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Song P, Adeloye D, Acharya Y, Bojude DA, Ali S, Alibudbud R, Bastien S, Becerra-Posada F, Berecki M, Bodomo A, Borrescio-Higa F, Buchtova M, Campbell H, Chan KY, Cheema S, Chopra M, Cipta DA, Castro LD, Ganasegeran K, Gebre T, Glasnović A, Graham CJ, Igwesi-Chidobe C, Iversen PO, Jadoon B, Lanza G, Macdonald C, Park C, Islam MM, Mshelia S, Nair H, Ng ZX, Htay MNN, Akinyemi KO, Parisi M, Patel S, Peprah P, Polasek O, Riha R, Rotarou ES, Sacks E, Sharov K, Stankov S, Supriyatiningsih W, Sutan R, Tomlinson M, Tsai AC, Tsimpida D, Vento S, Glasnović JV, Vokey LB, Wang L, Wazny K, Xu J, Yoshida S, Zhang Y, Cao J, Zhu Y, Sheikh A, Rudan I. Setting research priorities for global pandemic preparedness: An international consensus and comparison with ChatGPT's output. J Glob Health 2024; 14:04054. [PMID: 38386716 PMCID: PMC10869134 DOI: 10.7189/jogh.14.04054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
Background In this priority-setting exercise, we sought to identify leading research priorities needed for strengthening future pandemic preparedness and response across countries. Methods The International Society of Global Health (ISoGH) used the Child Health and Nutrition Research Initiative (CHNRI) method to identify research priorities for future pandemic preparedness. Eighty experts in global health, translational and clinical research identified 163 research ideas, of which 42 experts then scored based on five pre-defined criteria. We calculated intermediate criterion-specific scores and overall research priority scores from the mean of individual scores for each research idea. We used a bootstrap (n = 1000) to compute the 95% confidence intervals. Results Key priorities included strengthening health systems, rapid vaccine and treatment production, improving international cooperation, and enhancing surveillance efficiency. Other priorities included learning from the coronavirus disease 2019 (COVID-19) pandemic, managing supply chains, identifying planning gaps, and promoting equitable interventions. We compared this CHNRI-based outcome with the 14 research priorities generated and ranked by ChatGPT, encountering both striking similarities and clear differences. Conclusions Priority setting processes based on human crowdsourcing - such as the CHNRI method - and the output provided by ChatGPT are both valuable, as they complement and strengthen each other. The priorities identified by ChatGPT were more grounded in theory, while those identified by CHNRI were guided by recent practical experiences. Addressing these priorities, along with improvements in health planning, equitable community-based interventions, and the capacity of primary health care, is vital for better pandemic preparedness and response in many settings.
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Affiliation(s)
- Peige Song
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, China
| | - Davies Adeloye
- School of Health & Life Sciences, Teesside University, UK
| | - Yubraj Acharya
- Department of Health Policy and Administration, The Pennsylvania State University, USA
| | | | - Sajjad Ali
- Department of Medicine, Ziauddin Medical University, Karachi, Pakistan
| | - Rowalt Alibudbud
- Department of Sociology and Behavioral Sciences, De La Salle University, Manila, Philippines
| | | | | | | | | | | | - Marie Buchtova
- Olomouc University Social Health Institute, Palacký University, Olomouc, Czechia
| | - Harry Campbell
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Kit Yee Chan
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
- School of Social Sciences, Monash University, Australia
| | | | | | | | - Lina Diaz Castro
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | | | - Teshome Gebre
- The Task force for Global Health, Addis Ababa, Ethiopia
| | - Anton Glasnović
- Croatian Institute for Brain Research, Zagreb University School of Medicine, Zagreb, Croatia
| | - Christopher J Graham
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | | | | | - Bismeen Jadoon
- Egyptian Representative, Committee of Fellows of Obstetrics and Gynaecology, Oxford, UK, and Royal Berkshire Hospital, NHS, UK
