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The Impact of Health Promotion on Healthy Behavior Viewed from Health Beliefe Model Perspective (Study in Kediri Regency, East Java Province)
Nurwulan Andadari,
Andarini Andarini,
Soemarno Soemarno,
Edi Widjajanto
Issue:
Volume 4, Issue 4, December 2019
Pages:
110-121
Received:
9 September 2019
Accepted:
4 October 2019
Published:
25 October 2019
Abstract: Health promotion or health promotion is an important effort that must be done by health workers in collaboration with the community to create a healthy community both physically and mentally, especially in achieving the Healthy Indonesia target. But until now health promotion in Indonesia has not reached the maximum stage. There are still many people who are not health conscious. Preventing better than cure is also still a motto and cannot yet become a foundation of awareness in the community. If these constraints are not immediately found a solution, then it will gradually have an impact on the erosion of healthy living behavior of the community. In fact, the real form of this threat is the increase in mortality. The danger of this death will be more dangerous if it threatens pregnant women, because the threatened soul is not only the soul of a mother, but also her baby. Regarding these problems, the study was conducted to examine the impact of health promotion on healthy behavior in terms of the perspective of health beliefs. A positivist or scientific approach using SEM-AMOS analysis techniques. The data used are primary data distributed to 100 respondents. The results of this study indicate that Health promotion has a significant effect on perceived susceptibility, perceived severity, perceived benefits and perceived barriers. Perceived susceptibility and Perceived benefits have no significant effect on cues to action. While perceived severity & perceived barriers have a significant effect on cues to action, then Cues to action has a significant effect on self efficacy.
Abstract: Health promotion or health promotion is an important effort that must be done by health workers in collaboration with the community to create a healthy community both physically and mentally, especially in achieving the Healthy Indonesia target. But until now health promotion in Indonesia has not reached the maximum stage. There are still many peop...
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Healthcare Access Among Cambodia’s Poor: An Econometric Examination of Rural Care-seeking and Out-of-Pocket Expenditure
Robert John Kolesar,
Sambo Pheakdey,
Bart Jacobs,
Rebecca Ross
Issue:
Volume 4, Issue 4, December 2019
Pages:
122-131
Received:
26 September 2019
Accepted:
23 October 2019
Published:
30 October 2019
Abstract: To inform efforts to improve Cambodia’s social health protection system and advance universal health coverage, health care-seeking and out-of-pocket expenditure (OOPE) were assessed using the 2016 Cambodia Socioeconomic Survey data. This study focuses on the poorest wealth quintile who reside in rural areas- the primary target population of Cambodia’s largest social health protection scheme, the Health Equity Fund (HEF). The study also estimates the proportion of poor with an Equity card which provides access to HEF benefits at public facilities. Overall, 76% of people who sought healthcare in the past 30 days went to private providers, paying, on average, US$39.43 for treatment. About 18% of patients first sought care from public facilities, paying, on average, US$38.15. Though HEF aims to provide free healthcare for the rural poor, this analysis found that 67.2% of such patients seeking first care at public health facilities pay, on average, US$11.61 after controlling for confounding factors. However, treatment expenditure among the rural poor is about 52% less compared to third wealth quintile patients (p<0.01). About 36% of people under the national poverty line do not hold an Equity card to access HEF benefits. Thus, we conclude that HEF is not yet fully reaching its intended impact of removing OOPE as a barrier to access among the poor. Finally, free access to healthcare should incentivize utilization of public services; however, this study was unable to isolate such an effect among patients from the poorest wealth quintile. Access to healthcare can be strengthened with policy directives focused on further reducing OOPE and addressing other challenges to improve patient demand for public services such as quality of care. Enrollment exclusion errors should be corrected by relaxing the eligibility criteria with population coverage expansion. In addition, health service access should be systematically monitored by integrating service utilization, OOPE, and quality indicators into national monitoring and evaluation systems.
Abstract: To inform efforts to improve Cambodia’s social health protection system and advance universal health coverage, health care-seeking and out-of-pocket expenditure (OOPE) were assessed using the 2016 Cambodia Socioeconomic Survey data. This study focuses on the poorest wealth quintile who reside in rural areas- the primary target population of Cambodi...
