Search results

The purpose of this research was to determine the extent of the unmet need for modern contraceptives (MC) and its associated factors.

This community-based cross-sectional survey was conducted via interview among 306 women. Percentages, means, standard deviations, Chi-square tests and multiple logistic regression were completed for data analysis.

In total, 46.7% of respondents had total unmet need (24.8% spacing and 21.9% limiting). Multiple logistic regression for spacing showed the number of living children (AOR = 40.893, 95% CI = 6.930–241.292), no previous experience of MC (AOR = 30.149, 95% CI = 11.572–78.548) and level of knowledge (AOR = 5.587, 95% CI = 1.366–22.851). With regard to limiting pregnancies, respondent's age (AOR = 12.470, 95% CI = 1.264–86.734), number of living children (AOR = 21.257, 95% CI = 4.825–93.639) and no previous experience of MC (AOR = 120.542, 95% CI = 31.044–486.062) were recorded. Findings revealed that no previous experience of MC (AOR = 714.511, 95% CI = 160.646–3177.955) was a significant predictor of total unmet need.

Experience and knowledge of MC play a vital role in the unmet need of MC use. A comprehensive education program to promote decision-making on MC choice and integrated family planning services at local communities by capacity building of service providers should be scaled up.

The purpose of this paper is to ascertain the oral health experiences of people living with HIV/AIDS in the provinces of Kwazulu-Natal (KZN) and Western Cape (WC) in South Africa. Many studies have reported that people living with HIV have unmet needs for dental care and this study considered the various factors that affect the accessibility and utilisation of dental services as these factors are even more pertinent for the people living with HIV who have increased need for dental care.

The participants were selected among HIV-positive people attending selected Community Health Centre and regional hospital HIV clinics in KZN and WC provinces. The sample consisted of people living with HIV that were 18 years or older and who had given written, informed consent. The sample (n=435) comprised mainly of black females in the age group 20-29 years. In total, 347 participants (79.8 per cent) had an oral health problem of which 83 per cent (n=288) received care.

Of those that received care, 56.6 per cent (n=163) of the participants stated that the staff were aware of their HIV status. Almost a third of the participants who received care reported a negative experience at the clinic. If the participant lived in a metropolitan area, the participant was 3.647 times more likely to receive care than if the participant lived in a non-metropolitan area (p < 0.01) If the participant earned R5,000 or less, the participant was 0.106 times less likely to receive care (p=0.048). If the participant lived 1-5 km from the clinic, the participant was 3.371 times more likely to receive care (p=0.015).

The results are specific to KZN and WC and cannot be extrapolated with caution to the rest of South Africa. However, to the best of the author’s knowledge, there is no other study that has compared differences in the use of oral health care services by people with HIV in South Africa and these results serve as an indication of some the important issues in this regard. Additionally, this study did not have a control group of HIV-negative people which would have enabled one to determine whether certain barriers were unique to people living with HIV.

The study highlighted the barriers to care existing within the current public health system relative to the provision of oral health services for people living with HIV in KZN and WC. It was anticipated that by ascertaining the nature and extent of unmet needs and barriers to dental care for people living with HIV, measures can be put in place to remove or at least reduce the barriers to care and improve the quality of life for people living with HIV/AIDS in South African communities.

The high prevalence of oral health problems in people living with HIV makes it imperative for the DOH to make every attempt to remove barriers to oral health care and thereby secure equitable, affordable and accessible oral health care which is acceptable for people living with HIV and accountable to the greater society.

This study emphasises the importance of embracing people that are being discriminated and marginalised by society such as people living with HIV to ensure that they feel a franchised member of society who can take the initiative to be in control of their own health and, with the necessary aid from public resources and societal support, join forces to reduce the public health burden and its impact on the socio-economic milieu.

We find the presence of a sibling with disability in a household is associated with greater risk of lower health status, unmet needs for routine medical care, and number of bed days due to sickness or injury. This is true both for children with or without disability. These relationships persist with controls for other aspects of the family environment that are associated with disability (socioeconomic status, family structure, and labor force participation). Having a co-resident sibling with disability rivals poverty, minority race or ethnic status, and one-parent households as a major risk factor for these negative child health outcomes.

This chapter explores the role of cultural activity within prison libraries for not only the general wellbeing of prisoners, but also as a form of indirect intervention for addressing unrecognised and/or unaddressed information needs amongst prisoners; particularly important needs of a more sensitive nature often repressed (e.g. remorse, mental health, relationships). Drawing on research to date, the authors discuss the information needs of prisoners, the associated benefits of cultural activity for information need recognition and understanding, and the support role of the prison library; and in relation, identify opportunities for further development of the library as a key change agent in the progressive rehabilitation of prisoners.