| | - Giuseppe Lanza
- Oasi Research Institute-IRCCS, Troina, Italy
- University of Catania, Italy
| | - Calum Macdonald
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Chulwoo Park
- Department of Public Health and Recreation, San José State University, San Jose, California, USA
| | | | | | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Zhi Xiang Ng
- School of Biosciences, Faculty of Science and Engineering, University of Nottingham Malaysia, Semenyih, Malaysia
| | - Mila Nu Nu Htay
- Department of Community Medicine, Faculty of Medicine, Manipal University College Malaysia, Melaka, Malaysia
| | | | | | - Smruti Patel
- Editor, Journal of Global Health Reports, Washington, USA
| | - Prince Peprah
- Social Policy Research Centre/Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Ozren Polasek
- Croatian Science Foundation, Zagreb, Croatia
- Algebra University College, Zagreb, Croatia
| | - Renata Riha
- Royal Infirmary of Edinburgh, University of Edinburgh, UK
| | | | - Emma Sacks
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Konstantin Sharov
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow, Russia
| | | | | | - Rosnah Sutan
- Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | | | | | - Dialechti Tsimpida
- Department of Public Health, Policy and Systems, The University of Liverpool, UK
| | | | | | - Laura B Vokey
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Liang Wang
- Guangdong Provincial People’s Hospital, Guangzhou, China
| | - Kerri Wazny
- Children's Investment Fund Foundation, London, UK
| | - Jingyi Xu
- School of Health Humanities, Peking University, Beijing, China
| | | | | | - Jin Cao
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, China
| | - Yajie Zhu
- School of Information Science and Technology, Hangzhou Normal University, Hangzhou, China
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, UK
| | - Igor Rudan
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
- Croatian Science Foundation, Zagreb, Croatia
| | - International Society of Global Health (ISoGH)
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, China
- School of Health & Life Sciences, Teesside University, UK
- Department of Health Policy and Administration, The Pennsylvania State University, USA
- Gombe State University, Gombe, Nigeria
- Department of Medicine, Ziauddin Medical University, Karachi, Pakistan
- Department of Sociology and Behavioral Sciences, De La Salle University, Manila, Philippines
- Norwegian University of Life Sciences, Ås, Norway
- Public Health Development Organization, El Paso, USA
- School of Medicine, University of Zagreb, Croatia
- African Studies, University of Vienna, Austria
- Universidad Adolfo Ibañez, Santiago, Chile
- Olomouc University Social Health Institute, Palacký University, Olomouc, Czechia
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
- School of Social Sciences, Monash University, Australia
- Weill Cornell Medicine – Qatar, Doha, Qatar
- The World Bank, Washington, USA
- Universitas Pelita Harapan, Jakarta, Indonesia
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
- Seberang Jaya Hospital, Ministry of Health, Malaysia
- The Task force for Global Health, Addis Ababa, Ethiopia
- Croatian Institute for Brain Research, Zagreb University School of Medicine, Zagreb, Croatia
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- University of Bradford, UK
- University of Nigeria, Enugu Campus, Nigeria
- Department of Nutrition, University of Oslo, Norway
- Egyptian Representative, Committee of Fellows of Obstetrics and Gynaecology, Oxford, UK, and Royal Berkshire Hospital, NHS, UK
- Oasi Research Institute-IRCCS, Troina, Italy
- University of Catania, Italy
- Department of Public Health and Recreation, San José State University, San Jose, California, USA
- University of Dhaka, Bangladesh
- Jos University Teaching Hospital, Nigeria
- School of Biosciences, Faculty of Science and Engineering, University of Nottingham Malaysia, Semenyih, Malaysia
- Department of Community Medicine, Faculty of Medicine, Manipal University College Malaysia, Melaka, Malaysia
- Lagos State University, Ojo, Lagos, Nigeria
- Clemson University, USA
- Editor, Journal of Global Health Reports, Washington, USA
