O. Erinoso, A. Oyapero, Oluwabukunmi Familoye, A. Omosun, A. Adeniran, Y. Kuyinu
INTRODUCTION Health insurance is a health-financing mechanism to protect people from catastrophic healthcare costs and limits out-of-pocket spending on healthcare, which is directly linked to poverty. This study assesses the extent of health-insurance uptake and associated factors in Lagos, Nigeria. METHODS We conducted a cross-sectional survey of consenting adults residing in Lagos, Nigeria. Participants were enrolled at general outpatient clinics of four public health facilities in Lagos State. Sociodemographic characteristics and data on health-insurance uptake were obtained and grouped into uninsured, National HealthInsurance Scheme (NHIS) and Private Health-Insurance (PHI). Factors associated with health-insurance uptake was determined using chi-squared tests and logistic regression models. Statistical significance was placed at p<0.05. RESULTS A total of 1000 respondents were enrolled in the study. Overall, 9.5% of participants had health-insurance: NHIS (5.6%) and PHI (3.9%). Males had a higher healthinsurance uptake than females (p=0.035). Respondents who were married had higher odds of health-insurance uptake than those that were single (AOR=2.23; 95% CI: 1.20–4.16; p=0.01). Similarly, respondents who had a secondary-school diploma had higher odds of having a health insurance compared to those with less than a secondary-school education (AOR=5.20; 95% CI: 1.14–23.68; p=0.03). CONCLUSIONS Our findings suggest a low rate of healthinsurance uptake in the population. Being male, married and possessing a secondary school diploma or higher were associated with higher odds of health insurance uptake. Policy measures should focus on expanding access to health insurance, particularly among the less educated and the informal employment sector. Research Paper | Population Medicine Popul. Med. 2023;5(July):19 https://doi.org/10.18332/popmed/169666 2 and inequalities3. UHC is a multisectoral issue that requires legislation, budgetary allocations, and regulatory oversight, and it involves several governmental and non-governmental sectors for its implementation. Financing health services is essential to achieving UHC, and health insurance is a critical component of financing options to achieve qualitative healthcare4. In Nigeria, healthcare is funded through different sources; however, current estimates suggest that over 70% of Nigerians still depend on out-of-pocket payments, making it the country’s major source of healthcare financing5. According to the World Bank, out-of-pocket spending on healthcare is directly linked to an increase in the number of people who fall into extreme poverty6. With over 90 million Nigerians living in poverty7, financial protection is crucial so more people are not pushed into extreme poverty due to healthcare costs. The Nigerian government established the National Health Insurance Scheme (NHIS) in response to increased out-ofpocket payments and the call for a movement towards UHC8. Although NHIS started its operation in
{"title":"Predictors of health insurance uptake among residents\u0000of Lagos, Nigeria","authors":"O. Erinoso, A. Oyapero, Oluwabukunmi Familoye, A. Omosun, A. Adeniran, Y. Kuyinu","doi":"10.18332/popmed/169666","DOIUrl":"https://doi.org/10.18332/popmed/169666","url":null,"abstract":"INTRODUCTION Health insurance is a health-financing mechanism to protect people from catastrophic healthcare costs and limits out-of-pocket spending on healthcare, which is directly linked to poverty. This study assesses the extent of health-insurance uptake and associated factors in Lagos, Nigeria. METHODS We conducted a cross-sectional survey of consenting adults residing in Lagos, Nigeria. Participants were enrolled at general outpatient clinics of four public health facilities in Lagos State. Sociodemographic characteristics and data on health-insurance uptake were obtained and grouped into uninsured, National HealthInsurance Scheme (NHIS) and Private Health-Insurance (PHI). Factors associated with health-insurance uptake was determined using chi-squared tests and logistic regression models. Statistical significance was placed at p<0.05. RESULTS A total of 1000 respondents were enrolled in the study. Overall, 9.5% of participants had health-insurance: NHIS (5.6%) and PHI (3.9%). Males had a higher healthinsurance uptake than females (p=0.035). Respondents who were married had higher odds of health-insurance uptake than those that were single (AOR=2.23; 95% CI: 