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Nurses’ Perception of Causes of 2015 Strikes at Federal Medical Centre Owerri: Implication for Preventive Strategies
Bridget Omowumi Akin-Otiko,
Modupe Motunrayo Adamolekun,
Julie Remilekun Amoka
Issue:
Volume 4, Issue 4, December 2019
Pages:
132-142
Received:
24 May 2019
Accepted:
26 June 2019
Published:
5 November 2019
Abstract: “Get the nurses to go back to work” was the directive, after two years of intermittent labour strikes and consequent shutdown of the Federal Medical Centre, Owerri, South Eastern Nigeria. It was assumed that, since nurses constituted the largest percentage of health workers, their resumption would frustrate and end the strike. However, studies have shown that the use of force rarely worked. This study examined the nurses’ perception of causes of the strikes and the government interventions. The WHO healthy workplace framework was adapted in recommending strategies to prevent reoccurrence. Exploratory research design with mixed method sequential exploratory data collection strategy was utilized. Findings from focus group discussions in first phase were used to develop Likert scale self-administered questionnaire at second quantitative phase. One hundred and thirty-nine and 461 nurses participated in the qualitative and quantitative phases respectively. Epi Info statistical package was used for data entry and analysis of the quantitative data. Frequencies and percentages were calculated for all the items, and Chi-square was calculated between the senior and junior nurses’ responses. The responses of the senior and junior nurses were similar on the items. All sixteen causes of the strike identified by participants were within Psychosocial Work Environment of the WHO framework. Disparity in salary was highest (443(96.1%), followed by highhandedness of the chief executive (436(94.58%). Participants opined that insincerity of the investigation panel (369(80%) and seriousness of the crisis led to the shutdown (341(73.97%) of the facility. Suggested fifteen preventive strategies against strikes covered two of the WHO’s workplace environments. They included, the psychosocial environment: effective communication (450(97.61%), promotion of nurses as and when due (447(96.96%), harmonization of salaries (445(96.53%), change of chief executive (442(95.87%); and the physical environment: provision of materials to work with in the hospital (406(88%). Accurate reports by panels of enquiry (448(97.18%), appropriate prompt attention to the causes (447(96.96%), and avoidance of sentiments (446(96.75%) could prevent repeat shutdown of the facility. Chi-square showed no significant difference in the responses of the senior and junior nurses. According to the WHO healthy work place intervention model, elimination, substitution and modification of contents and processes in the workplace may be required. Stakeholders should avoid factors that hinder appropriate interventions; and uphold values that protect workers and the benefitting communities.
Abstract: “Get the nurses to go back to work” was the directive, after two years of intermittent labour strikes and consequent shutdown of the Federal Medical Centre, Owerri, South Eastern Nigeria. It was assumed that, since nurses constituted the largest percentage of health workers, their resumption would frustrate and end the strike. However, studies have...
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Assessing Factors Associated with Catastrophic Healthcare Expenditure in Côte d’Ivoire: Evidence from the Household Living Standard Survey 2015
Akissi Regine Attia-Konan,
Agbaya Serge Stephane Oga,
Kouame Koffi,
Jerome Kouame,
Amadou Toure,
Luc Kouadio
Issue:
Volume 4, Issue 4, December 2019
Pages:
143-150
Received:
30 September 2019
Accepted:
23 October 2019
Published:
13 November 2019
Abstract: Catastrophic healthcare expenditure (CHE) occurs in all countries and is responsible for inequalities in access to health care, particularly in low- and middle-income countries. The objective of this work is to analyse the determinants of CHEs in households living in Côte d'Ivoire. The data for the study are from the national household living standards survey conducted from January 23 to March 25, 2015 by the National Statistics Institute of Côte d’Ivoire (Institut National de la Statistique de Côte d'Ivoire). A one-way analysis and logistic regression were conducted to measure the association between CHEs and the socio-demographic, economic and health characteristics of households. The sample consisted of 12,899 households. Nearly 4% of households had experienced CHEs after completing OOPs. CHEs were more frequent in households including people over 65 years of age (OR: 4.75; 95% CI: 1.66-13.58), with chronic disease (OR: 2.10; 95% CI: 1.43-3.08), with more comfortable living conditions. Households without health insurance experienced fewer CHEs (OR: 0.29; 95% CI: 0.09-0.85) with large households including people over 65 years of age (OR: 0.60 95% CI: 0.40-0.91). This work highlighted socio-demographic and health determinants of CHEs. The reduction of CHEs involves considering social and individual factors.