- Social Policy Research Centre/Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
- Croatian Science Foundation, Zagreb, Croatia
- Algebra University College, Zagreb, Croatia
- Royal Infirmary of Edinburgh, University of Edinburgh, UK
- Universidad San Sebastián, Santiago, Chile
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow, Russia
- Pasteur Institute, Novi Sad, Novi Sad, Serbia
- Children and Mother Health Movement Action, Yogyakarta, Indonesia
- Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
- Stellenbosch University, Cape Town, South Africa
- Massachusetts General Hospital, Boston, USA
- Department of Public Health, Policy and Systems, The University of Liverpool, UK
- University of Puthisastra, Phnom Penh, Cambodia
- Department of Hematology, Dubrava University Hospital, Zagreb, Croatia
- Guangdong Provincial People’s Hospital, Guangzhou, China
- Children's Investment Fund Foundation, London, UK
- School of Health Humanities, Peking University, Beijing, China
- World Health Organization, Geneva, Switzerland
- Capital Institute of Pediatrics, Beijing, China
- School of Information Science and Technology, Hangzhou Normal University, Hangzhou, China
- Usher Institute, University of Edinburgh, UK
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Polašek O, Wazny K, Adeloye D, Song P, Chan KY, Bojude DA, Ali S, Bastien S, Becerra-Posada F, Borrescio-Higa F, Cheema S, Cipta DA, Cvjetković S, Castro LD, Ebenso B, Femi-Ajao O, Ganesan B, Glasnović A, He L, Heraud JM, Igwesi-Chidobe C, Iversen PO, Jadoon B, Karim AJ, Khan J, Biswas RK, Lanza G, Lee SWH, Li Y, Liang LL, Lowe M, Islam MM, Marušić A, Mshelia S, Manyara AM, Htay MNN, Parisi M, Peprah P, Sacks E, Akinyemi KO, Shahraki-Sanavi F, Sharov K, Rotarou ES, Stankov S, Supriyatiningsih W, Chan BTY, Tremblay M, Tsimpida D, Vento S, Glasnović JV, Wang L, Wang X, Ng ZX, Zhang J, Zhang Y, Campbell H, Chopra M, Cousens S, Krstić G, Macdonald C, Mansoori P, Patel S, Sheikh A, Tomlinson M, Tsai AC, Yoshida S, Rudan I. Research priorities to reduce the impact of COVID-19 in low- and middle-income countries. J Glob Health 2022; 12:09003. [PMID: 35475006 PMCID: PMC9010705 DOI: 10.7189/jogh.12.09003] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs. Methods The Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise: 1) feasibility and answerability; 2) potential for burden reduction; 3) potential for a paradigm shift; 4) potential for translation and implementation; and 5) impact on equity. Results Among the top 10 research priorities, research questions related to vaccination were prominent: health care system access barriers to equitable uptake of COVID-19 vaccination (ranked 1st), determinants of vaccine hesitancy (4th), development and evaluation of effective interventions to decrease vaccine hesitancy (5th), and vaccination impacts on vulnerable population/s (6th). Health care delivery questions also ranked highly, including: effective strategies to manage COVID-19 globally and in LMICs (2nd) and integrating health care for COVID-19 with other essential health services in LMICs (3rd). Additionally, the assessment of COVID-19 patients’ needs in rural areas of LMICs was ranked 7th, and studying the leading socioeconomic determinants and consequences of the COVID-19 pandemic in LMICs using multi-faceted approaches was ranked 8th. The remaining questions in the top 10 were: clarifying paediatric case-fatality rates (CFR) in LMICs and identifying effective strategies for community engagement against COVID-19 in different LMIC contexts. Interpretation Health policy and systems research to inform COVID-19 vaccine uptake and equitable access to care are urgently needed, especially for rural, vulnerable, and/or marginalised populations. This research should occur in parallel with studies that will identify approaches to minimise vaccine hesitancy and effectively integrate care for COVID-19 with other essential health services in LMICs. ISoGH calls on the funders of health research in LMICs to consider the urgency and priority of this research during the COVID-19 pandemic and support studies that could make a positive difference for the populations of LMICs.