1.20–4.16; p=0.01). Similarly, respondents who had a secondary-school diploma had higher odds of having a health insurance compared to those with less than a secondary-school education (AOR=5.20; 95% CI: 1.14–23.68; p=0.03). CONCLUSIONS Our findings suggest a low rate of healthinsurance uptake in the population. Being male, married and possessing a secondary school diploma or higher were associated with higher odds of health insurance uptake. Policy measures should focus on expanding access to health insurance, particularly among the less educated and the informal employment sector. Research Paper | Population Medicine Popul. Med. 2023;5(July):19 https://doi.org/10.18332/popmed/169666 2 and inequalities3. UHC is a multisectoral issue that requires legislation, budgetary allocations, and regulatory oversight, and it involves several governmental and non-governmental sectors for its implementation. Financing health services is essential to achieving UHC, and health insurance is a critical component of financing options to achieve qualitative healthcare4. In Nigeria, healthcare is funded through different sources; however, current estimates suggest that over 70% of Nigerians still depend on out-of-pocket payments, making it the country’s major source of healthcare financing5. According to the World Bank, out-of-pocket spending on healthcare is directly linked to an increase in the number of people who fall into extreme poverty6. With over 90 million Nigerians living in poverty7, financial protection is crucial so more people are not pushed into extreme poverty due to healthcare costs. The Nigerian government established the National Health Insurance Scheme (NHIS) in response to increased out-ofpocket payments and the call for a movement towards UHC8. Although NHIS started its operation in ","PeriodicalId":33626,"journal":{"name":"Population Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49240627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sabina Mahmutovic Vranic, Olga Cvijanović-Peloza, Anesa Jurković-Mujkić, Aida Kustura, Enisa Ademovic, S. Šegalo, Sajra Vincevic-Smajlovic, A. Jogunčić, Ana Terezija Jerbić Radetić, Ivan Dražić, Ivan Šoša, Haris Čampara, Amina Valjevac
https:
https：
{"title":"Knowledge, attitudes, and practices among medical and non-medical students about immunization during the COVID-19 pandemic: A cross-sectional study","authors":"Sabina Mahmutovic Vranic, Olga Cvijanović-Peloza, Anesa Jurković-Mujkić, Aida Kustura, Enisa Ademovic, S. Šegalo, Sajra Vincevic-Smajlovic, A. Jogunčić, Ana Terezija Jerbić Radetić, Ivan Dražić, Ivan Šoša, Haris Čampara, Amina Valjevac","doi":"10.18332/popmed/168706","DOIUrl":"https://doi.org/10.18332/popmed/168706","url":null,"abstract":"https:","PeriodicalId":33626,"journal":{"name":"Population Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47298652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
INTRODUCTION Secondhand smoke (SHS) exposure during pregnancy among non-smoking women is associated with mortality and morbidity risks in infants. However, little is known about SHS inside the house and low birth weight in newborns. This study aims to assess the prevalence, level, and frequency of SHS exposure inside the house and investigate their associations with low birth weight. METHODS We used the Indonesian Demographic and Health Survey (IDHS) 2017, a large-scale, nationally representative survey. Women aged 15–49 years who had given birth in the last five years before the study and their husbands were interviewed (n=19935). Two dependent variables included low birth weight (LBW) and birth weight. RESULTS In all, 78.4% of mothers were exposed to SHS inside the home, of whom 7.2% had LBW children. Compared to non-exposed to SHS mothers, those exposed to SHS were younger, had their first birth before the age of 20 years, were married, lower educated, non-workers, lived in rural areas, were grand multipara, had pollution from cooking fuel, cooked in a separate building, and had a higher risk of delivering a lower birth weight (AOR=1.16; 95% CI: 1.02– 1.33). CONCLUSIONS Exposure to SHS inside the home was significantly associated with LBW. Given the high prevalence of smoking, relevant policies and health promotion are needed. Research Paper | Population Medicine Popul. Med. 2023;5(June):17 https://doi.org/10.18332/popmed/168620 2 basis6. Based on Demographic and Health Survey data collected between 2008 and 2013, from 30 lowand middle-income countries (LMICs), daily SHS exposure accounted for a more significant population-attributable