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Bocean CG, Vărzaru AA. Assessing social protection influence on health status in the European Union. Front Public Health 2024; 12:1287608. [PMID: 38528863 PMCID: PMC10962762 DOI: 10.3389/fpubh.2024.1287608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 02/26/2024] [Indexed: 03/27/2024] Open
Abstract
Introduction Health status and access to healthcare services are crucial factors that directly impact the well-being of individuals and societies. In the European Union (EU), social protection measures are significant in supporting citizens' health and providing access to healthcare resources. Methods This study investigates the relationship between social protection and health status in EU countries. We collected data from Eurostat on the EU member states' health status, healthcare expenditure, and social protection expenditure. The paper used structural equation modeling (SEM) and cluster analysis to analyze the complex interplay among these variables. Results Findings revealed a strong positive correlation between EU countries' social protection expenditure and healthcare status. Higher social protection spending was associated with improved access to healthcare services and facilities. Moreover, the analysis showed that countries with higher social protection expenditure tended to exhibit better overall health status indicators among their populations. Discussion The results suggest that adequate social protection expenditure positively influences health status in the European Union. By investing in robust social protection programs, governments can enhance citizens' access to healthcare services and resources, ultimately leading to improved health outcomes. These findings underscore the importance of prioritizing social protection policies to address health disparities and promote public health in the EU.
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Affiliation(s)
- Claudiu George Bocean
- Department of Management, Marketing and Business Administration, Faculty of Economics and Business Administration, University of Craiova, Craiova, Romania
| | - Anca Antoaneta Vărzaru
- Department of Economics, Accounting and International Business, Faculty of Economics and Business Administration, University of Craiova, Craiova, Romania
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Martins ALJ, de Souza AA, da Silva GDM, Dantas ACDMTV, Marinho RA, Fernandes LDMM, Oliveira AMC, Magalhães Júnior HM, Paes-Sousa R. Access to health and social protection policies by homeless people during the COVID-19 pandemic: a mixed-methods case study on tailored inter-sector care during a health emergency. Front Public Health 2024; 12:1356652. [PMID: 38469268 PMCID: PMC10926274 DOI: 10.3389/fpubh.2024.1356652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/05/2024] [Indexed: 03/13/2024] Open
Abstract
Introduction The article analyzed homeless people's (HP) access to health and social protection policies and tailored inter-sector care, including emergency measures, during the COVID-19 pandemic in Belo Horizonte (BH), capital of Minas Gerais state, Brazil. It intended to provide data on HP and evaluate existing public policies focused on vulnerable populations during this health emergency. Methods The study adopted a mixed-methods design with triangulation of quantitative and qualitative data. Results Social cartography showed that in the early months of the pandemic, the health administration had difficulty reordering the health system, which experienced constant updates in the protocols but was nevertheless consolidated over the months. The evidence collected in the study showed that important emergency interventions in the municipality of BH involved activities that facilitated access by HP to the supply of services. Discussion The existence of national guidelines for inter-sector care for HP cannot be ruled out as a positive influence, although the municipalities are responsible for their implementation. Significantly, a health emergency was necessary to intensify the relationship between health and social protection services. Roving services were among those with the greatest positive evidence, with the least need for infrastructure to be replicated at the local level. In addition, the temporary supply of various inter-sector services, simultaneously with the provision of day shelters by organized civil society, was considered a key factor for expanding and intensifying networks of care for HP during the emergency phase. A plan exists to continue and expand this model in the future. The study concluded that understanding the inter-sector variables that impact HP contributes to better targeting of investments in interventions that work at the root causes of these issues or that increase the effectiveness of health and social protection systems.
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Affiliation(s)
- Ana Luisa Jorge Martins
- Health and Social Protection Policies Research Group, René Rachou Institute/Fiocruz Minas, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
| | - Anelise Andrade de Souza
- Health and Social Protection Policies Research Group, René Rachou Institute/Fiocruz Minas, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
- School of Nutrition, Federal University of Ouro Preto (UFOP), Ouro Preto, Minas Gerais, Brazil
| | - Gabriela Drummond Marques da Silva
- Health and Social Protection Policies Research Group, René Rachou Institute/Fiocruz Minas, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
| | | | - Rafaela Alves Marinho
- Health and Social Protection Policies Research Group, René Rachou Institute/Fiocruz Minas, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
| | - Luísa da Matta Machado Fernandes
- Health and Social Protection Policies Research Group, René Rachou Institute/Fiocruz Minas, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
| | - Ana Maria Caldeira Oliveira
- Health and Social Protection Policies Research Group, René Rachou Institute/Fiocruz Minas, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
| | - Helvécio Miranda Magalhães Júnior
- Health and Social Protection Policies Research Group, René Rachou Institute/Fiocruz Minas, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
| | - Rômulo Paes-Sousa
- Health and Social Protection Policies Research Group, René Rachou Institute/Fiocruz Minas, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
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Ongoh M, Afranie S, Ohemeng F, Abekah-Carter K, Godi AH. Planning for retirement during active service in Ghana: Insights from pensioners in the Greater Accra Region. J Aging Soc Policy 2024:1-19. [PMID: 38402598 DOI: 10.1080/08959420.2024.2320045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 11/30/2023] [Indexed: 02/27/2024]
Abstract
Workers often participate in pre-retirement planning activities to gain awareness of the likely changes they may experience when they retire to enable them to prepare accordingly. Although pre-retirement planning is essential for successful retirement and healthy aging, studies on pre-retirement planning activities among older adults in Ghana are limited. This study explored pre-retirement planning actions that were taken by Social Security and National Insurance Trust (SSNIT) pensioners in the Greater Accra Region of Ghana. A sequential explanatory mixed-methods approach was adopted to gather data from 437 pensioners aged 60 years and above through surveys, interviews, and focus group discussions. The results indicate that while in active service, many (309) pensioners were not motivated to plan for retirement due to issues, such as low income, and distrust of financial institutions. When planning did take place, the pensioners favored financial planning over social, mental, and physical planning. The respondents also revealed that they did not prepare adequately for retirement due to low salaries, as well as low knowledge on pre-retirement planning. Policies are needed to encourage pre-retirement planning among workers in Ghana to enable them to have an appreciable quality of life in old age.
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Affiliation(s)
- Myles Ongoh
- LEAP Management Secretariat, Ministry of Gender, Children and Social Protection, Accra, Ghana
- Centre for Social Policy Studies, University of Ghana, Legon, Accra, Ghana
| | - Stephen Afranie
- Centre for Social Policy Studies, University of Ghana, Legon, Accra, Ghana
| | - Fedelia Ohemeng
- Department of Sociology, University of Ghana, Legon, Accra, Ghana
| | | | - Anthony H Godi
- Department of Biostatistics, School of Public Health, University of Ghana, Legon, Accra, Ghana
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Besnier E, Kotzias V, Hlabana T, Beck K, Sieu C, Muthengi K. Exploring health equity in Lesotho's Child Grants Programme. Health Policy Plan 2024; 39:138-155. [PMID: 38266253 PMCID: PMC10883666 DOI: 10.1093/heapol/czad116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 01/26/2024] Open
Abstract
Despite their growing popularity, little is known about how cash transfers (CTs) can affect health equity in targeted communities. Lesotho's Child Grants Programme (CGP) is an unconditional CT targeting poor and vulnerable households with children. Started in 2009, the CGP is one of Lesotho's key programmes in developing the country's social protection system. Using the CGP's early phases as a case study, this research aims to capture how programme stakeholders understood and operationalized the concept of health equity in Lesotho's CGP. The qualitative analysis relied on the triangulation of findings from a desk review and semi-structured key informant interviews with programme stakeholders. The programme documents were coded deductively and the interview transcripts inductively. Both materials were analysed thematically before triangulating their findings. We explored determining factors for differences or disagreements within a theme according to the programme's chronology, the stakeholders' affiliations and their role(s) in the CGP. The definitions of health equity in the context of the CGP reflected an awareness among stakeholders of these issues and their determinants but also the challenges raised by the complex (or even debated) nature of the concept. The most common definition of this concept focused on children's access to health services for the most disadvantaged households, suggesting a narrow, targeted approach to health equity as targeting disadvantages. Yet, even the most common definition of this concept was not fully translated into the programme, especially in the day-to-day operations and reporting at the local level. This operationalization gap affected the study of selected health spillover effects of the CGP on health equity and might have undermined other programme impacts related to specific health disadvantages or gaps. As equity objectives become more prominent in CTs, understanding their meaning and translation into concrete, observable and measurable applications in programmes are essential to support impact.
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Affiliation(s)
- Elodie Besnier
- Centre for Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), PO box 8900, Torgarden, Trondheim 7491, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU PO box 8900, Torgarden, Trondheim 7491, Norway
| | - Virginia Kotzias
- Centre for Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), PO box 8900, Torgarden, Trondheim 7491, Norway
| | - Thandie Hlabana
- National University of Lesotho, P.O Roma 180, Roma, Lesotho
- School of Environmental Sciences, University of Hull, Cottingham Rd, Hull HU6 7RX, United Kingdom
| | - Kathryn Beck
- Centre for Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), PO box 8900, Torgarden, Trondheim 7491, Norway
- Centre for Fertility and Health, Norwegian Institute of Public Health, PO Box 222 Skøyen, Oslo N-0213, Norway
| | - Céline Sieu
- UNICEF Lesotho Country office, 13 UN Road UN House, Maseru, Lesotho
| | - Kimanzi Muthengi
- UNICEF Lesotho Country office, 13 UN Road UN House, Maseru, Lesotho
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Besnier E, Finseraas H, Sieu C, Muthengi K. Using cash transfers to promote child health equity: an analysis of Lesotho's Child Grants Program. Health Policy Plan 2024; 39:118-137. [PMID: 38266251 PMCID: PMC11020256 DOI: 10.1093/heapol/czad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 05/05/2023] [Accepted: 07/03/2023] [Indexed: 01/26/2024] Open
Abstract
Cash transfers (CTs) are increasingly popular tools for promoting social inclusion and equity in children in sub-Saharan Africa. However, less is known about their implications for reducing the health gap between the beneficiary and non-beneficiary children in the community. Using Lesotho's Child Grants Program (CGP) as a case study, we aim to understand better the potential for CT programmes to reduce the gap in child health in the targeted communities. Using a triple difference model, we examine to what extent CGP improved child health outcomes in eligible households compared with non-eligible households in treatment communities vs control communities and to what extent this effect varied in different population subgroups. We find that the child health gap by beneficiary children's health outcomes catching-up on the health of non-beneficiary children narrowed but that eduction was not statistically significant. However, such a 'catch-up' effect among beneficiaries was observed for selected nutrition outcomes amongst female-headed households and subjective child health assessment for comparatively more food-secure households. This study highlights the potential and limitations of CT programmes like the CGP to address health inequalities in preschool children for selected population subgroups in the community.
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Affiliation(s)
- Elodie Besnier
- Centre for Global Health Inequalities Research, NTNU Department of Sociology and Political Science, SU Faculty, Norwegian University of Science and Technology, PO box 8900, Torgarden, Trondheim 7491, Norway
- NTNU Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, PO box 8900, Torgarden, Trondheim 7491, Norway
| | - Henning Finseraas
- Centre for Global Health Inequalities Research, NTNU Department of Sociology and Political Science, SU Faculty, Norwegian University of Science and Technology, PO box 8900, Torgarden, Trondheim 7491, Norway
| | - Celine Sieu
- UNICEF Lesotho Country office, 13 UN Road, UN House, Maseru, Lesotho
| | - Kimanzi Muthengi
- UNICEF Lesotho Country office, 13 UN Road, UN House, Maseru, Lesotho
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Besnier E, Hlabana T, Kotzias V, Beck K, Sieu C, Muthengi K. Exploring economic empowerment and gender issues in Lesotho's Child Grants Programme: a qualitative study. Health Policy Plan 2024; 39:95-117. [PMID: 36760020 DOI: 10.1093/heapol/czad009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/19/2022] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
Cash transfers (CTs) have been increasingly used in low- and middle-income countries as a poverty reduction and social protection tool. Despite their potential for empowering vulnerable groups (especially women), the evidence for such outcomes remains unclear. Additionally, little is known about how this broad concept fits into and is perceived in such programmes. For example, Lesotho's Child Grants Programme (CGP) is an unconditional CT targeting poor and vulnerable households with children. The CGP has been presented as one of the Lesotho's flagship programmes in developing the country's social safety net system. Using the CGP's early phases as a case study, this research aims to capture how programme stakeholders understood and operationalized the concept of economic empowerment (especially women's) in Lesotho's CGP. The qualitative analysis relied on the triangulation of information from a review of programme documents and semi-structured key informant interviews with programme stakeholders. First, the programme documents were coded deductively, while the interview transcripts were coded inductively, and then both materials were analysed thematically. Finally, differences or disagreements within each theme were explored individually according to the programme's chronology, the stakeholders' affiliation and their role in the CGP. The complexity of economic empowerment was reflected in the diversity of definitions found in the desk review and interviews. Economic empowerment was primarily understood as improving access to economic resources and opportunities and, less so, as agency and social and economic inclusion. There were stronger disagreements on other definitions as they seemed to be a terminology primarily used by specific stakeholders. This diversity of definitions impacted how these concepts were integrated into the programme, with particular gaps between the strategic vision and operational units as well as between the role this concept was perceived to play and the effects evaluated so far.