The purpose of this paper is to assess the health promotion needs of vulnerable young prisoners and the existing health promotion activities in custodial settings in seven European Union (EU) Member States.

The research comprised two components: the first involved identifying existing health promotion practices. The second involved mapping out young offenders’ health promotion needs by carrying out a needs assessment. Both quantitative and qualitative methods were adopted. The quantitative element comprised surveys among young prisoners and prison staff and focused on the availability and perceived importance of health promotion activities in prison. The qualitative element comprised focus groups with young offenders and individual interviews with prison staff, field experts and NGO members.

The findings from the research have identified a number of similar, but also some diverse areas of unmet need for health promotion activities in prison settings across these diverse seven EU countries. There is no consistency of approach within and between countries regarding health promotion policy, guidance, resources and programmes for young prisoners. In order to improve the health of young prisoners and to establish and increase sustainability of existing health promotion programmes, there is a need for the establishment of National and EU standards.

Providing health promotion activities for young prisoners while in custodial settings is key to addressing their unmet health and well-being needs and to facilitate their reintegration back into the community. Despite the barriers identified by this research, health promotion is to some extent being delivered in the partner countries and provides a foundation upon which further implementation of health promotion activities can be built especially when the benefits of health promotion activities, like dealing with the common problems of alcohol and drug addiction, mental health and communicable diseases are linked to successful reintegration.

This research project explored how refugee community organisations (RCOs) could become more involved in the government's health agenda to improve the level of consultation and responsiveness in the design and provision of mental health services for ethnic minorities. The method involved a review of relevant literature, interviews with refugee community organisation leaders and community workers, and a survey of refugee service users' involvement with RCOs. The research found that the causes and effects of mental ill health in refugees as understood by interviewees were consistent with much of the literature in this area. The mental health needs of refugees are very similar across nationalities and ethnicities, and distinct from those of the general population and of other migrant groups. Appropriate responses, as understood by community leaders and professional community workers, are currently only partly and insufficiently provided by statutory health services, and there is extensive unmet need.

Racial and ethnic minorities utilize less healthcare than their similarly situated white counterparts in the United States, resulting in speculation that these actions may stem in part from less desire for care. In order to adequately understand the role of care-seeking for racial and ethnic disparities in healthcare, we must fully and systematically consider the complex set of social factors that influence healthcare seeking and use.

Data for this study come from a 2005 national survey of community-dwelling Medicare beneficiaries (N = 2,138). We examine racial and ethnic variation in intentions to seek care, grounding our analyses in the behavioral model of healthcare utilization. Our analysis consists of a series of nested multivariate logistic regression models that follow the sequencing of the behavioral model while including additional social factors.

We find that Latino, Black, and Native American older adults express greater preferences for seeking healthcare compared to whites. Worrying about one’s health, having skepticism toward doctors in general, and living in a small city rather than a Metropolitan Area, but not health need, socioeconomic status, or healthcare system characteristics, explain some of the racial and ethnic variation in care-seeking preferences. Overall, we show that even after comprehensively accounting for factors known to influence disparities in utilization, elderly racial and ethnic minorities express greater desire to seek care than whites.

We suggest that future research examine social factors such as unmeasured wealth differences, cultural frameworks, and role identities in healthcare interactions in order to understand differences in care-seeking and, importantly, the relationship between care-seeking and disparities in utilization.

This study represents a systematic analysis of the ways individual, social, and structural context may account for racial and ethnic differences in seeking medical care. We build on healthcare seeking literature by including more comprehensive measures of social relationships, healthcare and system-level characteristics, and exploring a wide variety of health beliefs and expectations. Further, our study investigates care seeking among multiple understudied racial and ethnic groups. We find that racial and ethnic minorities are more likely to say they would seek healthcare than whites, suggesting that guidelines promoting the elicitation and understanding of patient preferences in the context of the clinical interaction is an important step toward reducing utilization disparities. These findings also underscore the notion that health policy should go further to address the broader social factors relating to care-seeking in the first place.

