• Title/Summary/Keyword: low/middle income countries

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Distribution and Determinants of Out-of-pocket Healthcare Expenditures in Bangladesh

  • Mahumud, Rashidul Alam;Sarker, Abdur Razzaque;Sultana, Marufa;Islam, Ziaul;Khan, Jahangir;Morton, Alec
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.2
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    • pp.91-99
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    • 2017
  • Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.

Value of Nutritional Screening Tools Versus Anthropometric Measurements in Evaluating Nutritional Status of Children in a Low/Middle-Income Country

  • Shaimaa Sayed;Mortada H. F. El-Shabrawi ;Eman Abdelmonaem ;Nehal El Koofy;Sara Tarek
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.4
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    • pp.213-223
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    • 2023
  • Purpose: Pediatric patients in low-income countries are at a high risk of malnutrition. Numerous screening tools have been developed to detect the risk of malnutrition, including the Subjective Global Nutritional Assessment (SGNA), Pediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and Screening Tool for Risk of Nutritional Status and Growth (STRONGkids). However, anthropometry remains the main tool for assessing malnutrition. We aimed to identify the value of four nutritional screening tools versus anthropometry for evaluating the nutritional status of children. Methods: We conducted a cross-sectional study of 1,000 children aged 1-12 years who visited the outpatient clinic of Cairo University Pediatric Hospital. Each participant was evaluated using anthropometric measurements (weight, length/height, and weight for length/height) as well as the PYMS, STAMP, STRONGkids, and SGNA screening tools. The sensitivities and specificities of these four tools were assessed using anthropometry as the gold standard. Results: Of the patients, 1.7% were underweight, 10.2% were wasted, and 35% were stunted. STRONGkids demonstrated the highest sensitivity (79.4%) and a high specificity (80.2%) for detecting malnutrition compared with weight for height, followed by STAMP, which demonstrated lower sensitivity (73.5%) but higher specificity (81.4%). PYMS demonstrated the lowest sensitivity (66.7%) and the highest specificity (93.5%), whereas SAGA demonstrated higher sensitivity (77.5%) and lower specificity (85.4%) than PYMS. Conclusion: The use of nutritional screening tools to evaluate the nutritional status of children is valuable and recommended as a simple and rapid method for identifying the risk of malnutrition in pediatric patients.

The Effects of Personality and Attitude on Risky Driving Behavior Among Public van Drivers: Hierarchical Modeling

  • Tanglai, Wirampa;Chen, Ching-Fu;Rattanapan, Cheerawit;Laosee, Orapin
    • Safety and Health at Work
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    • v.13 no.2
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    • pp.187-191
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    • 2022
  • Background: Traffic injuries have become a significant public health problem in low- and middle-income countries. Several studies have examined the role of personality and attitude toward traffic safety in predicting driving behaviors in diverse types of drivers. Few studies have investigated risky behavior among public passenger van drivers. This study aims to identify the predictors of self-reported risky driving behavior among public van drivers. Method: A total of 410 public van drivers were interviewed at terminal stations in Bangkok. Hierarchical regression models were applied to determine the effects of demographics, personality traits, and attitude on self-reported risky driving behaviors. Results: The results indicated that drivers with a high education level, more working days, and high scores for normlessness and anger were more likely to report risky driving behaviors (p < 0.05). Conclusion: The personality traits and attitude toward speeding account for aberrant self-reported risky driving behavior in passenger van drivers. This could be another empirical basis for evidence-based road safety interventions in the context of public transport.

Public Debt Management and Its Impact on Economic Development: The Case of Vietnam

  • THI, Phuong Lan Vo
    • The Journal of Asian Finance, Economics and Business
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    • v.9 no.9
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    • pp.283-289
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    • 2022
  • Public investment is the process of investing capital in projects that serve national interests and thereby create a driving force for economic development in each country. Especially in developing countries, investment capital is limited, so improving the efficiency of public investment becomes a decisive factor for economic development and enhancing the country's status and ultimately making the country a should be rich. Vietnam has a low starting point, has gone through the doi moi process, and has gradually become a middle-income country, and public investment is attracting attention to improve the quality of the country's infrastructure. The objective of this study is to evaluate the factors affecting the effectiveness of public debt management in Vietnam, through a survey of 150 experts with knowledge of public investment and public debt management, using the results of the estimation through the Using SPSS software, the research results show that the monitoring system and human resource quality have an impact on the effectiveness of public debt management. The study could not, however, discover any proof of the influence of institutional quality, geographic location, or accountability on the effectiveness of public debt management. The research also addresses several policy recommendations for Vietnam that would help the country manage its public debt better in the future.