Abstract: Catastrophic healthcare expenditure (CHE) occurs in all countries and is responsible for inequalities in access to health care, particularly in low- and middle-income countries. The objective of this work is to analyse the determinants of CHEs in households living in Côte d'Ivoire. The data for the study are from the national household living stand...
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Study About the Management of Medical Waste and Non Medical Waste in Kwaingga Public Hospital, District Keerom, Jayapura
Issue:
Volume 4, Issue 4, December 2019
Pages:
151-157
Received:
11 October 2019
Accepted:
23 November 2019
Published:
7 December 2019
Abstract: Kwaingga Public Hospital is categorized as type C hospital because there are several aspects need to be improved for management and quality in order to fill the standard from Ministry of Health. Especially for a medical waste management, hospital staffs said that an incinerator has potential to explode due to bad structure because its pillar consists wood. This study aimed to observe the management of medical waste and general waste in Kwaingga Public Hospital. This study is qualitative study where the population is all staffs that work in Kwaingga Public Hospital, and the study sample is six Hospital staffs including hospital director, planning division, treasurer, and sanitarians. They have been deep interviewed and recorded. Study took visual documentations. There are 20 trashes distributed in hospital for daily waste and it is end in a small landfill in hospital backyard. This managed by 10 cleaning services and the staffs said that that number is still inadequate. Sanitarian staffs are six and they all have background sanitation diploma, but they still have overload tasks and they don’t get any training for development yet, the last training was in 2012. There are incinerator, wastewater treatment plant, septic tank, filtration for wastewater, and an old incinerator; there is no machine for destroyed needles. Unfortunately, the incinerator was rarely to use since its structure is bad and has potential to explode; also diesel fuel cost is expensive, so the medical waste burned manually including needles. Similarly, wastewater treatment plant is rarely used due to electricity cost, so it only runs if the wastewater is full. Wastewater treatment plant had bought from Local government Revenue costing 4.5 billion rupiah. Salary for contact staffs and cleaning services are also from local government revenue. Therefore, local government revenue must be increased its allocation for hospital waste management.
Abstract: Kwaingga Public Hospital is categorized as type C hospital because there are several aspects need to be improved for management and quality in order to fill the standard from Ministry of Health. Especially for a medical waste management, hospital staffs said that an incinerator has potential to explode due to bad structure because its pillar consis...
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Community-Based Health Insurance Enrollment and Determinants in Addis Ababa: Insights from Behavioral Economics and Discrete Choice Experiments
Abel Eshetu,
Abrham Seyoum
Issue:
Volume 4, Issue 4, December 2019
Pages:
158-167
Received:
13 July 2019
Accepted:
7 August 2019
Published:
26 December 2019
Abstract: Community-based health insurance target those employed in the rural and informal sector in urban by pooling risks and protect households from out-of-pocket expenditures when receiving health facility services. However, Ethiopian community-based health insurance is schemes characterized by low enrollment. The aim of this study is to analyze the determinants of community-based health insurance enrollment in Addis Ababa from behavioral economics and discrete choice experiment insights. A total of 222 households from ten pilot woredas were selected for the study using a simple random sampling technique. A simple social experiment is used to examine the significance of behavioral biases. A discrete choice experiment conducted across three attributes and conditional logit model used to determine the relative importance of the selected attributes and willingness-to-pay for those attributes. In addition, the binary logit regression model is used to estimate the probability of households enrollment in community-based health insurance. The study result indicates that households have the highest willingness to pay for only private health service providers (Birr 1849.6/year) compared to status-quo level. Non-member households’ willingness to pay for comprehensive health service package Birr 2271.7/year. Moreover, this study revealed loss-aversion bias, over-optimistic bias, and herding bias had significantly affected the household decision on community-based health insurance enrollment. The study suggests that behavioral biases affect Community-based health insurance enrollment. The study finding also reveals that respondent households are willingness to pay more for comprehensive health service package and for health insurance scheme that includes private health service providers. In addition, the study concludes eligible household enrollment decision varied based on their socio-demographic and household characteristic. This study recommends the need to consider mandatory community-based health insurance schemes and apply targeting intervention (coverage) to the particular group.
Abstract: Community-based health insurance target those employed in the rural and informal sector in urban by pooling risks and protect households from out-of-pocket expenditures when receiving health facility services. However, Ethiopian community-based health insurance is schemes characterized by low enrollment. The aim of this study is to analyze the dete...
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