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Affiliation(s)
- Elodie Besnier
- Centre for Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), PO Box 8900, Torgarden, Trondheim 7491, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, PO Box 8900, Torgarden, Trondheim 7491, Norway
| | - Thandie Hlabana
- National University of Lesotho, P.O. Roma 180, Roma, Lesotho
- School of Environmental Sciences, University of Hull, Cottingham Rd., Hull HU6 7RX, UK
| | - Virginia Kotzias
- Centre for Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), PO Box 8900, Torgarden, Trondheim 7491, Norway
| | - Kathryn Beck
- Centre for Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), PO Box 8900, Torgarden, Trondheim 7491, Norway
- Centre for Fertility and Health, Norwegian Institute of Public Health, P.O. box 222, Skøyen, Oslo N-0213, Norway
| | - Celine Sieu
- UNICEF Lesotho Country Office, 13 UN Road, UN House, Maseru, Lesotho
| | - Kimanzi Muthengi
- UNICEF Lesotho Country Office, 13 UN Road, UN House, Maseru, Lesotho
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Laurenzi CA, Toska E, Tallarico R, Sherr L, Steventon Roberts KJ, Hansen M, Tolmay J, Jochim J, Ameyan W, Yates R. Key normative, legal, and policy considerations for supporting pregnant and postpartum adolescents in high HIV-burden settings: a critical analysis. Sex Reprod Health Matters 2023; 31:2249696. [PMID: 37712411 PMCID: PMC10506436 DOI: 10.1080/26410397.2023.2249696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023] Open
Abstract
Rates of adolescent pregnancy within sub-Saharan Africa are increasing. Adolescent mothers ages 10-19 years face a distinct set of risks to their own and their children's health, compounded by many economic, social, and epidemiological challenges, such as living with HIV. In navigating this complex developmental period, many adolescent mothers face structural barriers impeding safe transitions to adulthood and motherhood. Drawing on existing literature and emerging data, we outline three normative, legal, and policy issues - violence and gender inequity, access to sexual and reproductive health services, and access to social and structural supports - which affect the health, wellbeing and development of adolescent mothers and their children. We also highlight emergent evidence about programming and policy changes that can better support adolescent mothers and their children. These key proposed responses include removing barriers to SRH and HIV service integration; ensuring implementation of return-to-school policies; and extending social protection systems to cater for adolescent mothers. Despite ongoing global crises and shifts in funding priorities, these normative, legal, and policy considerations remain critical to safeguard the health and wellbeing of adolescent mothers and their children.
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Affiliation(s)
- Christina A. Laurenzi
- Senior Researcher, Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Elona Toska
- Associate Professor, Centre for Social Science Research, Department of Sociology, University of Cape Town, Rondebosch, South Africa; Co-director, Accelerate Hub, University of Cape Town, Rondebosch, South Africa; Associate Professor, Department of Social Policy and Intervention, Oxford University, Oxford, United Kingdom
| | - Renata Tallarico
- Youth Team Lead and SYP Regional Coordinator, United Nations Population Fund, Eastern and Southern Regional Office, Johannesburg, South Africa
| | - Lorraine Sherr
- Professor, Clinical and Health Psychology, University College London, London, United Kingdom
| | - Kathryn J. Steventon Roberts
- Postdoctoral Researcher, Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom; Postgraduate Researcher, Institute for Global Health, University College London, London, United Kingdom
| | - Maja Hansen
- Technical Advisor, Gender Equality, United Nations Population Fund, Dar es Salaam, Tanzania
| | - Janke Tolmay
- Quantitative Research Assistant, Accelerate Hub, Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa
| | - Janina Jochim
- Postdoctoral Research Officer, Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Wole Ameyan
- Technical Officer, Adolescent HIV, Global HIV Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Rachel Yates
- Strategic Advocacy Lead, Accelerate Hub, University of Oxford, Oxford, United Kingdom
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Athe R, Dwivedi R, Singh K, Babusab Hulmani S, Karadi N, Boraiah C, Vasu S. Impact of COVID-19 on the Mental Health of Healthcare Workers and Job Loss From a Gender Perspective in India: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e48219. [PMID: 38050506 PMCID: PMC10693901 DOI: 10.7759/cureus.48219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 12/06/2023] Open
Abstract
The COVID-19 pandemic caused significant stress and anxiety among the general population and healthcare workers (HCWs) worldwide. India is one of the countries severely impacted by the pandemic. This review explores the gender perspective of mental health conditions among HCWs and job loss during the pandemic in India. Electronic databases (PubMed, Scopus, and Web of Science) were searched for articles published till March 2021. Studies that reported the prevalence of depression, anxiety, stress, and worry among HCWs in India during the pandemic and job loss in both males and females due to COVID-19 were included. We used a random-effects model to estimate pooled prevalence rates with 95% CIs. We assessed heterogeneity using the I2 statistic. The meta-analysis included 11 studies; the pooled prevalence of depression, anxiety, stress, and worry among HCWs was 34.9% (95%CI 27.33, 42.47), 35.4% (95%CI 24.46, 46.33), 32.9% (95%CI 25.43, 40.37), and 42.87% (95%CI 25.83, 59.91), respectively. The pooled prevalence of job loss due to COVID-19 was 16.6% (95%CI 8.34, 19.66). We employed meta-regression and Egger's regression for publication bias. The meta-analysis findings suggest that the prevalence of depression, anxiety, stress, and worry among HCWs in India during COVID-19 was high. Furthermore, job loss due to COVID-19 has also been prevalent in India. These findings emphasize the need for mental health support for HCWs and those who have lost their jobs during the pandemic. It is essential to prioritize mental health and job creation policies in India to support individuals affected by COVID-19.
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Affiliation(s)
- Ramesh Athe
- Data Science and Intelligent Systems, Indian Institute of Information Technology Dharwad, Dharwad, IND
| | - Rinshu Dwivedi
- Science and Humanities, Indian Institute of Information Technology Tiruchirappalli, Tiruchirappalli, IND
| | - Kasha Singh
- Computer Science and Engineering, Indian Institute of Information Technology Dharwad, Dharwad, IND
| | - Sabiha Babusab Hulmani
- Computer Science and Engineering, Indian Institute of Information Technology Dharwad, Dharwad, IND
| | - Nikhita Karadi
- Computer Science and Engineering, Indian Institute of Information Technology Dharwad, Dharwad, IND
| | - Chaithanya Boraiah
- Computer Science and Engineering, Indian Institute of Information Technology Dharwad, Dharwad, IND
| | - Sindhu Vasu
- Science and Humanities, Indian Institute of Information Technology Tiruchirappalli, Tiruchirappalli, IND
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Hung J, Chen J, Chen O. The practice of social protection policies in China: a systematic review on how left-behind children's mental health can be optimised. Perspect Public Health 2023:17579139231205491. [PMID: 37889069 DOI: 10.1177/17579139231205491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
AIMS By discussing the mental health challenges faced by left-behind children, this article recommends or comments on existing social protection policies that can affect left-behind children's mental health at the micro-, meso- and macro-levels to holistically understand how a range of parties can jointly socially include left-behind children, a process which is conducive to the latter's mental health development. METHODS J.H. carried out a systematic review by searching through the English bibliographical databases Google Scholar, Web of Science and Scopus, in addition to Chinese bibliographic databases CNKI, Wanfang Data and VIP Chinese Science and Technology Periodicals. Here J.H. searched for the words ('social protection' OR 'socially protected') AND ('mental health' OR 'psychological wellbeing' OR 'mental problems' OR 'psychological problems') AND ('left-behind children' OR 'LBC' OR 'leftover children') AND ('China' OR 'Chinese'). Publication dates of the search results were limited to between 2010 and 2022. RESULTS One of the primary problems encountered by left-behind children is their inadequate home supervision. A further study indicates that parental migration serves as a crucial risk factor for child depression. State-level provision of insurance programmes helps curtail these children's encounters of mental health challenges. Moreover, an improvement in family and school protection is essential when optimising the protection system for left-behind rural Chinese children from poor villages. It is necessary for upper-level government units to re-structure their lower-level counterparts to improve the local administration. This allows lower-level government units to exploit preferential policies, refine relevant regulations and policies on child protection, and facilitate the establishment of social organisations where local policies can be successfully implemented to socially include and protect left-behind children in villages. CONCLUSIONS At the meso-level, community environment construction should be emphasised. At macro- and meso-levels, government authorities and social organisations should encourage the marketisation of hiring professional surrogate parents. At the micro-level, migrant parents should proactively take an initiative to contact their left-behind children via telecommunications.
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Affiliation(s)
- J Hung
- Department of Sociology, University of Cambridge, Cambridge, UK
- Institute of Sociology, Academia Sinica, Taipei City Collegiate Castle Street, Cambridge CB3 0SZ, Cambridgeshire, UK
| | - J Chen
- Department of Sociology, The London School of Economics and Political Science, London, UK
| | - O Chen
- Department of Social Policy, The London School of Economics and Political Science, London, UK
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Voivozeanu A, Lafleur JM. Welfare brokers and European Union migrants' access to social protection. Br J Sociol 2023; 74:717-732. [PMID: 37656814 DOI: 10.1111/1468-4446.13021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 03/17/2023] [Accepted: 04/04/2023] [Indexed: 09/03/2023]
Abstract
In spite of the existence of an extensive national and supranational legal framework, European Union (EU) citizens who exercise their right to freedom of movement to work in another Member State face numerous hurdles in accessing social protection. While recent scholarship on street-level bureaucracy and on migration and welfare has shed light on the role of discretion and stereotypes in access to rights, little is known about the processes through which such hurdles are overcome. In this article, we focus on a specific strategy which is the recourse to what we call "welfare brokers". These actors offer assistance to EU migrants to overcome specific cross-border administrative challenges in the area of social protection that derive from their use of the right to freedom of movement. Relying on qualitative data collected with brokers and Romanian migrants working in Germany, the article also demonstrates that welfare brokers attempt to transform the norms, bureaucratic practices and representations that condition access to these entitlements. The article concludes by underlining how the existence of a brokerage industry is a sign of existing inequalities in the exercise of freedom of movement within the EU.
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Affiliation(s)
| | - Jean-Michel Lafleur
- Université de Liège, Centre for Ethnic and Migration Studies, Liège, Belgium
- FRS-FNRS, Liège, Belgium
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Parbst M, Wheaton B. The Effect of Welfare State Policy Spending on the Equalization of Socioeconomic Status Disparities in Mental Health. J Health Soc Behav 2023; 64:336-353. [PMID: 37096773 PMCID: PMC10486153 DOI: 10.1177/00221465231166334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This article examines whether and how the relationship between socioeconomic status (SES) and depression is modified by welfare state spending using the 2006, 2012, and 2014 survey rounds of the European Social Survey (ESS) merged with macroeconomic data from the World Bank, Eurostat, and SOCX database (N = 87,466). Welfare state spending effort divided between social investment and social protection spending modifies the classic inverse relationship between SES and depression. Distinguishing policy areas in both social investment and social protection spending demonstrates that policy programs devoted to education, early childhood education and care, active labor market policies, old age care, and incapacity account for differences in the effect of SES across countries. Our analysis finds that social investment policies better explain cross-national differences in the effect of SES on depression, implying policies focused earlier in the life course matter more for understanding social disparities in the mental health of populations.