Challenges to Promoting Population-Based Cancer Registration in Iran: a Workshop Report

  • Hadji, Maryam;Nahvijou, Azin;Seddighi, Zahra;Beiki, Omid;Mohagheghi, Mohammad Ali;Mosavi-Jarrahi, Alireza;Marnani, Ahmad Barati;Zendehdel, Kazem
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.6189-6193
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    • 2013
  • In December 2011, the Cancer Research Centre of the Cancer Institute of Iran sponsored a 3-day workshop on "Cancer Registration Principle and Challenges in Iran", which convened cancer registry experts. The objectives of the workshop were: to introduce standard cancer registration, to review the policy and procedure of cancer registration in Iran, and to review the best practices in the cancer registries in Iran. Challenges to cancer registration were discussed and recommendations were developed. The workshop was evaluated by participants for better organization of subsequent workshops. The objective of publication of this report is that based on Cancer in 5 Continents, many low- or middle-income countries do not meet the criteria for a standard population-based cancer registry (PBCR); on the other hand cancer is the most important cause of mortality and the essential part of any cancer control program is the cancer registry. Therefore this report focuses on problems and challenges of PBCR and provides recommendations which might help other developing countries to decrease their PBCR defects.

A Consensus Plan for Action to Improve Access to Cancer Care in the Association of Southeast Asian Nations (ASEAN) Region

  • Woodward, Mark
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8521-8526
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    • 2014
  • In many countries of the Association of Southeast Asian Nations (ASEAN), cancer is an increasing problem due to ageing and a transition to Western lifestyles. Governments have been slow to react to the health consequences of these socioeconomic changes, leading to the risk of a cancer epidemic overwhelming the region. A major limitation to motivating change is the paucity of high-quality data on cancer, and its socioeconomic repercussions, in ASEAN. Two initiatives have been launched to address these issues. First, a study of over 9000 new cancer patients in ASEAN - the ACTION study - which records information on financial difficulties, as well as clinical outcomes, subsequent to the diagnosis. Second, a series of roundtable meetings of key stakeholders and experts, with the broad aim of producing advice for governments in ASEAN to take appropriate account of issues relating to cancer, as well as to generate knowledge and interest through engagement with the media. An important product of these roundtables has been the Jakarta Call to Action on Cancer Control. The growth and ageing of populations is a global challenge for cancer services. In the less developed parts of Asia, and elsewhere, these problems are compounded by the epidemiological transition to Western lifestyles and lack of awareness of cancer at the government level. For many years, health services in less developed countries have concentrated on infectious diseases and mother-and-child health; despite a recent wake-up call (United Nations, 2010), these health services have so far failed to allow for the huge increase in cancer cases to come. It has been estimated that, in Asia, the number of new cancer cases per year will grow from 6.1 million in 2008 to 10.6 million in 2030 (Sankaranarayanan et al., 2014). In the countries of the Association of Southeast Asian Nations (ASEAN), corresponding figures are 770 thousand in 2012 (Figure 1), rising to 1.3 million in 2030 (Ferlay et al., 2012). ASEAN consists of Brunei Darussalam, Cambodia, Indonesia, Lao, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam. It, thus, includes low- and middle-income countries where the double whammy of infectious and chronic diseases will pose an enormous challenge in allocating limited resources to competing health issues. Cancer statistics, even at the sub-national level, only tell part of the story. Many individuals who contract cancer in poor countries have no medical insurance and no, or limited, expectation of public assistance. Whilst any person who has a family member with cancer can expect to bear some consequential burden of care or expense, in a poor family in a poor environment the burden will surely be greater. This additional burden from cancer is rarely considered, and even more rarely quantified, even in developed nations.

Determinants of Participation in a Breast Cancer Screening Trial in Trivandrum District, India

  • Frie, Kirstin Grosse;Ramadas, Kunnambath;Anju, Gopan;Mathew, Beela Sara;Muwonge, Richard;Sauvaget, Catherine;Thara, Somanathan;Sankaranarayanan, Rengaswamy
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7301-7307
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    • 2013
  • Background: Conspicuous differences in participation rates for breast self-examination (BSE), clinical breast examination (CBE), and referral for further investigations have been observed indicating involvement of a number of different factors. This study analysed determinants for participation in different levels of the breast cancer screening process in Indian females. Materials and Methods: An intervention group of 52,011 women was interviewed in a breast cancer screening trial in Trivandrum district, India. In order to assess demographic, socio-economic, reproductive, and cancer-related determinants of participation in BSE, CBE, and referral, uni- and multi-variate logistic regression was employed. Results: Of the interviewed women, 23.2% reported practicing BSE, 96.8% had attended CBE, and 49.1% of 2,880 screen-positives attended referral. Results showed an influence of various determinants on participation; women who were currently not married or who had no family history of cancer were significantly less likely to attend the screening process at any level. Conclusions: Increasing awareness about breast cancer, early detection methods, and the advantages of early diagnoses among women, and their families, as well as health care workers offering social support, could help to increase participation over the entire screening process in India.