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Affiliation(s)
- Ozren Polašek
- Department of Public Health, University of Split School of Medicine, Split, Croatia
- Croatian Centre for Global Health, University of Split, Croatia
- Algebra University College, Zagreb, Croatia
| | - Kerri Wazny
- Children's Investment Fund Foundation, London, UK
| | - Davies Adeloye
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Peige Song
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, China
| | - Kit Y Chan
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | | | - Sajjad Ali
- Department of Medicine, Ziauddin Medical University, Karachi, Pakistan
| | | | | | | | | | | | | | - Lina D Castro
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Bassey Ebenso
- Leeds Institute of Health Sciences, University of Leeds, UK
| | - Omolade Femi-Ajao
- Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Balasankar Ganesan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Anton Glasnović
- Croatian Institute for Brain Research, Zagreb University School of Medicine, Zagreb, Croatia
| | - Longtao He
- Southwestern University of Finance and Economics, Chengdu, China
| | | | | | | | - Bismeen Jadoon
- Egyptian Representative, Committee of Fellows of Obstetrics and Gynaecology, Oxford, UK, Royal Berkshire Hospital, NHS, UK
| | | | - Johra Khan
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| | | | - Giuseppe Lanza
- Oasi Research Institute-IRCCS, Troina, Italy
- University of Catania, Catania, Italy
| | | | - You Li
- School of Public Health, Nanjing Medical University, China
| | - Li-Lin Liang
- National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mat Lowe
- Society for the Study of Women's Health, Kanifing, The Gambia
| | | | - Ana Marušić
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
| | | | | | - Mila NN Htay
- Department of Community Medicine, Faculty of Medicine, Manipal University College Malaysia, Melaka, Malaysia
| | | | - Prince Peprah
- Social Policy Research Centre/Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Emma Sacks
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | | | | | - Konstantin Sharov
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow, Russia
| | | | | | | | | | | | | | | | | | - Liang Wang
- Xuzhou Medical University, Yuzhou, China
| | - Xin Wang
- School of Public Health, Nanjing Medical University, China
| | - Zhi X Ng
- School of Biosciences, Faculty of Science and Engineering, University of Nottingham Malaysia, Semenyih, Malaysia
| | | | | | - Harry Campbell
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Mickey Chopra
- The World Bank, Washington, District of Columbia, USA
| | - Simon Cousens
- London School of Hygiene and Tropical Medicine, London, UK
| | - Goran Krstić
- International Society of Global Health, Edinburgh, UK
| | - Calum Macdonald
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | | | - Smruti Patel
- Editor, Journal of Global Health Reports, Washington, DC, USA
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | | | | | - Igor Rudan
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
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Aubert J, Durán D, Monsalves MJ, Rodríguez MF, Rotarou ES, Gajardo J, Alfaro T, Bertoglia MP, Muñoz S, Cuadrado C. [Diagnostic properties of case definitions of suspected COVID-19 in Chile, 2020Características diagnósticas das definições de caso suspeito de COVID-19 no Chile, 2020]. Rev Panam Salud Publica 2021; 45:e14. [PMID: 33643397 PMCID: PMC7905736 DOI: 10.26633/rpsp.2021.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/22/2020] [Indexed: 01/12/2023] Open
Abstract
Objective Compare the diagnostic properties of five case definitions of suspected COVID-19 that were used or proposed in Chile during the first eight months of the pandemic. Methods An analysis was done of the diagnostic properties (sensitivity, specificity, and positive and negative predictive values) of three case definitions of suspected COVID-19 used in Chile between March and October 2020, as well as two alternative proposed definitions. The sample was 2,019 people with known results for the polymerase chain reaction (PCR) test for SARS-CoV-2. Stepwise logistic regression was used to develop criterion 5, optimizing sensitivity and specificity values. Multifactor logistic regression was used to explore the association between demographic variables, symptoms and signs, and PCR positivity. Different positivity scenarios were analyzed and ROC curves were compared. Results The presence of anosmia (OR = 8.00; CI95%: 5.34-11.99), fever (OR = 2.15; CI95%: 1.28-3.59), and having been in close contact with a person sick with COVID-19 (OR = 2.89; CI95%: 2.16-3.87) were associated with a positive PCR result. According to the analysis of the ROC curve, criterion 5 had the highest capacity for discrimination, although there were no significant differences with the other four criteria. Conclusions Criterion 5-based on anosmia, close contact with people with COVID-19, and fever as sufficient unique elements-was the most sensitive in identifying suspected cases of COVID-19, a key aspect in controlling the spread of the pandemic.