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Bustos M, Lau LL, Kirkpatrick SI, Dubin JA, Manguerra H, Dodd W. Examining the Association Between Household Enrollment in the Pantawid Pamilyang Pilipino Program (4Ps) and Wasting and Stunting Status Among Children Experiencing Poverty in the Philippines: A Cross-Sectional Study. Asia Pac J Public Health 2023; 35:420-428. [PMID: 37501321 PMCID: PMC10510302 DOI: 10.1177/10105395231189570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
This study assessed whether enrollment in a national conditional cash transfer program was associated with wasting and stunting among children experiencing extreme poverty in the Philippines. Data were drawn from cross-sectional surveys collected from 10 regional areas in the Philippines between April 2018 and May 2019. A total of 2945 children aged between six months and 12 years comprised the analytical sample. Multilevel logistic regression was conducted to estimate the association between enrollment in Pantawid Pamilyang Pilipino Program (4Ps) and stunting and wasting, controlling for sociodemographic factors and clustering by region. There was no meaningful association between household enrollment in 4Ps and the wasting status of children, but enrollment in 4Ps was associated with lower odds of stunting and differed by geography type. Findings suggest that the current design of 4Ps may not address sudden shocks that contribute to wasting, but may address the underlying socioeconomic risk factors associated with stunting.
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Affiliation(s)
- Monica Bustos
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Lincoln L. Lau
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- International Care Ministries, Manila, Philippines
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Joel A. Dubin
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Warren Dodd
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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13
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Dinh LV, Wiemers AMC, Forse RJ, Phan YTH, Codlin AJ, Annerstedt KS, Dong TTT, Nguyen L, Pham TH, Nguyen LH, Dang HMT, Tuan MH, Le PT, Lonnroth K, Creswell J, Khan A, Kirubi B, Nguyen HB, Nguyen NV, Vo LNQ. Comparing Catastrophic Costs: Active vs. Passive Tuberculosis Case Finding in Urban Vietnam. Trop Med Infect Dis 2023; 8:423. [PMID: 37755885 PMCID: PMC10535862 DOI: 10.3390/tropicalmed8090423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 09/28/2023] Open
Abstract
Active case finding (ACF) is a strategy that aims to identify people with tuberculosis (TB) earlier in their disease. This outreach approach may lead to a reduction in catastrophic cost incurrence (costs exceeding 20% of annual household income), a main target of WHO's End TB Strategy. Our study assessed the socio-economic impact of ACF by comparing patient costs in actively and passively detected people with TB. Longitudinal patient cost surveys were prospectively fielded for people with drug-sensitive pulmonary TB, with 105 detected through ACF and 107 passively detected. Data were collected in four Vietnamese cities between October 2020 and March 2022. ACF reduced pre-treatment (USD 10 vs. 101, p < 0.001) and treatment costs (USD 888 vs. 1213, p < 0.001) in TB-affected individuals. Furthermore, it reduced the occurrence of job loss (15.2% vs. 35.5%, p = 0.001) and use of coping strategies (28.6% vs. 45.7%, p = 0.004). However, catastrophic cost incurrence was high at 52.8% and did not differ between cohorts. ACF did not significantly decrease indirect costs, the largest contributor to catastrophic costs. ACF reduces costs but cannot sufficiently reduce the risk of catastrophic costs. As income loss is the largest driver of costs during TB treatment, social protection schemes need to be expanded.
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Affiliation(s)
| | | | - Rachel J. Forse
- Friends for International TB Relief, Ha Noi 10000, Vietnam
- WHO Collaboration Centre on Tuberculosis and Social Medicine, Department of Global Public Health, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Yen T. H. Phan
- Center for Development of Community Health Initiatives, Ha Noi 10000, Vietnam
| | - Andrew J. Codlin
- Friends for International TB Relief, Ha Noi 10000, Vietnam
- WHO Collaboration Centre on Tuberculosis and Social Medicine, Department of Global Public Health, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Kristi Sidney Annerstedt
- WHO Collaboration Centre on Tuberculosis and Social Medicine, Department of Global Public Health, Karolinska Institutet, 171 76 Stockholm, Sweden
| | | | - Lan Nguyen
- IRD VN, Ho Chi Minh City 700000, Vietnam
| | | | - Lan H. Nguyen
- Pham Ngoc Thach Hospital, Ho Chi Minh City 700000, Vietnam
| | - Ha M. T. Dang
- Pham Ngoc Thach Hospital, Ho Chi Minh City 700000, Vietnam
| | - Mac H. Tuan
- Hai Phong Lung Hospital, Hai Phong 188140, Vietnam
| | | | - Knut Lonnroth
- WHO Collaboration Centre on Tuberculosis and Social Medicine, Department of Global Public Health, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Jacob Creswell
- Stop TB Partnership, Le Grand-Saconnex, 1218 Geneva, Switzerland
| | - Amera Khan
- Stop TB Partnership, Le Grand-Saconnex, 1218 Geneva, Switzerland
| | - Beatrice Kirubi
- Stop TB Partnership, Le Grand-Saconnex, 1218 Geneva, Switzerland
| | | | | | - Luan N. Q. Vo
- Friends for International TB Relief, Ha Noi 10000, Vietnam
- WHO Collaboration Centre on Tuberculosis and Social Medicine, Department of Global Public Health, Karolinska Institutet, 171 76 Stockholm, Sweden
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14
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Faria L, Alvarez REC, Santos LADC. Socioeconomic inequality in Latin America and the Caribbean: the post-pandemic future for the training of health professionals. Hist Cienc Saude Manguinhos 2023; 30:e2023029. [PMID: 37585974 PMCID: PMC10481621 DOI: 10.1590/s0104-59702023000100029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/21/2022] [Indexed: 08/18/2023]
Abstract
Inequality is a global, structural problem that is particularly marked in the world's poorest countries. The covid-19 pandemic exacerbated this historic problem in Latin America and the Caribbean and deepened uncertainties in relation to basic human needs. This study presents an overview of the subject on the basis of official reports from international agencies (PAHO, WHO, ECLAC) between 2019 and 2022 and discusses some paths for the training of health professionals in Brazil. It also investigates how health practices could be changed to ensure greater social protection for vulnerable populations, based on the proposals of Paulo Freire and Edgar Morin, which highlight current social and health problems.
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Affiliation(s)
- Lina Faria
- Professora associada e coordenadora institucional, Mestrado Profissional em Saúde da Família/Universidade Federal do Sul da Bahia.Porto Seguro - BA - Brasil
| | - Rocío Elizabeth Chavez Alvarez
- Professora permanente, Mestrado Profissional em Saúde da Família/ Universidade Federal do Sul da Bahia.Porto Seguro - BA - Brasil
| | - Luiz Antonio de Castro Santos
- Docente permanente (colaborador), Mestrado Profissional em Saúde da Família/Universidade Federal do Sul da Bahia.Porto Seguro - BA - Brasil
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15
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Raub A, Heymann J. Assessing national action through emergency paid leave to mitigate the impact of COVID-19-related school closures on working families in 182 countries. Glob Soc Policy 2023; 23:247-267. [PMID: 38603401 PMCID: PMC9468866 DOI: 10.1177/14680181221123800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
In April 2020, nearly 1.6 billion learners were out of school. While a growing body of literature has documented the detrimental impact of these closures on children, less attention has been devoted to the steps countries took to mitigate the impact of these closures on working families. Paid leave is recognized as an important policy tool to enable working parents the time they need to respond to family needs without risking job or income loss. This article uses a novel data set to assess whether countries had policies in place prior to the pandemic to respond to increased care needs and the extent to which policies were introduced or expanded during the pandemic to fill the gap. Only 48 countries had policies in place prior to the pandemic that could be used to respond to the care needs created by school and childcare center closures. In the vast majority of these countries, the duration of leave in these policies was too short to meet the care needs of the pandemic or relied on parents reserving extended parental leave options. Only 36 countries passed new legislation during the pandemic, but the majority of those that did covered the full duration of closures. As countries continue to face COVID-19 and consider how to better prepare for the next pandemic, emergency childcare paid leave policies should be part of pandemic preparedness frameworks to prevent further exacerbating inequalities. The policies introduced during the pandemic offer a wide range of approaches for countries to identify feasible solutions.
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Affiliation(s)
- Amy Raub
- University of California, Los Angeles, USA; The University of Melbourne, Australia
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16
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Mont D. Estimating the extra disability expenditures for the design of inclusive social protection policies. Front Rehabil Sci 2023; 4:1179213. [PMID: 37583874 PMCID: PMC10423933 DOI: 10.3389/fresc.2023.1179213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/29/2023] [Indexed: 08/17/2023]
Abstract
For social protection policies to be inclusive they must address the extra costs that people with disabilities incur. Studies show that these costs are highly significant and if not taken into account the economic wellbeing of people with disabilities is underestimated. Additionally, disability costs vary significantly by the type and degree of disability. To align the structure of social protection programs with how costs are incurred to promote equal participation requires estimating those costs. The Goods and Services Required approach, it is argued, is better than the often used Standard of Living Approach, and has implications for policy design.
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Affiliation(s)
- Daniel Mont
- Center for Inclusive Policy, Washington, DC, United States
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17
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Gao J, Kim H, Mitra S. Out-of-Pocket Health Expenditures Associated with Chronic Health Conditions and Disability in China. Int J Environ Res Public Health 2023; 20:6465. [PMID: 37569006 PMCID: PMC10418713 DOI: 10.3390/ijerph20156465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/13/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023]
Abstract
The objective of this study is to estimate the extra costs of living associated with chronic health conditions and disabilities in China. Leveraging the 2018 China Health and Retirement Longitudinal Study involving 13,530 respondents aged 50 and over, we apply both an ordinary least squares linear regression model and a logistic model to analyze the correlation between medical out-of-pocket expenditures (OOPEs) and chronic health conditions, as well as disabilities measured by Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) limitations. This paper bridges the gap in the literature on OOPEs and their association with disabilities and chronic health conditions, respectively. We find that ADL limitations, IADL limitations, and chronic health conditions are consistently associated with higher OOPEs. The odds that older persons with disabilities and chronic health conditions incur OOPEs are two to three times higher than for persons without disabilities and chronic health conditions, respectively. Persons with disabilities and chronic health conditions have the highest OOPEs. The findings suggest that more policy and research attention is necessary to improve the financial protection of those with chronic health conditions and disabilities, including through access to comprehensive health insurance coverage.
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Affiliation(s)
- Jingyi Gao
- Department of Economics, Fordham University, Bronx, NY 10458, USA
| | - Hoolda Kim
- College of Business and Economics, Fayetteville State University, Fayetteville, NC 28301, USA;
| | - Sophie Mitra
- Department of Economics, Fordham University, Bronx, NY 10458, USA
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18
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McNamara CL, Kotzias V, Bambra C, Labonté R, Stuckler D. Have COVID-19 Stimulus Packages Mitigated the Negative Health Impacts of Pandemic-Related Job Losses? A Systematic Review of Global Evidence from the First Year of the Pandemic. Int J Soc Determinants Health Health Serv 2023; 53:311-322. [PMID: 37272269 PMCID: PMC10243096 DOI: 10.1177/27551938231176374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 06/06/2023]
Abstract
Social protection can buffer the negative impacts of unemployment on health. Have stimulus packages introduced during the COVID-19 pandemic mitigated potential harms to health from unemployment? We performed a systematic review of the health effects of job loss during the first year of the pandemic. We searched three electronic databases and identified 49 studies for inclusion. Three United States-based studies found that stimulus programs mitigated the impact of job loss on food security and mental health. Furloughs additionally appeared to reduce negative impacts when they were paid. However, despite the implementation of large-scale stimulus packages to reduce economic harms, we observed a clear pattern that job losses were nevertheless significantly associated with negative impacts, particularly on mental health, quality of life, and food security. We also observe suggestive evidence that COVID-related job loss was associated with child maltreatment, worsening dental health, and poor chronic disease outcomes. Overall, although we did find evidence that income-support policies appeared to help protect people from the negative health consequences of pandemic-related job loss, they were not sufficient to fully offset the threats to health. Future research should ascertain how to ensure adequate access to and generosity of social protection programs during epidemics and economic downturns.
