International Journal of Health Planning and Management最新文献

This study applied the effective coverage framework to analyse trends and equity in the utilization of maternity care in Cambodia from 2000 to 2021 using data from the Cambodia Demographic and Health Surveys. The findings revealed a significant increase in the proportion of women attending at least four antenatal care (ANC) visits, rising from 7.5% in 2000 to 78.2% in 2021. However, coverage of the WHO-recommended ANC components varied, with the lowest compliance observed in urine and blood tests (64.1%) while the highest in iron/syrup supplementation (92.6%). Despite this, fewer than half of the women received all recommended ANC services. Facility-based delivery increased dramatically from 8.5% in 2000 to 91.5% in 2021, and the cesarean section rate rose from 0.9% to 14.2% during the same period. Utilization of postnatal care remained relatively low, with only 51.7% of women having at least one postnatal visit by 2021. Furthermore, only 22.7% of women accessed quality-adjusted continuous maternity care by 2021. Significant disparities were observed that 27.8% of urban and 31.3% of the wealthiest women received quality-adjusted continuous maternity care, compared to 20.3% of rural and 14.2% of the poorest women. Women who were older, had higher levels of education, or were covered by social health insurance were more likely to access quality-adjusted continuous care. Persistent gaps in comprehensive care highlight the need for targeted efforts to reduce disparities and enhance care quality across all population segments.

This study evaluates how community belonging influences over time changes in self-rated health (SRH) and self-rated mental health (SRMH) after the COVID-19 pandemic using a large Canadian population survey (N = 9013, response rate 25%). The study uses descriptive analysis and a set of ordered logistic regressions. The results suggest that 1 year after the height of the pandemic, most of the respondents consider their SRH and SRMH as excellent, good, or fair, with 89.1% for SRH and 85.7% for SRMH. By contrast, only 10.8% and 14.3% of respondents reported poor and very poor SRH and SRMH. Furthermore, about 25%–29% of respondents reported that their SRH and SRMH became better over time, and only 11%–12% reported worsening SRH and SRMH, while the rest reported no changes. Regression results suggest that higher levels of community belonging are associated with higher SRH and SRHM. For instance, reporting strong community belonging is associated with higher SRH (OR = 4.734, 95% CI [4.004, 5.598]) and SRMH (OR = 5.778, 95% CI [4.879, 6.842]). Moreover, they suggest that a higher level of community belonging is associated with perceived improvement over time in SRH and SRMH. For example, reporting strong community belonging is associated with more improvement over time in SRH (OR = 2.105, 95% CI [1.757, 2.523]) and SRHM (OR = 1.927, 95% CI [1.607, 2.312]). The study concluded by discussing theoretical, policy, and methodological implications of these findings.

Introduction: Abortion is one of the major public health problems among women during pregnancy and is regarded as the third cause of death in many societies such as Iran. To this end, this systematic review aimed to estimate the prevalence of induced abortion and its causes in Iran.

Methods: PubMed, Scopus, Web of Science, and national Persian databases such as SID, Magiran, and Elmnet were searched from inception to March 11, 2023. In addition, the relevant conference abstracts in Elmnet, Scopus, and Embase were searched. The pooled prevalence of abortions (induced, spontaneous, and therapeutic) and related factors were calculated at a 95% confidence interval.

Results: Of 310 papers retrieved from seven electronic databases, 34 were included in the quantitative synthesis (meta-analysis). The pooled prevalence of abortion 18.1% (95% CI: 14.5%-21.7%). The prevalence of induced abortion was 27.4% in the central areas of Iran. A short preceding birth interval, economic hardship situation, adequate number of previous alive children, low level of education, academic education, younger parents, maternal occupation, older age (> 35), and low knowledge about contraceptive use were the most frequent reasons for induced abortion.

Conclusion: The prevalence of induced abortion was 18%, showing a high rate for a religious country. Thus, policies and programs to reduce unwanted pregnancies should focus on increasing women's knowledge and access to suitable contraceptives, especially for women with a low socio-economic status.

Clinicians, who engage in research alongside their clinical duties, not only improve patient outcomes but contribute to cultural and workforce benefits for their healthcare organisations. The nomenclature of workplace titles for these roles has evolved over time and across international and geographical boundaries, as has the perceived level of research expertise or qualifications required. We propose that consistent titling for these roles would be of significant benefit for individuals, as well as healthcare leaders, and in the Australian context, clinicians conducting relevant research as part of their role, and who have a PhD or recognised research qualification, should be titled 'Clinician Scientists'.

This study examines how federal distribution policies affected regional disparities in access to COVID-19 therapeutics over time in Texas. To evaluate therapeutic accessibility, drug-to-case ratios were calculated by comparing the amount of therapeutic supply to confirmed case counts across counties during each policy period. A Bayesian spatiotemporal Integrated Nested Laplace Approximation (INLA) model was used to analyse how healthcare infrastructure, demographic characteristics, and regional vulnerabilities affected access. During the period when distribution was managed by state authorities, supply was quickly mobilized but often lagged demand, particularly in rural areas and communities with high rates of diabetes and older populations. In the next phase, test-to-treat program expanded overall supply, but access remained limited in areas with high racial and ethnic vulnerability due to the absence of demographic targeting. In the final phase, when therapeutics were allocated based on population thresholds and replenished regularly, spatial distribution became more stable and racial disparities narrowed. However, certain high-risk populations continued to face lower access. Findings show that each policy phase not only reflected but also reshaped regional disparities in therapeutic access. While early centralized efforts enabled swift response, they failed to address local needs. Later phases offered improved consistency but were still limited in addressing demographic and health-related vulnerabilities. This study underscores the importance of developing unified yet flexible distribution strategies that can respond to population-specific risks and infrastructure gaps, ensuring equitable access to treatment in future public health emergencies.