fraction of stillbirths than active smoking, which was 14% in Indonesia. This number is the highest among the other 30 LMICs7. Indonesia has compiled various regulations governing public protection from the dangers of exposure to cigarette smoke. One of them is the adoption of no-smoking zones in various public places and workplaces, especially in schools and hospitals. However, the World Health Organization (WHO) notes that regulations regarding smoke-free areas in public areas in Indonesia are still relatively low compared to other South-East Asian countries, and in accordance with the geographical distribution as well as socioeconomic disparity, in urban settings, the wealthier and more educated population were more likely to adopt a smoke-free policy8. Given the implications for child mortality, a significant reduction in the prevalence of LBW is necessary to achieve the Sustainable Development Goals, and there is a similar need to strengthen the implementation of the Framework Convention on Tobacco Control (FCTC) of the WHO in all countries9. Only a few robust studies examined a clear association between exposure to SHS inside the house and birth outcomes, especially in Indonesia10,11. This study contributes to filling the knowledge gap in SHS exposure inside the house and low birth weight in Indonesia by u
{"title":"Secondhand smoke exposure inside the house and low\u0000birth weight in Indonesia: Evidence from a demographic\u0000and health survey","authors":"H. Andriani, N. Rahmawati, A. Ahsan, D. Kusuma","doi":"10.18332/popmed/168620","DOIUrl":"https://doi.org/10.18332/popmed/168620","url":null,"abstract":"INTRODUCTION Secondhand smoke (SHS) exposure during pregnancy among non-smoking women is associated with mortality and morbidity risks in infants. However, little is known about SHS inside the house and low birth weight in newborns. This study aims to assess the prevalence, level, and frequency of SHS exposure inside the house and investigate their associations with low birth weight. METHODS We used the Indonesian Demographic and Health Survey (IDHS) 2017, a large-scale, nationally representative survey. Women aged 15–49 years who had given birth in the last five years before the study and their husbands were interviewed (n=19935). Two dependent variables included low birth weight (LBW) and birth weight. RESULTS In all, 78.4% of mothers were exposed to SHS inside the home, of whom 7.2% had LBW children. Compared to non-exposed to SHS mothers, those exposed to SHS were younger, had their first birth before the age of 20 years, were married, lower educated, non-workers, lived in rural areas, were grand multipara, had pollution from cooking fuel, cooked in a separate building, and had a higher risk of delivering a lower birth weight (AOR=1.16; 95% CI: 1.02– 1.33). CONCLUSIONS Exposure to SHS inside the home was significantly associated with LBW. Given the high prevalence of smoking, relevant policies and health promotion are needed. Research Paper | Population Medicine Popul. Med. 2023;5(June):17 https://doi.org/10.18332/popmed/168620 2 basis6. Based on Demographic and Health Survey data collected between 2008 and 2013, from 30 lowand middle-income countries (LMICs), daily SHS exposure accounted for a more significant population-attributable fraction of stillbirths than active smoking, which was 14% in Indonesia. This number is the highest among the other 30 LMICs7. Indonesia has compiled various regulations governing public protection from the dangers of exposure to cigarette smoke. One of them is the adoption of no-smoking zones in various public places and workplaces, especially in schools and hospitals. However, the World Health Organization (WHO) notes that regulations regarding smoke-free areas in public areas in Indonesia are still relatively low compared to other South-East Asian countries, and in accordance with the geographical distribution as well as socioeconomic disparity, in urban settings, the wealthier and more educated population were more likely to adopt a smoke-free policy8. Given the implications for child mortality, a significant reduction in the prevalence of LBW is necessary to achieve the Sustainable Development Goals, and there is a similar need to strengthen the implementation of the Framework Convention on Tobacco Control (FCTC) of the WHO in all countries9. Only a few robust studies examined a clear association between exposure to SHS inside the house and birth outcomes, especially in Indonesia10,11. This study contributes to filling the knowledge gap in SHS exposure inside the house and low birth weight in Indonesia by u","PeriodicalId":33626,"journal":{"name":"Population Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44480881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ejovwokeoghene J. Omohwovo, Lucero-Prisno Iii Don Eliseo