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Affiliation(s)
- Josefina Aubert
- Facultad de Medicina y Ciencia, Universidad San Sebastián Santiago Chile Facultad de Medicina y Ciencia, Universidad San Sebastián, Santiago, Chile
| | - Doris Durán
- Facultad de Medicina y Ciencia, Universidad San Sebastián Santiago Chile Facultad de Medicina y Ciencia, Universidad San Sebastián, Santiago, Chile
| | - María José Monsalves
- Facultad de Medicina y Ciencia, Universidad San Sebastián Santiago Chile Facultad de Medicina y Ciencia, Universidad San Sebastián, Santiago, Chile
| | - María Francisca Rodríguez
- Facultad de Medicina y Ciencia, Universidad San Sebastián Santiago Chile Facultad de Medicina y Ciencia, Universidad San Sebastián, Santiago, Chile
| | - Elena S Rotarou
- Facultad de Medicina y Ciencia, Universidad San Sebastián Santiago Chile Facultad de Medicina y Ciencia, Universidad San Sebastián, Santiago, Chile
| | - Jean Gajardo
- Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián Santiago Chile Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Santiago, Chile
| | - Tania Alfaro
- Programa de Epidemiología, Escuela de Salud Pública, Universidad de Chile Santiago Chile Programa de Epidemiología, Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
| | - María Paz Bertoglia
- Unidad de Nutrición de Poblaciones, Escuela de Salud Pública, Universidad de Chile Santiago Chile Unidad de Nutrición de Poblaciones, Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
| | - Sergio Muñoz
- Programa de Políticas, Sistemas y Gestión en Salud, Escuela de Salud Pública, Universidad de Chile Santiago Chile Programa de Políticas, Sistemas y Gestión en Salud, Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
| | - Cristóbal Cuadrado
- Departamento de Salud Pública-CIGES, Facultad de Medicina, Universidad de La Frontera Temuco Chile Departamento de Salud Pública-CIGES, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
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Affiliation(s)
- Elena S Rotarou
- Faculty of Medicine and Science, Universidad San Sebastián, Chile
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Sakellariou D, Malfitano APS, Rotarou ES. Disability inclusiveness of government responses to COVID-19 in South America: a framework analysis study. Int J Equity Health 2020; 19:131. [PMID: 32746851 PMCID: PMC7396888 DOI: 10.1186/s12939-020-01244-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/17/2020] [Indexed: 02/07/2023] Open
Abstract
Background Disabled people are particularly exposed to the risks of COVID-19, as well as to the measures taken to address it, and their impact. The aim of the study was to examine the disability-inclusiveness of government responses to COVID-19 in four South American Countries: Argentina, Brazil, Chile, and Peru. Methods We conducted documentary research, using framework analysis to analyse reports, legislation, decrees, and other official documents that communicated measures taken in response to the pandemic, published from February 1st until May 22nd, 2020. We included documents reporting measures that affected disabled people either directly (measures specifically designed for disabled people) or indirectly (measures for the general population). We developed an analytical framework based on recommendations for disability-inclusive response to COVID-19 published by the Economic Commission for Latin America and the Carribean, the World Health Organisation, and other international organisations. Results We analysed 72 documents. The findings highlight that while some positive measures were taken, the needs of disabled people were not fully considered. Several countries published recommendations for a disability-inclusive response to COVID-19, without ensuring their translation to practice. All countries took at least some steps to ensure access to financial support, health, and education for disabled people, but at the same time they also implemented policies that had a detrimental impact on disabled people. The populations that are most exposed to the impacts of COVID-19, including disabled people living in institutional care, were protected in several cases only by recommendations rather by legislation. Conclusions This study illustrates how the official government responses taken by four countries in the region – while positive, in several aspects – do not fully address the needs of disabled people, thus further disadvantaging them. In order to ensure response to COVID − 19 is disability inclusive, it is necessary to translate recommendations to practice, consider disabled people both in mainstream policy and in disability-specific measures, and focus on the long-term reconstruction phase.