Chronic Pain and Its Determinants: A Population-based Study in Southern Iran

  • Zarei, Safar;Bigizadeh, Shiva;Pourahmadi, Mohammad;Ghobadifar, Mohamed Amin
    • The Korean Journal of Pain
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    • v.25 no.4
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    • pp.245-253
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    • 2012
  • Background: Prevalence of chronic pain and its association with demographic characteristics have been reported by different studies from different geographical regions in the world. However, data from many Middle East countries including Iran (especially southern Iran) are scare. The aim of the present study was to demonstrate the prevalence of chronic pain and its association with demographic, psychological and socioeconomic factors in an Iranian population. Methods: In this population-based survey, the target population was comprised of subjects aged 20 to 85 years residing in Jahrom, southern Iran during 2009-2011. All eligible subjects were invited to participate in the study. Before a detailed questionnaire was given; face to face interviews were done for each individual. Results: There were 719 men and 874 women with an average age of 40.5 years at the onset of the study. Among the study population, 38.9% (620/1,593) complained of chronic pain, of whom 40.8% (253/620) were men and 59.2% (367/620) were women. Foot and joint pain were observed in 31.9%. Hip and spine pain, migraine and tension headaches, heart pain, and abdomen pain were observed in 21.5%, 15.5%, 9.5%, and 8.0% of chronic pain cases, respectively. There was a significant association among the covariables age, sex, overweight, educational level, income, and type of employment with chronic pain as the dependent variable (P < 0.0001). Conclusions: Our findings show the prevalence of chronic pain and its association with demographic, psychological and socioeconomic factors. Individuals with low incomes and less education became accustomed to pain due to a lack of knowledge.

Public Awareness of Warning Signs and Symptoms of Cancer in Oman: A Community-Based Survey of Adults

  • Al-Azri, Mohammed;Al-Hamedi, Ibtisam;Al-Awisi, Huda;Al-Hinai, Mustafa;Davidson, Robin
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2731-2737
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    • 2015
  • Background: The majority of deaths from cancer occur in low and middle income countries, partly due to poor public awareness of the signs and symptoms of cancer. Materials and Methods: A community based survey using the Cancer Awareness Measure (CAM) questionnaire was conducted in three different communities in Oman. Omani adults aged 18 years and above were invited to participate in the study. Results: A total of 345 responded from 450 invited participants (response rate=76.7%). The majority of respondents were unable to identify the common signs and symptoms of cancer identified in the CAM (average awareness was 40.6%). The most emotional barrier to seeking help was worry about what the doctor might find (223, 64.6%); a practical barrier was too busy to make an appointment (259, 75.1%) and a service barrier was difficulty talking to the doctor (159, 46.1%). The majority of respondents (more than 60% for seven out of ten symptoms) would seek medical help in two weeks for most signs or symptoms of cancer. Females were significantly more likely than males to be embarrassed (p<0.001), scared (p=0.001), and lack confidence talking about their symptoms (p=0.022). Conclusions: Urgent strategies are needed to improve public awareness of the signs and symptoms of cancer in Oman. This might leads to earlier diagnosis, improved prognosis and reduced mortality from cancer.

Anticancer activities of Papaya (Carica papaya): A Review

  • Parray, Zahoor ahmad;Parray, Shabir ahmad;Khan, Javed ahmad;Zohaib, Sharique;Nikhat, Shagufta
    • CELLMED
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    • v.8 no.4
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    • pp.20.1-20.5
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    • 2018
  • Cancer is considered one of the deadly diseases in the world. According to WHO cancer now causes more deaths than all coronary heart disease. The incidence and mortality of the worldwide major cancers are now available in the GLOBOCAN series of the International Agency for Research on Cancer. The transition of global demographic and epidemiologic shows that burden of cancer will increase particularly in low and middle income countries, with over 20 million new cancer cases expected annually as early as 2025. Medicinal plants made known to be prospective and useful job for the treatment of several diseases and disorders from prehistoric days to nowadays. One of the commonly used plants, which have supporting evidences from the recent scientific data for the different types of cancers, is Carica papaya. Papaya (Carica papaya) is widely used as folk caloric herbal medicine, being a powerhouse of nutrients and accessible throughout the year. It is a rich source of three powerful antioxidants, the minerals, vitamins and contains high content of fibre. Carica papaya has provided many remedies for various diseases from ancient days to nowadays, and is regarded as a Nutraceutical. Because of this comprehensive medicinal value of Carica papaya, we are trying here to convey the reports studied especially for the anticancer activities of the age-old fruit, which will help researchers to pull in concert data and may be a "lead" for the one of the dangerous disease in the world.