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Affiliation(s)
- Courtney L. McNamara
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- Centre for Global Health Inequalities Research (CHAIN). Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Virginia Kotzias
- Centre for Global Health Inequalities Research (CHAIN). Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Clare Bambra
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- Centre for Global Health Inequalities Research (CHAIN). Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ronald Labonté
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - David Stuckler
- Dondena Centre for Research on Social Dynamics and Department of Social & Political Sciences, Bocconi University, Milano, Italy
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19
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Kundo HK, Brueckner M, Spencer R, Davis JK. Enhancing the resilience and well-being of rural poor to climate risks: are the economic functions of social protection enough? Disasters 2023; 47:651-675. [PMID: 35913085 DOI: 10.1111/disa.12559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
As climate change accelerates, adaptive social protection programmes are becoming increasingly more popular than conventional social assistance programmes, since they are seen to enhance people's resilience and well-being outcomes. Despite this upsurge, little is known about the impacts of adaptive programmes on resilience and well-being outcomes as compared to conventional programmes. This paper examines the economic functions that both types of social protection programmes offer through empirical studies in two climate-vulnerable zones in Bangladesh. By operationalising a simplified analytical framework to comprehend subjective resilience, the qualitative data reveal that the adaptive programme is more effective in enhancing beneficiaries' perceived resilience to climate risks. Regrettably, neither programme is found to contribute much significantly in terms of enabling beneficiaries to achieve the desired well-being outcomes that one might expect to see. The paper offers rich insights into the design components of the programmes, affording an on-the-ground understanding of their implications for resilience and well-being.
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Affiliation(s)
- Hare Krisna Kundo
- PhD Researcher at Murdoch University, Australia
- Associate Professor in Public Administration at Jahangirnagar University, Bangladesh
| | - Martin Brueckner
- Associate Professor in Sustainability at Murdoch University, Australia
| | - Rochelle Spencer
- Associate Professor in Development Studies and Sustainability at Murdoch University, Australia
| | - John K Davis
- Adjunct Lecturer at the Sheridan Institute of Higher Education, Australia
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20
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Yokobori Y, Kiyohara H, Mulati N, Lwin KS, Bao TQQ, Aung MN, Yuasa M, Fujita M. Roles of Social Protection to Promote Health Service Coverage among Vulnerable People toward Achieving Universal Health Coverage: A Literature Review of International Organizations. Int J Environ Res Public Health 2023; 20:ijerph20095754. [PMID: 37174271 PMCID: PMC10177917 DOI: 10.3390/ijerph20095754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/19/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023]
Abstract
A wider range of social protection services, including social insurance and social assistance, are gaining global attention as a key driver of improved health service coverage and financial protection among vulnerable populations. However, only a few studies have investigated the associations between social protection and universal health coverage (UHC). Therefore, we conducted a literature review on relevant international organizations with respect to this topic. We found that many international organizations consider the wide range of social protection services, including social insurance and social assistance, essential for achieving UHC in 2030. In specific health programs, social protection is considered an important service to promote health service access and financial protection, especially among vulnerable populations. However, discussions about social protection for achieving UHC are not given high priority in the World Health Organization. Currently, the coverage of social protection services is low among vulnerable populations in low- and middle-income countries. To address this issue, we employed the metrics recommended by the migrant integration policy index (MIPEX). Based on our findings, a conceptual framework was developed. We expect this framework to lead synergy between social protection and health systems around the globe, resulting in healthy ageing.
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Affiliation(s)
- Yuta Yokobori
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Hiroyuki Kiyohara
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Nadila Mulati
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Kaung Suu Lwin
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
| | - Truong Quy Quoc Bao
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue 530000, Vietnam
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Motoyuki Yuasa
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Masami Fujita
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
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21
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Parisi D, Srivastava S, Parmar D, Strupat C, Brenner S, Walsh C, Neogi R, Basu S, Ziegler S, Jain N, De Allegri M. Awareness of India's national health insurance scheme (PM-JAY): a cross-sectional study across six states. Health Policy Plan 2023; 38:289-300. [PMID: 36478057 PMCID: PMC10019566 DOI: 10.1093/heapol/czac106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/19/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022] Open
Abstract
The literature suggests that a first barrier towards accessing benefits of health insurance in low- and middle-income countries is lack of awareness of one's benefits. Yet, across settings and emerging schemes, limited scientific evidence is available on levels of awareness and their determinants. To fill this gap, we assessed socio-demographic and economic determinants of beneficiaries' awareness of the Pradhan Mantri Jan Arogya Yojana (PM-JAY), the national health insurance scheme launched in India in 2018, and their awareness of own eligibility. We relied on cross-sectional household (HH) survey data collected in six Indian states between 2019 and 2020. Representative data of HHs eligible for PM-JAY from 11 618 respondents (an adult representative from each surveyed HH) were used. We used descriptive statistics and multivariable logistic regression models to explore the association between awareness of PM-JAY and of one's own eligibility and socio-economic and demographic characteristics. About 62% of respondents were aware of PM-JAY, and among the aware, 78% knew that they were eligible for the scheme. Regression analysis confirmed that older respondents with a higher educational level and salaried jobs were more likely to know about PM-JAY. Awareness was lower among respondents from Meghalaya and Tamil Nadu. Respondents from Other Backward Classes, of wealthier socio-economic status or from Meghalaya or Gujarat were more likely to be aware of their eligibility status. Respondents from Chhattisgarh were less likely to know about their eligibility. Our study confirms that while more than half of the eligible population was aware of PM-JAY, considerable efforts are needed to achieve universal awareness. Socio-economic gradients confirm that the more marginalized are still less aware. We recommend implementing tailored, state-specific information dissemination approaches focusing on knowledge of specific scheme features to empower beneficiaries to demand their entitled services.
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Affiliation(s)
| | - Swati Srivastava
- *Corresponding author. Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Im Neuenheimer Feld 130/3, Heidelberg 69120, Germany. E-mail:
| | - Divya Parmar
- King’s Centre for Global Health and Health Partnerships, King’s College London, Strand, London WC2R 2LS, UK
| | - Christoph Strupat
- German Institute of Development and Sustainability, Tulpenfeld, Bonn 6 53113, Germany
| | - Stephan Brenner
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Im Neuenheimer Feld 130.3, Heidelberg 69120, Germany
| | - Caitlin Walsh
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Im Neuenheimer Feld 130.3, Heidelberg 69120, Germany
| | - Rupak Neogi
- Nielsen India Private Limited, 7th floor Infotech Center 404-405 Near Country Inns and Suites, Phase III, Gurugram 122016, India
| | - Sharmishtha Basu
- Indo-German Social Security Programme (IGSSP), Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, B – 5/1 & 5/2 Ground Floor, Safdurjung Enclave, New Delhi 110029, India
| | - Susanne Ziegler
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Im Neuenheimer Feld 130.3, Heidelberg 69120, Germany
- Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, Friedrich-Ebert-Allee 32+36, Bonn 53113, Germany
| | - Nishant Jain
- Indo-German Social Security Programme (IGSSP), Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, B – 5/1 & 5/2 Ground Floor, Safdurjung Enclave, New Delhi 110029, India
| | - Manuela De Allegri
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Im Neuenheimer Feld 130.3, Heidelberg 69120, Germany
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22
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Trafford Z, Swartz L. The Care Dependency Grant for children with disabilities in South Africa: perspectives from implementation officials. Dev South Afr 2023; 40:259-272. [PMID: 36937539 PMCID: PMC7614334 DOI: 10.1080/0376835x.2021.1981250] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
For people with disabilities, appropriate social protection interventions can contribute to breaking the cyclical relationship between poverty and disability and may improve social inclusion. In South Africa, a national social assistance programme provides 'social grants' to individuals on the basis of poverty, age, or disability. These grants have been extensively studied but there has been little investigation into the Care Dependency Grant, designed to support the care of children with disabilities. These children consistently have far poorer outcomes on key metrics for wellbeing, health, and education than their non-disabled peers. More attention ought to be focused on uplifting this profoundly marginalised population. We present initial findings from interviews with officials at the South African Social Security Agency, the country's grants implementation agency. These narratives add weight to the growing local and international consensus that complementary interventions and effective intersectoral collaboration may greatly enhance the impact of cash transfers.
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Affiliation(s)
- Zara Trafford
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Leslie Swartz
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
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23
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Sjöberg O. Work-retirement transitions and mental health: A longitudinal analysis of the role of social protection generosity in 11 countries. Scand J Public Health 2023; 51:90-97. [PMID: 34510984 PMCID: PMC9903240 DOI: 10.1177/14034948211042130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
AIMS This study aimed to analyse the effect of work-retirement transitions on post-retirement mental health in individuals with different working conditions in late working life. The focus was on transitions that involve the use of social protection schemes to bridge the gap between the exit from work and retirement, and the extent to which the generosity of such schemes is related to mental health after retirement. METHODS Individual-level panel data from the Survey of Health, Ageing and Retirement in Europe for 11 European countries were analysed using structural equation models. A total of 1642 individuals who worked in 2004 or 2007 and who retired in 2013 or 2015 were included in the analyses. The outcome measure was mental health as measured by the EURO-D scale. RESULTS Respondents with a 'high strain' and 'passive' work situation have a significantly higher likelihood of using social protection schemes, such as early retirement, sickness, disability and invalidity schemes before retirement. The generosity of such schemes has a significant positive relation to post-retirement mental health. CONCLUSIONS
This study shows that the generosity of early exit pathways is important for post-retirement mental health, especially for individuals with adverse working conditions at the end of their working lives.
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Affiliation(s)
- Ola Sjöberg
- Ola Sjöberg, Swedish Institute for Social Research, Stockholm University, SE-10691 Stockholm, Sweden. E-mail:
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Konyuhova SG, Vagner VD, Nimaev BB, Chuykova EO. [On the question of legal regulation of the organization and provision of medical stomatological care to elderly citizens]. Stomatologiia (Mosk) 2023; 102:48-52. [PMID: 37622301 DOI: 10.17116/stomat202310204148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
The material of the article reflects the current state of the problem of organization and provision of medical dental care to elderly citizens. The content analysis of normative and legal sources regulating the provision of medical care to certain categories of senior citizens was carried out. The peculiarities of legal phenomena and imperfection of legislative acts are revealed which determine the further research work in this field of knowledge.
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Affiliation(s)
- S G Konyuhova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - V D Vagner
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - B B Nimaev
- A.I. Yevdokimov Moscow University of Medicine and Dentistry, Moscow, Russia
| | - E O Chuykova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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25
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Ranganathan M, Quinones S, Palermo T, Gilbert U, Kajula L, Quinones S, Kajula L, de Hoop J, Prencipe L, Groppo V, Tirivayi N, Waidler J, Nkolo JC, Mitti R, Mallet M, Munanka B, Luchemba P, Lukongo TM, Mulokozi A, Gilbert U, van Ufford PQ, Le Kirkegaard R, Eetaama F, Matafu J, Angemi D, Natali L. Transactional sex among adolescent girls and young women enrolled in a cash plus intervention in rural Tanzania: a mixed-methods study. J Int AIDS Soc 2022; 25:e26038. [PMID: 36451279 PMCID: PMC9712808 DOI: 10.1002/jia2.26038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 10/31/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Transactional sex or material exchange for sex is associated with HIV infection among adolescent girls and young women in sub-Saharan Africa. The motivations for engaging in transactional sex vary from the fulfilment of basic needs, to enhancing social status or for romantic reasons with the expectation that men should provide. Transactional sex is also associated with HIV risk behaviours, such as multiple sexual partners and other determinants of HIV risk, including partner violence and abuse, alcohol consumption and inconsistent condom use. METHODS We use data from a mixed-method, cluster randomised controlled trial of the Ujana Salama cash "plus" intervention in rural Tanzania. The data are from the first and third rounds of data collection (2017-2019). The impact evaluation consisted of a parallel mixed-methods design where the quantitative and qualitative data collection occurred simultaneously, and integration of the findings was done during the discussion. We first examine contextual factors associated with transactional sex using multivariable logistic regression models and then estimate whether the "plus" intervention reduced transactional sex among adolescent girls and young women using analysis of covariance. We used thematic content analysis for analysing qualitative transcripts. RESULTS The prevalence of transactional sex among unmarried adolescent girls and young women at round 3 was 26%. Findings show that increasing age is a risk factor for transactional sex (OR = 1.80; 95% CI: [1.50, 2.17]), staying in school was negatively associated with engagement in transactional sex (OR = 0.24; 95% CI: [0.14, 0.40]). The cash plus intervention showed no impacts on reducing transactional sex (β = 0.003, p = 0.905). CONCLUSIONS The mechanisms of impact for a cash plus intervention on transactional sex are complex; economic insecurity is an important driver of transactional sex and HIV infection, but psychosocial factors and gendered social norms need consideration in intervention development. Our findings suggest that combination prevention interventions to address the structural drivers of HIV infection should focus on efforts to increase school enrolment and completion.