1 Dear Editor, Nigeria, with a population of over 200 million people, is the most populous country in Africa1. Its diverse ecological zones, including the Sahel region in the north, the Sudan savannah, and the rainforest belt in the south2, play a significant role in shaping the transmission patterns of malaria within the country. Nigeria accounted for 31.3% of all global malaria deaths and 27% of all cases worldwide in 20213. Children under five and pregnant women are particularly vulnerable to malaria in Nigeria4, where poverty, limited access to healthcare services, inadequate vector control measures, and suboptimal use of preventive interventions exacerbate the burden of the disease. Malaria has significant economic and health consequences5, costing Nigeria over US$1.1 billion annually and accounting for 60% of all hospital visits6. Despite the proactive efforts of the National Malaria Elimination Programme (NMEP), the National Malaria Strategic Plan (2014–2020) fell short of its goal to eradicate malaria by 20207. While the establishment of the Nigeria End Malaria Council in August 2022 is a positive step8,9, additional efforts are necessary to effectively combat malaria in the country. The government must take further proactive measures to halt the ongoing spread of malaria and implement effective control strategies against malaria. To achieve this, increased funding for malaria control programs is crucial. Therefore, more funds and resources should be allocated by the government to the NMEP while ensuring efficient utilization. This financial boost will enable the program to carry out its activities effectively and expand its reach across the country. Additionally, prioritizing the acquisition and equitable distribution of the RTS, S malaria vaccine among children is essential in combating the high incidence of malaria in sub-Saharan Africa10. Therefore, it is imperative that the Nigerian government proactively fulfills its plan to ensure malaria vaccination in 202411 and ensures equitable distribution. Moreover, improving access to malaria prevention and treatment services is essential, particularly in rural areas where many people lack adequate healthcare access. This can be achieved through the expansion of distribution channels for insecticide-treated bed nets, diagnostic tests, and antimalarial drugs. Additionally, training healthcare workers in these areas will ensure proper diagnosis and treatment, thus reducing the burden of malaria. Also, enhancing vector control measures is vital in curbing the spread of malaria. Measures such as indoor residual spraying, larviciding, and utilizing drones in remote areas can be effective strategies to target mosquito breeding grounds and reduce the population of disease-carrying vectors. Furthermore, strengthening private sector engagement and community awareness is crucial to promoting the uptake of malaria prevention and treatment services. The involvement of NGOs, community-based organizations
{"title":"The urgency of intensifying efforts to combat malaria in\u0000Nigeria","authors":"Ejovwokeoghene J. Omohwovo, Lucero-Prisno Iii Don Eliseo","doi":"10.18332/popmed/168464","DOIUrl":"https://doi.org/10.18332/popmed/168464","url":null,"abstract":"1 Dear Editor, Nigeria, with a population of over 200 million people, is the most populous country in Africa1. Its diverse ecological zones, including the Sahel region in the north, the Sudan savannah, and the rainforest belt in the south2, play a significant role in shaping the transmission patterns of malaria within the country. Nigeria accounted for 31.3% of all global malaria deaths and 27% of all cases worldwide in 20213. Children under five and pregnant women are particularly vulnerable to malaria in Nigeria4, where poverty, limited access to healthcare services, inadequate vector control measures, and suboptimal use of preventive interventions exacerbate the burden of the disease. Malaria has significant economic and health consequences5, costing Nigeria over US$1.1 billion annually and accounting for 60% of all hospital visits6. Despite the proactive efforts of the National Malaria Elimination Programme (NMEP), the National Malaria Strategic Plan (2014–2020) fell short of