students who carried their pregnancy to term. Ethiopia's relatively permissive abortion law forms part of the backdrop for the exploration. We also consider how socio-cultural and religious norms surrounding female premarital sex/pregnancy, and gendered and urban-rural inequities, play a role in how students handle the challenge...
January 28, 2019: International Journal for Equity in Health
Michal Brzezinski
BACKGROUND: A growing literature investigates health effects of the recent economic crisis. This study examines how different economic mechanisms affected low self-rated health (SRH) in Europe over the crisis period (2008-2011). We measure changes in low SRH over 2008-2011 and analyze how they are accounted for by changes in household income levels and income distribution (income poverty, income inequality), labour market developments (increasing unemployment, falling employment, changes in labour market inactivity), and non-income poverty (material deprivation)...
January 28, 2019: International Journal for Equity in Health
Jörg Mahlich, Rosarin Sruamsiri
BACKGROUND: Co-insurance rates in Japan decrease when patients turn 70 years of age. We aim to compare changes in medical demand for Japanese patients with rheumatoid arthritis (RA) at age 70 prior to 2014, when there was a reduction in co-insurance rates from 30 to 10%, with changes in medical demand at age 70 after 2014 when co-insurance rates decreased from 30% to only 20%. METHODS: We used administrative data from large Japanese hospitals. We employed a discontinuity regression (RD) approach to control for unobserved endogeneity in the data...
January 28, 2019: International Journal for Equity in Health
Marte E S Haaland, Haldis Haukanes, Joseph Mumba Zulu, Karen Marie Moland, Charles Michelo, Margarate Nzala Munakampe, Astrid Blystad
INTRODUCTION: The Zambian Termination of Pregnancy Act permits abortion on socio-economic grounds, but access to safe abortion services is limited and this constitutes a considerable problem for rights to sexual and reproductive health. The case of Zambia provides an opportunity to explore the relationship between a legal framework that permits abortion on diverse grounds, the moral and political disputes around abortion and access to sexual and reproductive health services. METHODS: This paper draws upon eleven months of ethnographic fieldwork in Zambia...
January 28, 2019: International Journal for Equity in Health
Mariano Salazar, Kranti Vora, Kristi Sidney Annerstedt, Ayesha De Costa
BACKGROUND: The government of Gujarat, India runs a large public private partnership program to widen access to emergency obstetric care (EmOC). The program include a disincentive for Cesareans section (CS) which are capped at seven per 100 women. In this paper, we study if the disincentive works by comparing CS rates among similar groups of women who deliver within and outside the program. METHODS: Community-based panel study in three districts of Gujarat, India...
January 24, 2019: International Journal for Equity in Health
Astrid Fink, Eva-Maria Fach, Sara Lena Schröder
BACKGROUND: Diabetes mellitus type 2 is a central challenge for health policy and healthcare in all advanced countries. For the affected persons, living with a diagnosis of type 2 diabetes is difficult because the disease and its treatment have a considerable effect on daily life. The aim of this study was to investigate the challenges associated with a diagnosis of type 2 diabetes for those affected and the range, depth and complexities of the subjective perspectives of the patients under the conditions of the German healthcare system...
January 24, 2019: International Journal for Equity in Health
Sophie H Allcock, Elizabeth H Young, Manjinder S Sandhu
INTRODUCTION: Health insurance has been found to increase healthcare utilisation and reduce catastrophic health expenditures in a number of countries; however, coverage is often unequally distributed among populations. The sociodemographic patterns of health insurance in Namibia are not fully understood. We aimed to assess the prevalence of health insurance, the relation between health insurance and health service utilisation and to explore the sociodemographic factors associated with health insurance in Namibia...
January 22, 2019: International Journal for Equity in Health
Yao Leng, Weiwei Liu, Nanzi Xiao, Yannan Li, Jing Deng
OBJECTIVES: Analyzing the impact of the China's health care reform policy in 2009 on the intangible service efficiency of PHCI and exploring the way to improve the service efficiency of PHCI. METHODS: The Malmquist productivity index based on the Data Envelopment Analysis (DEA) was used to measure the variation of TFP and its decomposition of PHCI before and after the implementation of the health care reform policy in 2009. Then, the Tobit model was applied to estimate the key factors affecting the improvement of the intangible service efficiency of PHCI...
January 21, 2019: International Journal for Equity in Health
Diana Bowser, Bryan Patenaude, Manjiri Bhawalkar, Denizhan Duran, Peter Berman
BACKGROUND: Benefit Incidence Analysis (BIA) is used to understand the distribution of health care utilization and spending in comparison to income distribution. The results can illustrate how effectively governments allocate limited resources towards meeting the needs of the poor. In analyzing the distribution of public spending on inpatient, outpatient, and deliveries, this paper represents the most recent BIA completed in India. METHODS: In order to conduct the BIA statistical analysis for this project, 2014 utilization data from the most recently completed Indian National Sample Survey (NSS) was used...
January 21, 2019: International Journal for Equity in Health
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