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Affiliation(s)
- Dikaios Sakellariou
- School of Healthcare Sciences, Cardiff University, Eastgate House, Newport Road 35-43, Cardiff, CF24 0AB, UK.
| | - Ana Paula Serrata Malfitano
- Department of Occupational Therapy, Postgraduate Program in Occupational Therapy, Universidade Federal do São Carlos, São Carlos, SP, Brazil
| | - Elena S Rotarou
- Faculty of Medicine and Science, Universidad San Sebastián, Santiago, Chile
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Sakellariou D, Anstey S, Polack S, Rotarou ES, Warren N, Gaze S, Courtenay M. Pathways of disability-based discrimination in cancer care. Critical Public Health 2019. [DOI: 10.1080/09581596.2019.1648762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Sally Anstey
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Sarah Polack
- London School of Hygiene and Tropical Medicine, International Centre for Evidence in Disability, London, UK
| | | | - Narelle Warren
- School of Social Sciences, Faculty of Arts, Monash University, Melbourne, Australia
| | - Sarah Gaze
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Molly Courtenay
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
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Abstract
OBJECTIVES Research has shown that people with physical impairment report lower utilisation of preventive services. The aim of this study was to examine whether women with mobility impairments have lower odds of using mammography compared with women with no such impairment, and explore the factors that are associated with lower utilisation. SAMPLE AND DESIGN We performed secondary analysis, using logistic regressions, of deidentified cross-sectional data from the European Health Interview Survey, Wave 2. The sample included 9491 women from across the UK, 2697 of whom had mobility impairment. The survey method involved face-to-face and telephone interviews. OUTCOME MEASURES Self-report of the last time a mammogram was undertaken. RESULTS Adjusting for various demographic and socioeconomic variables, women with mobility impairment had 1.3 times (95% CI 0.70 to 0.92) lower odds of having a mammogram than women without mobility impairment. Concerning women with mobility impairment, married women had more than twice the odds of having a mammogram than women that had never been married (OR 2.07, 95% CI 1.49 to 2.88). Women in Scotland had 1.5 times (95% CI 1.08 to 2.10) higher odds of undertaking the test than women in England. Women with upper secondary education had 1.4 times (95% CI 1.10 to 1.67) higher odds of undergoing the test than women with primary or lower secondary education. Also, women from higher quintiles (third and fifth quintiles) had higher odds of using mammography, with the women in the fifth quintile having 1.5 times (95% CI 1.02 to 2.15) higher odds than women from the first quintile. CONCLUSIONS In order to achieve equitable access to mammography for all women, it is important to acknowledge the barriers that impede women with mobility impairment from using the service. These barriers can refer to structural disadvantage, such as lower income and employment rate, transportation barriers, or previous negative experiences, among others.