its goal to eradicate malaria by 20207. While the establishment of the Nigeria End Malaria Council in August 2022 is a positive step8,9, additional efforts are necessary to effectively combat malaria in the country. The government must take further proactive measures to halt the ongoing spread of malaria and implement effective control strategies against malaria. To achieve this, increased funding for malaria control programs is crucial. Therefore, more funds and resources should be allocated by the government to the NMEP while ensuring efficient utilization. This financial boost will enable the program to carry out its activities effectively and expand its reach across the country. Additionally, prioritizing the acquisition and equitable distribution of the RTS, S malaria vaccine among children is essential in combating the high incidence of malaria in sub-Saharan Africa10. Therefore, it is imperative that the Nigerian government proactively fulfills its plan to ensure malaria vaccination in 202411 and ensures equitable distribution. Moreover, improving access to malaria prevention and treatment services is essential, particularly in rural areas where many people lack adequate healthcare access. This can be achieved through the expansion of distribution channels for insecticide-treated bed nets, diagnostic tests, and antimalarial drugs. Additionally, training healthcare workers in these areas will ensure proper diagnosis and treatment, thus reducing the burden of malaria. Also, enhancing vector control measures is vital in curbing the spread of malaria. Measures such as indoor residual spraying, larviciding, and utilizing drones in remote areas can be effective strategies to target mosquito breeding grounds and reduce the population of disease-carrying vectors. Furthermore, strengthening private sector engagement and community awareness is crucial to promoting the uptake of malaria prevention and treatment services. The involvement of NGOs, community-based organizations","PeriodicalId":33626,"journal":{"name":"Population Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47615235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence and correlates of dyslipidemia, awareness,\u0000and management among adults in Bangladesh in 2018","authors":"K. Peltzer","doi":"10.18332/popmed/167806","DOIUrl":"https://doi.org/10.18332/popmed/167806","url":null,"abstract":"ABSTRACT","PeriodicalId":33626,"journal":{"name":"Population Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42403864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bikram Chhetri, Ugyen Dem, Zimba Letho, Kipchu Tshering, B. Škodlar
ABSTRACT
摘要
{"title":"Prevalence of major depressive disorder in adult patients\u0000with alcohol use disorder admitted in the psychiatric ward\u0000at the Jigme Dorji Wangchuck National Referral Hospital,\u0000Thimphu, Bhutan","authors":"Bikram Chhetri, Ugyen Dem, Zimba Letho, Kipchu Tshering, B. Škodlar","doi":"10.18332/popmed/166187","DOIUrl":"https://doi.org/10.18332/popmed/166187","url":null,"abstract":"ABSTRACT","PeriodicalId":33626,"journal":{"name":"Population Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45264043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Knowledge of HIV/AIDS and its determinants in India:\u0000Findings from the National Family Health Survey-5 (2019–\u00002021)","authors":"Minnie Malik, Siaa Girotra, Debolina Roy, S. Basu","doi":"10.18332/popmed/163113","DOIUrl":"https://doi.org/10.18332/popmed/163113","url":null,"abstract":"ABSTRACT","PeriodicalId":33626,"journal":{"name":"Population Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48135667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Confidence in midwives in prevention of HPV - associated diseases in Bulgaria","authors":"E. Stoyanova, M. Kamburova, E. Mineva","doi":"10.18332/popmed/165376","DOIUrl":"https://doi.org/10.18332/popmed/165376","url":null,"abstract":"","PeriodicalId":33626,"journal":{"name":"Population Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44994799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Trust in the scientific community and conspiracy thinking in Italy during the COVID-19 pandemic","authors":"C. Cadeddu, L. Regazzi, A. Rosano","doi":"10.18332/popmed/165694","DOIUrl":"https://doi.org/10.18332/popmed/165694","url":null,"abstract":"","PeriodicalId":33626,"journal":{"name":"Population Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45119328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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