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Affiliation(s)
| | - Sarah Quinones
- Department of Epidemiology and Environmental HealthUniversity at BuffaloBuffaloNew YorkUSA
| | - Tia Palermo
- Department of Epidemiology and Environmental HealthUniversity at BuffaloBuffaloNew YorkUSA
| | | | - Lusajo Kajula
- UNICEF Office of Research—InnocentiDar es SalaamTanzania
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Abstract
BACKGROUND Maternity protection rights incorporate comprehensive benefits that should be available to pregnant or breastfeeding working women. RESEARCH AIM To describe South Africa's maternity protection legal and policy landscape and compare it to global recommendations. METHOD A prospective cross-sectional comparative policy analysis was used to review and describe national policy documents published from 1994-2021. Entitlements were mapped and compared to International Labour Organization standards. The document analysis was supplemented by interviews conducted with key national government department informants. Thematic analysis was used to evaluate policy and interview content. RESULTS Elements of maternity protection policy are incorporated into South Africa's constitutional dispensation, and some measures are consistent with international labor and social security standards. However, the policy framework is fragmented and difficult to interpret. The fragmented policy environment makes it challenging for employees to know their maternity rights' entitlements and for employers to understand their responsibilities. Confusion regarding maternity protection rights is amplified by the complexity of ensuring access to different forms of maternal protection in pre- and postnatal stages, oversight by multiple government departments, and heterogenous working environments. CONCLUSIONS Maternity protection in South Africa is fragmented and difficult to access. Overcoming these challenges requires legislative and implementation measures to ensure greater policy coherence and comprehensive guidance on maternity protection rights. Addressing gaps in maternity protection in South Africa may provide insights for other countries with shortcomings in maternity protection provisions and could contribute to improved breastfeeding practices.
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Affiliation(s)
- Catherine Pereira-Kotze
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, , Bellville, Western Cape, South Africa
| | - Kitty Malherbe
- Department of Mercantile and Labour Law, University of the Western Cape, Bellville, Western Cape, South Africa
| | - Mieke Faber
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Western Cape, South Africa.,Department of Dietetics and Nutrition, University of the Western Cape, Bellville, Western Cape, South Africa
| | - Tanya Doherty
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, , Bellville, Western Cape, South Africa.,Health Systems Research Unit, South African Medical Research Council, Tygerberg, Western Cape, South Africa
| | - Diane Cooper
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, , Bellville, Western Cape, South Africa
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Karki A, Karki J, Joshi S, Black MN, Rijal B, Basnet S, Makai P, Fossier Heckmann A, Baral YR, Lee A. Mental Health Risks Among Informal Waste Workers in Kathmandu Valley, Nepal. Inquiry 2022; 59:469580221128419. [PMID: 36254497 PMCID: PMC9580097 DOI: 10.1177/00469580221128419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Informal waste workers are a vulnerable population group who are often socio-economically marginalized and disadvantaged, with more likelihood of experiencing ill health than the general population. To explore the determinants of mental ill health in this group, we conducted a cross-sectional survey of 1278 informal waste-workers in Nepal in 2017, using a demographic health assessment questionnaire and a modified Patient Health Questionnaire (PHQ-9). We looked at the potential associations between various exposure factors and mental health outcomes and found that 27.4% of waste-workers had depressive symptoms, more likely to be reported by female (OR 2.290), older person (OR 7.757), divorced/separated (5.859), and those with ill health (OR 2.030), or disability (OR 3.562). Waste-workers with access to social protection (OR 0.538) and financial savings (OR 0.280) were less likely to have depressive symptoms. There are key risk factors that may enable identification of particularly vulnerable persons within this group and also protective factors that may help improve their mental health resilience.
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Affiliation(s)
| | - Jiban Karki
- University of Sheffield, Sheffield, UK,Jiban Karki, University of Sheffield, 30 Regent St, Sheffield, Sheffield S1 4DA, UK.
| | | | | | | | | | | | | | - Yuba Raj Baral
- Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
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28
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Agudelo-Suárez AA, Vargas-Valencia MY, Vahos-Arias J, Ariza-Sosa G, Rojas-Gutiérrez WJ, Ronda-Pérez E. A qualitative study of employment, working and health conditions among Venezuelan migrants in Colombia. Health Soc Care Community 2022; 30:e2782-e2792. [PMID: 35023594 DOI: 10.1111/hsc.13722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 11/29/2021] [Accepted: 01/03/2022] [Indexed: 06/14/2023]
Abstract
This study aims to explore the perceptions of the Venezuelan immigrant population in Medellín, Colombia, regarding their employment, working and health conditions (physical, mental and psychosocial). A qualitative study was conducted (focused ethnography perspective). Semi-structured interviews were carried out with 31 Venezuelans and 12 key informants from different social organisations that work with the immigrant population. A narrative content analysis was carried out (Atlas.Ti 8.0 software). The migratory process for Venezuelans is caused for political, economical and social aspects in Venezuela and Colombia is offered as the first destination for labour establishing. Access to the labour market is limited to certain occupations, in many cases in the informal economy. Participants referring low salaries, working long hours and reduced social benefits. Occupational risks are evidenced by low experience in the labour market. Some health problems are perceived, and a good part of the interviewed population referred to signs and symptoms related to mental health problems. Barriers to access health and social protection services were found. Finally, future expectations depend on their adaptation to Colombia, the improvement of social conditions in Venezuela or having chances of improving their social and living conditions in another country. A high labour and social vulnerability were found in Venezuelan participants that impact on physical and mental health. Political and strategies from a public health perspective are required and the implementation of systems for monitoring and evaluating the labour and health situation in the working immigrant population.
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Affiliation(s)
- Andrés A Agudelo-Suárez
- Faculty of Dentistry, University of Antioquia, Medellín, Colombia
- Public Health Research Group, University of Alicante, Alicante, Spain
| | - Mary Y Vargas-Valencia
- The National Training Service (Servicio Nacional de Aprendizaje-SENA), Medellín, Colombia
| | | | | | | | - Elena Ronda-Pérez
- Public Health Research Group, University of Alicante, Alicante, Spain
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29
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Santana JDM, Pereira M, Lisboa CS, Santos DB, Oliveira AM. Influence of conditional cash transfer program on prenatal care and nutrition during pregnancy: NISAMI cohort study. SAO PAULO MED J 2022; 140:595-603. [PMID: 35946676 PMCID: PMC9491472 DOI: 10.1590/1516-3180.2021.0449.r1.23112021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 11/23/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND There are few studies on the influence of a cash transfer program on nutritional outcomes from pregnancy. OBJECTIVES To analyze how a Brazilian conditional cash transfer program (Bolsa Familia Program, BFP) was associated with changes in body mass index (BMI) and food consumption among pregnant women. DESIGN AND SETTING Cohort study on 250 pregnant women (≥ 18 years of age) in Brazilian prenatal services. METHODS A food frequency questionnaire was used to evaluate dietary intake. Weight was measured in each gestational trimester. Generalized estimation equations and structural equation modeling were used for statistical analyses. Correlations were analyzed using standardized coefficients (SCs). RESULTS Women benefitting from the BFP were of greater age and had lower education. The BFP exerted a direct negative effect on the pregnant women's consumption choices regarding refined grains, regional foods, vegetable oil, sausages, salted meats and snacks (SC = -0.10) and on maternal BMI (SC = -0.12). Among the intermediate variables, we observed that the time elapsed since pregnancy and the month of prenatal onset had direct negative effects; and that the number of visits to doctors, family income and number of years of education had direct positive effects. CONCLUSIONS Beneficiaries were less likely to increase their BMI outside of the recommended standards and had a greater tendency to receive prenatal care. Participation in the BFP had a direct negative effect on adherence to unhealthy diets.
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Affiliation(s)
- Jerusa da Mota Santana
- MSc, PhD. Adjunct Professor, Health Sciences Center, Universidade Federal do Recôncavo da Bahia (UFRB), Cruz das Almas (BA), Brazil
| | - Marcos Pereira
- MSc, PhD. Adjunct Professor, Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil
| | - Cinthia Soares Lisboa
- MSc. Doctoral Student, Universidade Estadual de Feira de Santana (UEFS), Feira de Santana (BA), Brazil
| | - Djanilson Barbosa Santos
- MSc, PhD. Adjunct Professor, Health Sciences Center, Universidade Federal do Recôncavo da Bahia (UFRB), Cruz das Almas (BA), Brazil
| | - Ana Marlucia Oliveira
- MSc, PhD. Full Professor, School of Nutrition, Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil
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30
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CAMILLETTI E, NESBITT‐AHMED Z. COVID-19 and a "crisis of care": A feminist analysis of public policy responses to paid and unpaid care and domestic work. Int Labour Rev 2022; 161:195-218. [PMID: 35602284 PMCID: PMC9111651 DOI: 10.1111/ilr.12354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has highlighted gender inequalities, increasing the amount of unpaid care weighing on women and girls, and the vulnerabilities faced by paid care workers, often women working informally. Using a global database on social protection responses to COVID-19 that focuses on social assistance, social insurance and labour market programmes, this article considers whether and how these responses have integrated care considerations. Findings indicate that, although many responses addressed at least one aspect of care (paid or unpaid), very few countries have addressed both types of care, prompting a discussion of the implications of current policy responses to COVID-19 (and beyond) through a care lens.
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Affiliation(s)
- Elena CAMILLETTI
- United Nations Children's Fund (UNICEF) Office of Research – Innocenti
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31
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Nordholm AC, Andersen AB, Wejse C, Norman A, Ekstrøm CT, Andersen PH, Koch A, Lillebaek T. Social determinants of tuberculosis: a nationwide case-control study, Denmark, 1990-2018. Int J Epidemiol 2022; 51:1446-1456. [PMID: 35595514 DOI: 10.1093/ije/dyac109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/05/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The global vision is a world free of tuberculosis (TB). Even in resource-rich TB low-incidence settings, we need more focus on the role of social risk factors to end the TB epidemic. METHODS Nationwide, retrospective register-based, case-control study from 1990 to 2018, including all TB patients in Denmark ≥18 years old (n = 9581) matched 1:3 on sex and age with population controls. TB risk factors were assessed in logistic regression models and estimated by odds ratio (OR). RESULTS All TB patients had considerably lower socio-economic status compared with controls (P < 0.0001). Among ethnic Danes, TB was mostly found among males, persons between 35 and 65 years, those living alone, those with low educational level, persons on social welfare benefits and those with low income. Conversely, for migrants, being younger, sex and living alone were less important, whereas having children was protective. In an adjusted multivariable regression model among Danes, key risk factors for TB were being on disability pension (OR = 2.7) and cash benefits (OR = 4.7). For migrants, fewer social risk factors increased TB risk, although low income and cash benefits did (OR = 3.1). CONCLUSION Even today in a resourceful setting, socio-economic status drives disparities in health. In our study, multifactorial social deprivation was highly associated with TB. Especially household structure, education, employment and income were important risk factors that should be addressed in the future to accelerate TB control and end the TB epidemic.