This paper is an account of the discussions and recommendations by the exper t advisory panel on potential metrics and ‘sentinel indicators’ for improved outcomes in housing and mental health, as par t of an inter‐agency seminar called to advise on the development of metrics and measures for community mental health, for Fair Society, Healthy Lives: The Marmot Review (Marmot, 2010). The seminar covered all aspects of mental health in both its broadest and narrower senses.Much of the background material for these discussions, therefore, cuts across familiar knowledge silos between the fields of health and housing. Where it is necessary to elucidate the text, references are included to relevant research and policy frameworks that may be unfamiliar to the general reader. This paper is not, however, intended as a general literature review nor is it an evaluation of the available research. A paper on this subject will feature in a future issue of the Journal.1The conclusions from the panel discussion are presented in four main areas, reflecting the need to specify metrics across the wide‐ranging interface between housing and mental health, while still keeping the task manageable. Five current or potential health service metrics were proposed as having par ticular value as signal indicators. Two of these (relating to primary care prevention and public health) have no precision as yet, par tly as new services and approaches are still evolving. Among existing health datasets, the Mental Health Minimum Dataset (MHMDS) (NHS Information Centre, 2009a), SITuation REPor ts (SITREPS) (Department of Health, 2003), and the Summary Care Record data were singled out, though each is thought to need more work to improve the current data categories as well as data collection.One rather more fundamental point made was that the identifying, assessing and encouraging of effective inter‐sector par tnership work will be the key to tackling health inequalities. The use of other, non‐health services data therefore holds great potential for a better recognition both of needs and of outcomes in successful par tnership work, especially where this can be interpreted at local level. These wider comments are elaborated in the context of housing, but may be applicable to all effor ts to evidence and work with the social determinants and the social outcomes of mental health. For the future, a combination of well‐crafted nationally sanctioned metrics and the ‘soft intelligence’ of locally identified meaning may be most effective.Subsequent developments confirm the potential in cross‐sector development work, and indicate the potential for fur ther collaboration via the local performance framework. As policy frameworks continue to evolve rapidly, the ar ticle ends with a Codex, updating the relevant policy frameworks context since the seminar (in Spring 2009) and especially in the context of a new coalition government with aspirations to ar ticulate and promote public health in the context of the local performance framework and the ‘new localism’ agenda. This final section and comments therein are therefore entirely the responsibility of the author.

This study evaluates whether sociodemographic characteristics, political affiliation, family-related circumstances, self-reported health status, and access to health insurance affect public opinion toward the current US health-care system. Opinions about the health-care system were measured in terms of consumer confidence and perceived need for health-care reform. Data come from the 2008 Cooperative Congressional Election Study (CCES), a nationwide survey of 1,000 respondents. All data were collected in November 2008, thus providing a useful alternative to volatile polling data because they were collected prior to and are thus immune to the polarized tone of the debates that have occurred over the past few years. Overall, we found that public confidence in medical technology and quality of care were consistently high, while confidence in the affordability of medical care was much lower among respondents. Younger adults, those with poor health, and those without health insurance had particularly low confidence in their ability to pay for health care. Although a strong majority of the population agreed that the US health-care system was in need of major reform, support for particular types of government-sponsored health insurance programs was primarily determined by political affiliation. In an era where a large proportion of the population has little access to health care (due to lack of insurance) and where the US government is facing tremendous opposition to the implementation of major reform efforts, it is useful to understand which subgroups of the population are most confident in the current health-care system and most likely to support reform efforts, as well as those who are most resistant to change given their precarious health needs, their inability to access health care (as a result of insurance or noninsurance), or their political affiliation.

The purpose of this paper is to evaluate the effectiveness of a targeted outreach program that referred World Trade Center Health Registry (Registry) enrollees, to specific post-disaster health care available through the World Trade Center Health Program (WTCHP) and evaluate differences in outreach effectiveness based on demographic and health characteristics.

The Registry’s Treatment Referral Program (TRP) targeted 22,981 enrollees based on symptoms and conditions known to be related to 9/11, reported on a 2011-2012 follow-up survey. A call vendor was utilized for the initial outreach phone call. Enrollees who requested a WTCHP application had follow-up from TRP staff, which typically included 4-6 interactions per enrollee until outreach was completed.

As of 12/31/2015, the vendor had reached 8,778 (38 percent) of the targeted sample. TRP staff spoke to 6,016 (68 percent) enrollees reached by the vendor, 5,554 (92 percent) of whom requested a WTCHP application, and 2,425 (43 percent) reported having submitted the WTCHP application. Application requests and submissions differed by survivor or responder status, race, income and health symptoms.

Registries created for surveillance and research among disaster-exposed populations provide a unique and effective outreach approach. A dedicated treatment referral unit within a disaster registry is an effective means for conducting post-disaster outreach to a large, diverse sample of exposed individuals.