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Affiliation(s)
| | - Elena S Rotarou
- Centre of Environmental and Natural Resource Economics, Faculty of Economics and Business, Universidad de Chile, Santiago de Chile, Chile
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Rotarou ES, Sakellariou D. Structural disadvantage and (un)successful ageing: gender differences in activities of daily living for older people in Chile. Critical Public Health 2018. [DOI: 10.1080/09581596.2018.1492092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
BACKGROUND Preventive health services play a vital role in population health. However, access to such services is not always equitably distributed. In this article, we examine the barriers affecting utilisation rates of preventive health services, using Chile as a case study. METHODS We conducted a cross-sectional study analysing secondary data from 206,132 Chilean adults, taken from the 2015 National Socioeconomic Characterisation Survey of the Government of Chile. We carried out logistic regressions to explore the relationship between the dependent variable use of preventive services and various demographic and socioeconomic variables. RESULTS Categories more likely to use preventive services were women (OR=1.16; 95%CI: 1.11-1.21) and inactive people (OR=1.41; 95%CI: 1.33-1.48). By contrast, single individuals (OR= 0.85 ; 95%CI: 0.80-0.91) and those affiliated with the private healthcare provider (OR= 0.89; 95%CI: 0.81-0.96) had fewer odds of undertaking preventive exams. CONCLUSIONS The findings underline the necessity of better information campaigns on the availability and necessity of preventive health services, addressing health inequality in accessing health services, and tackling lifestyle-related health risks. This is particularly important in countries - such as Chile - characterised by high income inequality and low utilisation rates of preventive health services.
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Affiliation(s)
- Elena S. Rotarou
- Department of Economics, University of Chile, Diagonal Paraguay 257, Office 1506, 8330015 Santiago, Chile
| | - Dikaios Sakellariou
- Cardiff University, School of Healthcare Sciences, Eastgate House, Newport Road 35-43, Cardiff, CF24 0AB UK
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Rotarou ES, Sakellariou D. Depressive symptoms in people with disabilities; secondary analysis of cross-sectional data from the United Kingdom and Greece. Disabil Health J 2018; 11:367-373. [DOI: 10.1016/j.dhjo.2017.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 11/25/2017] [Accepted: 12/05/2017] [Indexed: 11/28/2022]
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Sakellariou D, Rotarou ES. The effects of neoliberal policies on access to healthcare for people with disabilities. Int J Equity Health 2017; 16:199. [PMID: 29141634 PMCID: PMC5688676 DOI: 10.1186/s12939-017-0699-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/08/2017] [Indexed: 11/10/2022] Open
Abstract
Neoliberal reforms lead to deep changes in healthcare systems around the world, on account of their emphasis on free market rather than the right to health. People with disabilities can be particularly disadvantaged by such reforms, due to their increased healthcare needs and lower socioeconomic status. In this article, we analyse the impacts of neoliberal reforms on access to healthcare for disabled people. This article is based on a critical analytical review of the literature and on two case studies, Chile and Greece. Chile was among the first countries to introduce neoliberal reforms in the health sector, which led to health inequalities and stratification of healthcare services. Greece is one of the most recent examples of countries that have carried out extensive changes in healthcare, which have resulted in a deterioration of the quality of healthcare services. Through a review of the policies performed in these two countries, we propose that the pathways that affect access to healthcare for disabled people include: a) Policies directly or indirectly targeting healthcare, affecting the entire population, including disabled people; and b) Policies affecting socioeconomic determinants, directly or indirectly targeting disabled people, and indirectly impacting access to healthcare. The power differentials produced through neoliberal policies that focus on economic rather than human rights indicators, can lead to a category of disempowered people, whose health needs are subordinated to the markets. The effects of this range from catastrophic out-of-pocket payments to compromised access to healthcare. Neoliberal reforms can be seen as a form of structural violence, disproportionately affecting the most vulnerable parts of the population - such as people with disabilities - and curtailing access to basic rights, such as healthcare.