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Affiliation(s)
- Anne Christine Nordholm
- International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark
| | - Aase Bengaard Andersen
- Department of Infectious Diseases, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - Christian Wejse
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.,Department of Public Health, Center for Global Health, Aarhus University, Aarhus, Denmark
| | - Anders Norman
- International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark
| | - Claus Thorn Ekstrøm
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Peter Henrik Andersen
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Anders Koch
- Department of Infectious Diseases, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark.,Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark.,Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Troels Lillebaek
- International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark.,Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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32
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Prencipe L, Houweling TAJ, van Lenthe FJ, Kajula L, Palermo T. Effects of Adolescent-Focused Integrated Social Protection on Depression: A Pragmatic Cluster-Randomized Controlled Trial of Tanzania's Cash Plus Intervention. Am J Epidemiol 2022; 191:1601-1613. [PMID: 35581169 PMCID: PMC9437816 DOI: 10.1093/aje/kwac093] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 09/29/2021] [Revised: 03/29/2022] [Accepted: 05/12/2022] [Indexed: 01/29/2023] Open
Abstract
We assessed the impacts of Tanzania's adolescent-focused Cash Plus intervention on depression. In this pragmatic cluster-randomized controlled trial, 130 villages were randomly allocated to an intervention or control arm (1:1). Youth aged 14-19 years living in households receiving governmental cash transfers were invited to participate. The intervention included an intensive period (a 12-session course) and an aftercare period (9 months of mentoring, productive grants, and strengthened health services). We examined intervention impacts on a depressive symptoms scale (10-item Center for Epidemiologic Studies Depression Scale score (range, 0-30)) and rates of depressive symptomatology (score ≥10 points on the scale), recorded at study baseline (April-June 2017), midline (May-July 2018), and endline (June-August 2019). Using intention-to-treat methodology, we employed logistic and generalized linear models to estimate effects for binary and continuous outcomes, respectively. Quantile regression was used to estimate effects across the scale. From 2,458 baseline participants, 941 intervention and 992 control adolescents were reinterviewed at both follow-ups. At endline, the intervention reduced the odds of depressive symptomatology (adjusted odds ratio = 0.67, 95% confidence interval: 0.52, 0.86), with an undetectable mean scale difference (risk difference = -0.36, 95% confidence interval: -0.84, 0.11). Quantile regression results demonstrated an intervention effect along the upper distribution of the scale. Integration of multisectoral initiatives within existing social protection systems shows potential to improve mental health among youth in low-resource settings.
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Affiliation(s)
- Leah Prencipe
- Correspondence to Leah Prencipe, Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands (e-mail: )
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Novignon J, Prencipe L, Molotsky A, Valli E, de Groot R, Adamba C, Palermo T. The impact of unconditional cash transfers on morbidity and health-seeking behaviour in Africa: evidence from Ghana, Malawi, Zambia and Zimbabwe. Health Policy Plan 2022; 37:607-623. [PMID: 35157775 PMCID: PMC9113146 DOI: 10.1093/heapol/czac014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/21/2021] [Accepted: 02/11/2022] [Indexed: 11/12/2022] Open
Abstract
Unconditional cash transfers have demonstrated widespread, positive impacts on consumption, food security, productive activities and schooling. However, the evidence to date on cash transfers and health-seeking behaviours and morbidity is not only mixed, but the evidence base is biased towards conditional programmes from Latin America and is more limited in the context of Africa. Given contextual and programmatic design differences between the regions, more evidence from Africa is warranted. We investigate the impact of unconditional cash transfers on morbidity and health-seeking behaviour using data from experimental and quasi-experimental study designs of five government cash transfer programs in Ghana, Malawi, Zambia and Zimbabwe. Programme impacts were estimated using difference-in-differences models with longitudinal data. The results indicate positive programme impacts on health seeking when ill and on health expenditures. Our findings suggest that while unconditional cash transfers can improve health seeking when ill, morbidity impacts were mixed. More research is needed on longer-term impacts, mechanisms of impact and moderating factors. Additionally, taken together with existing evidence, our findings suggest that when summarizing the impacts of cash transfers on health, findings from conditional and unconditional programmes should be disaggregated.
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Affiliation(s)
- Jacob Novignon
- Department of Economics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Leah Prencipe
- Department of Public Health, Erasmus Medical Center, Rotterdam 3000 CA, The Netherlands
| | - Adria Molotsky
- American Institutes for Research, International Development Division, 1400 Crystal Drive, 10th Floor Arlington, VA 22202, USA
| | - Elsa Valli
- UNICEF Office of Research – Innocenti, Via degli Alfani 58, 50121 Florence, Italy
| | - Richard de Groot
- Independent Consultant, Josef Israelshof 23, Oosterhout 4907 PT, The Netherlands
| | - Clement Adamba
- Institute of Statistical, Social and Economic Research, University of Ghana-Legon, P.O. Box LG 74, Legon-Accra, Ghana
| | - Tia Palermo
- Department of Epidemiology and Environmental Health, State University of New York at Buffalo, 270 Farber Hall, Buffalo, NY 14214-800, USA
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Spasova S, Regazzoni P. Income protection for self-employed and non-standard workers during the COVID-19 pandemic. Int Soc Secur Rev 2022; 75:3-24. [PMID: 35941920 PMCID: PMC9349796 DOI: 10.1111/issr.12292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Based on original evidence from the European Social Policy Network (ESPN), the article investigates the extent to which self-employed and non-standard workers, who are less protected by "ordinary" social protection, were included in "extraordinary" income protection and job retention schemes during the COVID-19 pandemic in the European Union (EU) and the United Kingdom. When the crisis hit, countries quickly introduced unprecedented emergency income replacement measures for the self-employed. Nevertheless, most of these schemes provided only basic support through lump sums and were, in some cases, subject to a variety of eligibility conditions. Non-standard workers were in general included in job retention schemes, but substantial gaps remained in some countries. The article discusses how such gaps were addressed in five EU Member States. The article concludes by highlighting some policy pointers for better and more adequate "extraordinary" income protection for the self-employed and non-standard workers in times of crisis.
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Affiliation(s)
- Slavina Spasova
- European Social Observatory, Brussels, Belgium; University of MilanMilanItaly
| | - Pietro Regazzoni
- European Social Observatory, Brussels, Belgium; University of MilanMilanItaly
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35
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Antohi VM, Ionescu RV, Zlati ML, Mirica C, Cristache N. Approaches to Health Efficiency across the European Space through the Lens of the Health Budget Effort. Int J Environ Res Public Health 2022; 19:3063. [PMID: 35270757 PMCID: PMC8910186 DOI: 10.3390/ijerph19053063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/24/2022] [Accepted: 03/02/2022] [Indexed: 02/04/2023]
Abstract
In the context of the COVID-19 pandemic, financial resources allocated to the health system have been refocused according to priority 0: fighting the pandemic. The main objective of this research is to identify the vulnerabilities affecting the health budget effort in the EU and in the Member States during the health crisis period. The analysis takes into account relevant statistical indicators both in terms of financial allocation to health and expenditure on health protection of the population in the Member States, with the effect being tracked even during the pandemic period. The novelty of the study is the identification of viable directions of intervention based on the structural determination of expenditures related to measures to combat the pandemic and making proposals for changes in public policies based on the determination of the effectiveness of budget allocations in health in relation to the proposed purpose. The main outcome of the study is the identification of the vulnerabilities and the projection of measures to mitigate them in the medium and long term.
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Affiliation(s)
- Valentin Marian Antohi
- Department of Business Administration, Dunarea de Jos University, 800008 Galati, Romania or (M.L.Z.); (C.M.); (N.C.)
- Departament of Finance, Accounting and Economic Theory, Transylvania University, 500036 Brasov, Romania
| | - Romeo Victor Ionescu
- Department of Administrative Sciences and Regional Studies, Dunarea de Jos University, 800201 Galati, Romania;
| | - Monica Laura Zlati
- Department of Business Administration, Dunarea de Jos University, 800008 Galati, Romania or (M.L.Z.); (C.M.); (N.C.)
- Department of Accounting, Audit and Finance, Stefan cel Mare University, 720229 Suceava, Romania
| | - Cristian Mirica
- Department of Business Administration, Dunarea de Jos University, 800008 Galati, Romania or (M.L.Z.); (C.M.); (N.C.)
| | - Nicoleta Cristache
- Department of Business Administration, Dunarea de Jos University, 800008 Galati, Romania or (M.L.Z.); (C.M.); (N.C.)
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Istiko SN, Durham J, Elliott L. (Not That) Essential: A Scoping Review of Migrant Workers' Access to Health Services and Social Protection during the COVID-19 Pandemic in Australia, Canada, and New Zealand. Int J Environ Res Public Health 2022; 19:2981. [PMID: 35270672 DOI: 10.3390/ijerph19052981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/24/2022] [Accepted: 03/01/2022] [Indexed: 11/22/2022]
Abstract
Migrant workers have been disproportionately affected by the COVID-19 pandemic. To examine their access to health services and social protection during the pandemic, we conducted an exploratory scoping review on experiences of migrant workers in three countries with comparable immigration, health, and welfare policies: Australia, Canada, and New Zealand. After screening 961 peer-reviewed and grey literature sources, five studies were included. Using immigration status as a lens, we found that despite more inclusive policies in response to the pandemic, temporary migrant workers, especially migrant farm workers and international students, remained excluded from health services and social protection. Findings demonstrate that exploitative employment practices, precarity, and racism contribute to the continued exclusion of temporary migrant workers. The interplay between these factors, with structural racism at its core, reflect the colonial histories of these countries and their largely neoliberal approaches to immigration. To address this inequity, proactive action that recognizes and targets these structural determinants at play is essential.
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Korolev MA. [The opinions of social workers concerning means of development of medical social care of population]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2022; 30:259-263. [PMID: 35439386 DOI: 10.32687/0869-866x-2022-30-2-259-263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/26/2021] [Indexed: 06/14/2023]
Abstract
The article reflects main problems and opinions of social workers about possibilities of improving medical social care of population and providing social medical services. This group of specialists is forced to implement significant amount of work that is not regulated by their official duties. The lack of necessary competencies does not allow social workers to provide medical social assistance to consumers of medical social services to sufficient extent. To ensure interaction between medical and social workers largely falls on shoulders of the latter ones. They have to undertake a number of medical functions (examination, temporary stop of bleeding, blood pressure measurement, etc.). It conceives appropriate to transfer some of functions of junior and paramedical staff to social workers. The study results can be applied as methodological basis of increasing accessibility of medical social care and provided social and medical services to various groups of population.
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Affiliation(s)
- M A Korolev
- The State Budget Educational Institution of Higher Professional Education "The A. E. Evdokimov Moscow State University of Medicine and Dentistry" of Minzdrav of Russia, 127473, Moscow, Russia,
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Yu YH, Peng MM. Development and Poverty Dynamics in Severe Mental Illness: A Modified Capability Approach in the Chinese Context. Int J Environ Res Public Health 2022; 19:ijerph19042351. [PMID: 35206538 PMCID: PMC8872210 DOI: 10.3390/ijerph19042351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 01/27/2023]
Abstract
Albeit poverty reduction has been listed as an overarching objective in many countries’ development plans, little is known about how development could shape poverty dynamics in disadvantaged groups. Guided by a modified capability framework, this study aimed to explore the long-term experiences of poverty dynamics in severe mental illness. Semi-structured interviews were carried out with 20 caregivers who provided care for persons with severe mental illness in Chengdu, China. Their perceptions on development, the illness, and social security were addressed. Content analysis was employed to analyze data. Participants experienced an overall improvement of life quality due to changes on urban infrastructure and transformed lifestyle. However, they were more disadvantaged while facing ability-based opportunities. These families were hindered from transferring opportunities into incomes. Negative impacts of the illness were also reflected in multiple stigma and conversion difficulties. Additionally, the high threshold for payment made those inclusive social security policies not inclusive for them. Poverty associated with severe mental illness was unlikely to be alleviated automatically within the process of development. Social isolation and high caregiving burden had aggravated poverty for those disadvantaged families. Poverty alleviation should be closely linked to the improvement in social policies in China.
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Affiliation(s)
- Yue-Hui Yu
- School of Public Administration and Policy, Renmin University of China, Beijing 100872, China;
| | - Man-Man Peng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai, Zhuhai 519087, China
- Correspondence:
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Abstract
To overcome widespread barriers and lack of support, persons with disabilities face significant disability-related costs, including assistive technology (AT), that drive them to or maintain them in poverty and undermine their socio-economic participation. In many countries, social protection systems are a gateway to accessing assistive devices either through health insurance, integration in Universal Health Coverage (UHC) packages, subsidies, cash transfers or direct provision. However, the broader issues of access to AT (lack of awareness, information, availability, human resources, etc.) are compounded by barriers to social protection. In low- and middle-income countries globally, less than 20% of persons with significant disabilities, who are likely to need AT, receive disability benefits. This paper reflects on the relation of AT and disability-related costs, the evolution of the role of social protection in line with the CRPD, and the different social protection mechanisms used at the national level to provide access to AT. It further highlights some of the key issues to be tackled by social protection systems to enhance access to AT, with a focus on low- and middle-income countries.
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40
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Lawson‐McDowall J, McCormack R, Tholstrup S. The use of cash assistance in the Covid-19 humanitarian response: accelerating trends and missed opportunities. Disasters 2021; 45 Suppl 1:S216-S239. [PMID: 34873732 PMCID: PMC9299839 DOI: 10.1111/disa.12524] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The operational and socioeconomic consequences of Covid-19 have made cash assistance the global go-to relief modality, whether through humanitarian or social protection channels. Cash has proven to be an adaptable means of saving lives and supporting livelihoods and mitigating the pandemic's impacts on local economies while giving recipients the flexibility to decide what they require. Many humanitarian organisations have increased the scale of cash programmes, while government-administered social assistance mechanisms have been utilised on a huge scale. The crisis has bolstered attention on why linkages between social protection and humanitarian cash are important, including how to work together more effectively to enable better coverage of those in need. This paper has been developed with inputs from across the CALP Network. It explores how cash and voucher assistance-with a focus on humanitarian response-has been scaled up or adjusted in response to Covid-19, and how it is changing ways of working.
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Serván-Mori E, Orozco-Núñez E, Heredia-Pi I, Armenta-Paulino N, Wirtz VJ, Meneses-Navarro S, Nigenda G. Public health insurance and ethnic disparities in maternal health care: the case of vulnerable Mexican women over the last 25 years. Health Policy Plan 2021; 36:1671-1680. [PMID: 34557904 DOI: 10.1093/heapol/czab119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 09/14/2021] [Accepted: 09/23/2021] [Indexed: 11/13/2022] Open
Abstract
This article examines the coverage in the continuum of antenatal-postnatal care for vulnerable women in Mexico according to indigenous status and assesses the influence of public health insurance strategies on the evolution of coverage over the last 25 years. We studied a total of 19 613 567 Mexican women, aged 12-54 years at last birth, based on a pooled cross-sectional analysis of data from the 1997, 2009, 2014 and 2018 waves of the National Survey of Demographic Dynamics. After describing sociodemographic characteristics and maternal-health coverage by indigenous status, we constructed a pooled fixed-effects and interaction multivariable regression model to assess the influence of the Seguro Popular programme on continuum of care. We estimated adjusted continuum of care coverage between 1994 and 2018 according to Seguro Popular affiliation and indigenous status. Prior to the Seguro Popular programme, crude coverage in the continuum of care for non-indigenous women stood at 14.5% [95% confidence interval (CI): 13.2-15.8%] or 11 percentage points higher than for indigenous women. During the last period of the programme, it rose to 46.5% [95% CI: 45.6-47.5%] and 34.1% [95% CI: 30.7-37.4%], respectively. Our regression analysis corroborated findings that, on average, indigenous women faced lower odds of benefiting from continuum of care [adjusted odds ratio (aOR) = 0.48, 95% CI: 0.40-0.57] than did their non-indigenous counterparts. It also revealed that coverage for indigenous women without Seguro Popular affiliation was 26.7% [95% CI: 23.3-30.1%] or 12 percentage points lower than for those with Seguro Popular affiliation (38.6%, 95% CI: 35.7-41.4%). Our regression results confirmed that the latter benefited from higher odds of continuum of care (aOR = 1.67, 95% CI: 1.36-2.26). Gaps between those of indigenous and non-indigenous status have persisted, but the Seguro Popular clearly contributed to reducing the coverage gaps between these two groups of women. Strategies yielding better outcomes are required to improve the structural conditions of indigenous populations.
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Affiliation(s)
- Edson Serván-Mori
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico
| | - Emanuel Orozco-Núñez
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico
| | - Ileana Heredia-Pi
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico
| | - Nancy Armenta-Paulino
- International Center for Equity in Health, Federal University of Pelotas, Pelotas 96020-220, Brazil
| | - Veronika J Wirtz
- Department of Global Health, Boston University School of Public Health, Boston, MA 02118, USA
| | - Sergio Meneses-Navarro
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico
| | - Gustavo Nigenda
- National School of Nursing and Obstetrics, National Autonomous University of Mexico, Mexico City 14370, Mexico
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42
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Bustos M, Luu K, Lau LL, Dodd W. Addressing tuberculosis through complex community-based socioeconomic interventions in low- and middle-income countries: A systematic realist review. Glob Public Health 2021; 17:1924-1944. [PMID: 34403306 DOI: 10.1080/17441692.2021.1966487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The established relationship between poverty and tuberculosis has led to the implementation of complex socioeconomic interventions to address poverty as both a risk factor for and consequence of tuberculosis. However, limited research to date has examined the conditions that facilitate the successful implementation of these interventions. We conducted a systematic realist review to examine how complex socioeconomic interventions for tuberculosis treatment and care were defined, implemented, and evaluated in low- and middle-income countries. We used a systematic search to identify published work that implemented complex socioeconomic interventions for tuberculosis, followed by a realist analysis informed by existing programme theories. From a total of 2825 collected records, 36 peer-reviewed articles and 17 grey literature reports were included in this review. The realist analysis identified three main contexts (sociopolitical and cultural; relational and interpersonal; operational and administrative) and ten mechanisms that facilitated successful implementation of interventions. Overall, this review highlights the importance of political commitment in shaping sustainable programme delivery, the role of healthcare and community-based provider training in creating patient-centred treatment environments, and the opportunity to leverage operational research for evidence-based decision making to address the socioeconomic needs of tuberculosis patients experiencing poverty.
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Affiliation(s)
- Monica Bustos
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Kathy Luu
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Lincoln L Lau
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.,International Care Ministries, Manila, Philippines.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Warren Dodd
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Gonsamo DD, Lo HHM, Chan KL. The Role of Stomach Infrastructures on Children's Work and Child Labour in Africa: Systematic Review. Int J Environ Res Public Health 2021; 18:8563. [PMID: 34444309 PMCID: PMC8391661 DOI: 10.3390/ijerph18168563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 11/16/2022]
Abstract
Child labour remains a prevalent global concern, and progress toward eradicating harmful children's work appears to have stalled in the African continent and henceforth, integrated social policy intervention is still required to address the problem. Among several forms of social policy interventions, stomach infrastructure (i.e., in-kind and/or cash transfers) have been a key policy approach to support vulnerable families to lighten households' resources burden, which forces them to consider child labour as a coping strategy. There is growing evidence on the impacts of these programs in child labour. However, this evidence is often mixed regarding children's work outcomes, and the existing studies hardly describe such heterogeneous outcomes from the child-sensitive approach. To this end, a systematic literature search was conducted for studies in African countries. From 743 references retrieved in this study, 27 studies were included for the review, and a narrative approach has been employed to analyse extracted evidence. Results from the current study also demonstrate a mixed effect of in-kind and cash transfers for poor households on child labour decisions. Hence, the finding from the current review also demonstrates a reduced participation of children in paid and unpaid work outside the household due to in-kind and cash transfers to poor households, but children's time spent in economic and non-economic household labour and farm and non-farm labour, which are detrimental to child health and schooling, has been reported increasing due to the program interventions. The question remains how these programs can effectively consider child-specific and household-related key characteristics. To this end, a child-sensitive social protection perspective has been applied in this study to explain these mixed outcomes to inform policy design.
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Affiliation(s)
| | | | - Ko Ling Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong; (D.D.G.); (H.H.M.L.)
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Vladimirova ON, Afonina KP, Sevastianov MA, Ponomarenko GN, Raduto VI, Chernyakina TS, Shoshmin AV, Malakhovsky VV, Aliev AK, Minkova NK. [PERSONS WITH DISABILITIES IN TERMS OF THE SPREAD OF THE NEW CORONAVIRUS INFECTION COVID-19]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2021; 29:774-778. [PMID: 34327961 DOI: 10.32687/0869-866x-2021-29-s1-774-778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/21/2021] [Indexed: 11/06/2022]
Abstract
One of the vulnerable categories of the population during a pandemic of coronavirus infection is the disabled, both from the point of view of the high risk of a severe course of the disease, and from the point of view of the possibility of significantly limiting everyday, professional and social activities. The article discusses the regulatory and organizational measures taken to ensure the rights of people with disabilities in Russia to prevent the spread of coronavirus infection. The epidemiological situation and features of the spread of coronavirus in long-term care facilities have been analyzed. The mortality rate from COVID-19 among residents of inpatient institutions in the EU countries ranged from 24 to 80%, in Russia the average mortality rate was 2.34 per 100 patients, in St. Petersburg from 1.4% to 2.2% of the number of people living in dependence on the type of institution. Using the example of one of the stationary social service institutions in St. Petersburg, it has been shown that the timely introduction of a set of organizational measures makes it possible to successfully manage the spread of coronavirus among residents and staff of long-term care institutions.
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Affiliation(s)
- O N Vladimirova
- St. Petersburg Institute for Advanced Training of Medical Experts, 194044, St. Petersburg, Russia,
| | - K P Afonina
- Department for disabled people of the Ministry of Labour and Social Protection of the Russian Federation, 127994, Moscow, Russia
| | - M A Sevastianov
- St. Petersburg Institute for Advanced Training of Medical Experts, 194044, St. Petersburg, Russia
| | - G N Ponomarenko
- G. A. Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 195067, St. Petersburg, Russia
| | - V I Raduto
- G. A. Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 195067, St. Petersburg, Russia
| | - T S Chernyakina
- G. A. Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 195067, St. Petersburg, Russia
| | - A V Shoshmin
- G. A. Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 195067, St. Petersburg, Russia
| | - V V Malakhovsky
- I. M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, Russia
| | - A K Aliev
- I. M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, Russia
| | - N K Minkova
- Committee for social policy of St. Petersburg, 191060, St. Petersburg, Russia
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45
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Aung ST, Thu A, Aung HL, Thu M. Measuring Catastrophic Costs Due to Tuberculosis in Myanmar. Trop Med Infect Dis 2021; 6:130. [PMID: 34287379 DOI: 10.3390/tropicalmed6030130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 06/30/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This is the first survey to use the World Health Organization (WHO) methodology to document the magnitude and main drivers of tuberculosis (TB) patient costs in order to guide policies on cost mitigation and to produce a baseline measure for the percentage of TB-affected households experiencing catastrophic costs in Myanmar. METHODS A nationally representative cross-sectional survey was administered to 1000 TB patients in health facilities from December 2015 to February 2016, focusing on costs of TB treatment (direct and indirect), household income, and coping strategies. A total cost was estimated for each household by extrapolating reported costs and comparing them to household income. If the proportion of total costs exceeded 20% of the annual household income, a TB-affected household was deemed to have faced catastrophic costs. RESULTS 60% of TB-affected households faced catastrophic costs in Myanmar. On average, total costs were USD 759, and the largest proportion of this total was accounted for by patient time (USD 365), followed by food costs (USD 200), and medical expenses (USD 130). Low household wealth quintile and undergoing MDR-TB treatment were both significant predictors for households facing catastrophic costs. CONCLUSIONS The high proportion of TB-affected households experiencing catastrophic costs suggests the need for TB-specific social protection programs in patient-centered healthcare. The survey findings have led the government and donors to increase support for MDR-TB patients. The significant proportion of total spending attributable to lost income and food or nutritional supplements suggests that income replacement programs and/or food packages may ameliorate the burdensome costs.