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Affiliation(s)
- Dikaios Sakellariou
- School of Healthcare Sciences, Cardiff University, Eastgate House, Newport Road 35-43, Cardiff, CF24 0AB, UK.
| | - Elena S Rotarou
- Department of Economics, University of Chile, Diagonal Paraguay 257, Office 1506, 8330015, Santiago, Chile
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Abstract
OBJECTIVES The aim of this study was to investigate differences in access to healthcare between people with and without disabilities in the UK. The hypotheses were that: (1) people with disabilities would be more likely to have unmet healthcare needs and (2) there would be gender differences, with women more likely to report unmet needs. SETTING AND PARTICIPANTS We performed secondary analysis, using logistic regressions, of deidentified cross-sectional data from the European Health Interview Survey, Wave 2. The sample included 12 840 community-dwelling people over the age of 16 from across the UK, 5 236 of whom had a disability. The survey method involved face-to-face and telephone interviews. OUTCOME MEASURES Unmet need for healthcare due to long waiting lists or distance or transportation problems; not being able to afford medical examination, treatment, mental healthcare or prescribed medicines. All measures were self-reported. RESULTS Adjusting for age, sex and other factors, people with a severe disability had higher odds of facing unmet needs. The largest gap was in 'unmet need for mental healthcare due to cost', where people with a severe disability were 4.5 times (CI 95% 2.2 to 9.2) more likely to face a problem, as well as in 'unmet need due to cost of prescribed medicine', where people with a mild disability had 3.6 (CI 95% 2.2 to 5.9) higher odds of facing a difficulty. Women with a disability were 7.2 times (CI 95% 2.7 to 19.4) more likely to have unmet needs due to cost of care or medication, compared with men with no disability. CONCLUSIONS People with disabilities reported worse access to healthcare, with transportation, cost and long waiting lists being the main barriers. These findings are worrying as they illustrate that a section of the population, who may have higher healthcare needs, faces increased barriers in accessing services.
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Affiliation(s)
| | - Elena S Rotarou
- Department of Economics, University of Chile, Santiago, Chile
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Abstract
BACKGROUND Research has shown that women with disabilities face additional challenges in accessing and using healthcare services compared to non-disabled women. However, relatively little is known about the utilisation of cancer screening services for women with disabilities. This study addresses this gap by examining the utilisation of the Papanicolaou test and mammography for disabled women in Chile. METHODS We used cross-sectional data, taken from a 2015 nationally-representative survey. Initially, we employed logistic regressions to test for differences in utilisation rates for the Papanicolaou test (66,281 observations) and the mammogram (35,294 observations) between disabled and non-disabled women. Next, logistic regressions were used to investigate the demographic, socioeconomic, and health-related factors affecting utilisation rates for cancer screening services for disabled women (sample sizes: 5,823 observations for the Papanicolaou test and 5,731 observations for the mammogram). RESULTS Disabled women were less likely to undergo screening tests than non-disabled women. For the Papanicolaou test and mammography, the multivariable regression models showed that living in rural areas, having higher education, being affiliated with a private health insurance company, giving a good health self-assessment score, and being under medical treatment for other illnesses were associated with higher utilisation rates. On the other hand, being single, inactive with regard to employment, and having a better income were linked with lower utilisation. While utilisation rates for both disabled and non-disabled women have increased since 2006, the utilisation disparity has slightly increased. CONCLUSIONS This study shows the influence of various factors in the utilisation rates of preventive cancer screening services for disabled women. To develop effective initiatives targeting inequalities in the utilisation of cancer screening tests, it is important to move beyond an exclusively single-disease approach and acknowledge the complexity of the patient population.
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Affiliation(s)
| | - Elena S Rotarou
- Department of Economics, University of Chile, Santiago, Chile
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Rotarou ES, Sakellariou D. Inequalities in access to health care for people with disabilities in Chile: the limits of universal health coverage. Critical Public Health 2017. [DOI: 10.1080/09581596.2016.1275524] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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