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Timire C, Ngwenya M, Chirenda J, Metcalfe JZ, Kranzer K, Pedrazzoli D, Takarinda KC, Nguhiu P, Madzingaidzo G, Ndlovu K, Mapuranga T, Cornell M, Sandy C. Catastrophic costs among tuberculosis-affected households in Zimbabwe: a national health facility-based survey. Trop Med Int Health 2021; 26:1248-1255. [PMID: 34192392 DOI: 10.1111/tmi.13647] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To determine the incidence and major drivers of catastrophic costs among TB-affected households in Zimbabwe. METHODS We conducted a nationally representative health facility-based survey with random cluster sampling among consecutively enrolled drug-susceptible (DS-TB) and drug-resistant TB (DR-TB) patients. Costs incurred and income lost due to TB illness were captured using an interviewer-administered standardised questionnaire. We used multivariable logistic regression to determine the risk factors for experiencing catastrophic costs. RESULTS A total of 841 patients were enrolled and were weighted to 900 during data analysis. There were 500 (56%) males and 46 (6%) DR-TB patients. Thirty-five (72%) DR-TB patients were HIV co-infected. Overall, 80% (95% CI: 77-82) of TB patients and their households experienced catastrophic costs. The major cost driver pre-TB diagnosis was direct medical costs. Nutritional supplements were the major cost driver post-TB diagnosis, with a median cost of US$360 (IQR: 240-600). Post-TB median diagnosis costs were three times higher among DR-TB (US$1,659 [653-2,787]) than drug DS-TB-affected households (US$537 [204-1,134]). Income loss was five times higher among DR-TB than DS-TB patients. In multivariable analysis, household wealth was the only covariate that remained significantly associated with catastrophic costs: The poorest households had 16 times the odds of incurring catastrophic costs versus the wealthiest households (adjusted odds ratio [aOR: 15.7 95% CI: 7.5-33.1]). CONCLUSION The majority of TB-affected households, especially those affected by DR-TB, experienced catastrophic costs. Since the major cost drivers fall outside the healthcare system, multi-sectoral approaches to TB control and linking TB patients to social protection may reduce catastrophic costs.
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Affiliation(s)
- Collins Timire
- AIDS & TB Control Programme, Ministry of Health and Child Care, Harare, Zimbabwe.,International Union Against Tuberculosis and Lung Disease, Paris, France.,Faculty of Infectious & Tropical Diseases, London School of Hygiene &Tropical Medicine, London, UK
| | - Mkhokheli Ngwenya
- Zimbabwe Country Office, World Health Organization, Harare, Zimbabwe
| | - Joconiah Chirenda
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - John Z Metcalfe
- Division of Pulmonary and Critical Care Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, CA, USA
| | - Katharina Kranzer
- Faculty of Infectious & Tropical Diseases, London School of Hygiene &Tropical Medicine, London, UK
| | - Debora Pedrazzoli
- Faculty of Epidemiology & Population Health, London School of Hygiene &Tropical Medicine, London, UK.,World Health Organization, Geneva, Switzerland
| | - Kudakwashe C Takarinda
- AIDS & TB Control Programme, Ministry of Health and Child Care, Harare, Zimbabwe.,International Union Against Tuberculosis and Lung Disease, Paris, France
| | - Peter Nguhiu
- Health Economics Research Unit, Kenya Medical Research Institute, Wellcome Trust Research Programme, Nairobi, Kenya
| | - Geshem Madzingaidzo
- AIDS & TB Control Programme, Ministry of Health and Child Care, Harare, Zimbabwe
| | | | - Tawanda Mapuranga
- AIDS & TB Control Programme, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Morna Cornell
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Charles Sandy
- AIDS & TB Control Programme, Ministry of Health and Child Care, Harare, Zimbabwe
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Highet M. Rapid Scoping Review on the Topic of Ensuring Social Protection and Basic Services to Inform the United Nations Framework for the Immediate Socioeconomic Response to COVID-19. Int J Health Serv 2021; 51:462-473. [PMID: 34096801 PMCID: PMC8436287 DOI: 10.1177/00207314211024896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This rapid scoping review has informed the development of the UN Research Roadmap for the COVID-19 Recovery on the topic of “Ensuring Social Protection and Basic Services.” The aim was to provide a robust synthesis of key concepts and existing evidence drawn from a wide range of disciplines to support the identification and appraisal of research priorities. An emergent theme has been the notion that measures implemented in response to COVID-19 merely ameliorate symptoms of entrenched, systemic gender-, age-, and race-based inequity, inequality, and exclusion. Key findings include the critical role of contextual and community-based knowledge for informing the design, development, and delivery of programs, as well as the urgent need for implementation science to move existing knowledge into action. This review also describes how the disruption associated with “shock events” such as the COVID-19 pandemic is often associated with unusually high levels of interest and willingness to invest in programs and policies to strengthen strained systems. As such, an unprecedented window of opportunity exists to leverage measures implemented in response to the COVID-19 pandemic to effect large-scale, sustainable change and thereby increase the resiliency of our interconnected systems for the future.
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Affiliation(s)
- Megan Highet
- CIHR Health System Impact Fellowship Alumni, Calgary, Alberta, Canada
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48
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Budin CE, Râjnoveanu RM, Bordea IR, Grigorescu BL, Todea DA. Smoking in Teenagers from the Social Protection System-What Do We Know about It? ACTA ACUST UNITED AC 2021; 57:medicina57050484. [PMID: 34066069 PMCID: PMC8150939 DOI: 10.3390/medicina57050484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 11/24/2022]
Abstract
Background and Objectives: The impact of smoking on the young population is an extremely important issue for the public health system. As the prevalence of smoking is considerably increasing amongst the pubescent and adolescent population, the prevention of smoking at this age should be considered of high priority. The primary aim of this observational study was to assess tobacco use in teenagers included in the social protection system. Materials and Methods: 275 foster care teenagers (155 from the Professional Maternal Assistance System (AMP) and 120 from the residential system) from two different counties were enrolled. After a brief interactive session focused on the main consequences of smoking, a self-administered questionnaire was anonymously completed. Results: The mean age of the study group was 14 years, with a significant difference between the residential system and AMP (p = 0.001). Smoking status was significantly higher in participants from family-type houses (36.7%) than in those from the AMP (11.7%) (p < 0.001). The presence of smokers in the family (78.3%) and passive smoking (64.7%) were significantly higher in children from the residential system than in those from the AMP (32.9% and 31.8%, respectively) (p < 0.001). The number of cigarettes consumed daily was associated with the age of the participants (p = 0.01, rho 0.42). In total, 82.3% were cigarette users and 19.4% were e-cigarette users. Smokers bought the majority of their cigarettes from the store (63.2%) or asked a friend (19.3%) or an adult to buy them on their behalf (12.3%). Conclusions: The null hypothesis, according to which children who are abandoned but raised and cared for by professional nursing assistants are predisposed to earlier tobacco activity compared to children raised in a normal familiar environment, is supported. Future education and prevention campaigns conveying the benefits of a healthy long-term lifestyle to this population category are needed.
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Affiliation(s)
- Corina Eugenia Budin
- Department of Pathophysiology, University of Medicine, Pharmacy, Science and Technology Târgu Mureș, 540139 Târgu Mureș, Romania; (C.E.B.); (B.L.G.)
| | - Ruxandra-Mioara Râjnoveanu
- Department of Pneumology, University of Medicine and Pharmacy “Iuliu Hațieganu” Cluj Napoca, 400012 Cluj Napoca, Romania; (R.-M.R.); (D.A.T.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, University of Medicine and Pharmacy “Iuliu Hațieganu” Cluj Napoca, 400012 Cluj Napoca, Romania
- Correspondence:
| | - Bianca Liana Grigorescu
- Department of Pathophysiology, University of Medicine, Pharmacy, Science and Technology Târgu Mureș, 540139 Târgu Mureș, Romania; (C.E.B.); (B.L.G.)
| | - Doina Adina Todea
- Department of Pneumology, University of Medicine and Pharmacy “Iuliu Hațieganu” Cluj Napoca, 400012 Cluj Napoca, Romania; (R.-M.R.); (D.A.T.)
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49
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Abubakirov AS, Zudin AB. [The comparative analysis of mandatory and voluntary medical insurance in national and international practice]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2021; 29:313-315. [PMID: 33901374 DOI: 10.32687/0869-866x-2021-29-2-313-315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 10/29/2020] [Indexed: 11/06/2022]
Abstract
Nowadays, the formation and development of medical insurance system of citizens attracts attention of experts in the medical field and the insurance market. The possibilities of using foreign practice in the formation and organization of medical insurance, including improving of models of financing health care system in foreign countries and implementation of mechanisms of resource support of health care industry tested in world practice, deserve interest of researchers in order to enhance financial institutions of national system of mandatory and voluntary medical insurance. In Russia and foreign countries, the mandatory medical insurance policy allows citizens insured in mandatory medical insurance system, to undergo examination and receive treatment in medical organizations in amount established at the state level. In Russia, popularity of the voluntary medical insurance policy depends on medical care quality in the mandatory medical insurance system and volume of services guaranteed within the framework of mandatory medical insurance.
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Affiliation(s)
- A S Abubakirov
- N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia
| | - A B Zudin
- N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia,
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Riccardi N, Villa S, Giacomelli A, Diaw MM, Ndiaye M, Gning L, Robbiano M, Alagna R, Saderi L, Biagio AD, Bassetti M, Cirillo DM, Sotgiu G, Codecasa LR, Sarr M, Besozzi G. Tuberculosis treatment outcomes in a rural area of Senegal: a decade of experience from 2010 to 2019 by StopTB Italia. Future Microbiol 2021; 16:399-407. [PMID: 33847143 DOI: 10.2217/fmb-2020-0238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Tuberculosis (TB) unevenly affects individuals across the globe, especially in rural areas of low-income countries. Aim of the study was to assess the impact of social protection to increase TB awareness on treatment outcomes among TB patients in a rural area of Senegal. Materials & methods: The study, conducted in Fimela district (Senegal) from 1 January 2010 to 31 December 2019 and the intervention started from 31 January 2013, includes activities to increase awareness, active case finding, active follow-up and social protection. Results: Overall, 435 subjects - mainly male and young - were included in the analysis. Among TB cases, 94% had pulmonary involvement, 87% had no previous TB history, and 6% resulted positive HIV. Improved outcome was observed once intervention began (from 71 to 91%, p < 0.001); whereas mortality decreased (from 15 to 5%; p < 0.001), especially for those HIV co-infected for whom TB mortality rate dropped from 70 to 29%. Conclusion: After beginning the cooperation program, TB treatment success increased as a result of the decline of mortality, especially in people living with HIV.
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Affiliation(s)
- Niccolò Riccardi
- Stop TB Italia, Milan, 20159, Italy.,Department of Infectious, Tropical Diseases & Microbiology (DITM), IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, 37024, Italy
| | - Simone Villa
- Stop TB Italia, Milan, 20159, Italy.,Centre for Multidisciplinary Research in Health Science, University of Milan, Milan, 20122, Italy
| | - Andrea Giacomelli
- Stop TB Italia, Milan, 20159, Italy.,III Infectious Diseases Unit, ASST Fatebenefratelli Sacco, Milano, 20157, Italy
| | - Mama M Diaw
- Stop TB Italia, Milan, 20159, Italy.,Médecin coordonnateur lutte contre la TB, Région médicale de Thiès, Thiès, 21000, Sénégal
| | - Mamoud Ndiaye
- Stop TB Italia, Milan, 20159, Italy.,District Sanitaire de Diofior/Département de Fatick, Diofior, 23400, Sénégal
| | - Lamine Gning
- Stop TB Italia, Milan, 20159, Italy.,District Sanitaire de Diofior/Département de Fatick, Diofior, 23400, Sénégal
| | | | - Riccardo Alagna
- Stop TB Italia, Milan, 20159, Italy.,TB Supranational Reference Laboratory, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Laura Saderi
- Clinical Epidemiology & Medical Statistics Unit, Dept. of Medical, Surgical & Experimental Sciences, University of Sassari, Sassari, 07100, Italy
| | - Antonio Di Biagio
- Stop TB Italia, Milan, 20159, Italy.,Clinic of Infectious Diseases, IRCCS AOU San Martino-IST, Genoa, 16132, Italy
| | - Matteo Bassetti
- Stop TB Italia, Milan, 20159, Italy.,Clinic of Infectious Diseases, IRCCS AOU San Martino-IST, Genoa, 16132, Italy
| | - Daniela M Cirillo
- Stop TB Italia, Milan, 20159, Italy.,TB Supranational Reference Laboratory, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Giovanni Sotgiu
- Stop TB Italia, Milan, 20159, Italy.,Clinical Epidemiology & Medical Statistics Unit, Dept. of Medical, Surgical & Experimental Sciences, University of Sassari, Sassari, 07100, Italy
| | - Luigi R Codecasa
- Stop TB Italia, Milan, 20159, Italy.,Regional TB Reference Centre & Laboratory, Villa Marelli Institute/ASST Niguarda Ca' Granda, Milan, 20159, Italy
| | - Marie Sarr
- National TB Programme, Dakar, 10200, Senegal
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