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Estrada JAG. Unraveling socioeconomic determinants of health-related behavior, reception of information, and perceptions on disease disclosure at the time of the COVID-19 pandemic: did health insurance curb the disparities in the Philippines? BMC Public Health 2024; 24:767. [PMID: 38475807 DOI: 10.1186/s12889-024-18264-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 03/03/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The study uncovers micro and macro socioeconomic disparities in terms of health behavior, disease perception, and reception of information. Furthermore, findings shed light on the possible role of health insurance on access to information, disease perception and the adoption of preventive behaviors in the context of a public health emergency such as the COVID-19 pandemic. METHODS This study employed a cross-sectional design using the Philippine Demographic and Health Survey (DHS). With a total of 29,809 respondents, it evaluated the individual or household and systemwide socioeconomic determinants of four different outcomes: receipt of information, disease perception, uptake of free preventive services, and treatment-seeking behavior. In addition to logistic regression models with the socioeconomic variables as the independent variables, models for the evaluation of the moderating effect of insurance ownership were fitted. Predicted probabilities were reported for the analysis of moderating effects. RESULTS Findings show that individual and householdsocioeconomic determinants affected health-behavior and access to or receipt of information pertinent to the COVID-19 pandemic. Both education and wealth affected the receipt of information such that individuals in more advantaged socioeconomic positions were at least 30% more likely to have received information on COVID-19. Wealth was also associated to treatment-seeking behavior. Regional differences were seen across all dependent variables. Moreover, the study provides evidence that ownership of insurance can close education-based gaps in the uptake of free vaccination and COVID-19 testing. CONCLUSION It is imperative that targeted efforts be maximized by utilizing existing strategies and mechanisms to reach the marginalized and disadvantaged segments of the population. Health insurance may give off added benefits that increase proficiency in navigating through the healthcare system. Further research may focus on examining pathways by which health insurance or social policies may be used to leverage responses to public health or environmental emergencies.
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Brumwell AN, Babatunde GB, Wilson MW, le Roux K, Marks MM, Adam JK, Ivanova E, Batheja D, Goel S, Shilton S, Martínez-Pérez GZ. Values of COVID-19 Self-Testing among Urban and Rural South Africans: A Cross-Sectional Survey. Prev Med Rep 2023; 32:102114. [PMID: 36686721 PMCID: PMC9847323 DOI: 10.1016/j.pmedr.2023.102114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 01/19/2023] Open
Abstract
Self-testing for COVID-19 may be a preferable strategy for identifying SARS-CoV-2 infection among populations in low- and middle-income settings. To determine South Africans' values related to COVID-19 self-testing should it become widely available, a cross-sectional survey was administered in Durban, KwaZulu-Natal Province and the King Sabata Dalindyebo sub-district of the Eastern Cape. A 35-question survey was administered to 531 participants (268 female) in one urban and one rural setting of South Africa. Survey participants were randomly selected by household in the rural setting, while in the urban setting participants were approached in randomly selected public places. The survey assessed participants' likelihood of using and willingness to pay for a COVID-19 self-test and actions they would take following a COVID-19 self-test. The results were analysed using descriptive statistics and bivariate and multivariate regression. Overall, 93.03% of participants supported COVID-19 self-testing, 61.62% of participants were willing to pay for self-testing, and 90.15% indicated they would communicate their results if they tested positive. Rural participants were more positively associated with each of these outcomes compared with urban-based participants. Should they test positive, most participants said they would: go in-person to a health facility for counselling (76.45%), self-isolate (95.85%), notify close contacts (97.74%), and inform their employer (95.14%). COVID-19 self-testing was a preferable option for most participants, although this varied with setting and demographic characteristics. Self-testing may overcome barriers to care for South Africans, but to achieve this, policies for self-testing and delivery methods must not exacerbate individuals' underlying economic vulnerabilities.
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Affiliation(s)
- Amanda N. Brumwell
- Advance Access & Delivery South Africa (AA&D SA), Durban, South Africa
- Corresponding author.
| | | | - Michael W. Wilson
- Advance Access & Delivery South Africa (AA&D SA), Durban, South Africa
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Karl le Roux
- Zithulele Hospital, Zithulele, Mqanduli, South Africa
| | | | | | - Elena Ivanova
- FIND, the global alliance for diagnostics, Geneva, Switzerland
| | | | - Srishti Goel
- Centre for Disease Dynamics, Economics and Policy, India
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Misconceptions About COVID-19 and Associated Factors Among Residents of Dilla Town, Southern Ethiopia. Disaster Med Public Health Prep 2022; 17:e273. [PMID: 36229979 DOI: 10.1017/dmp.2022.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Despite the implementation of various coronavirus disease 2019 (COVID-19) prevention and control strategies, the rate of COVID-19 is alarmingly increasing in Ethiopia as well as worldwide. The success of COVID-19 prevention measures is highly influenced by a lack of knowledge and misconceptions. This study aimed to assess misconceptions about COVID-19 and associated factors among residents of Dilla Town, southern Ethiopia. METHODS A community-based cross-sectional study was conducted from December 1 to 30, 2020. Data were collected from 415 individuals using structured interviewer-based questionnaires. Logistic regression analyses were used to identify the relationship between the dependent and independent variables. RESULTS The proportion of respondents who have a high misconception about COVID-19 was 41.1%. Study participants who had poor knowledge were 2.1 (95% confidence interval [CI]: 1.1-3.8) times more likely to have a misconception about COVID-19 than their counterparts. Respondents who had access to information from more than 2 sources were 3.29 (with 95% CI: 1.2-9.2) times less likely to have a misconception about COVID-19 when compared with those who had access to 2 or fewer information sources. CONCLUSIONS A significant proportion of people have misconceptions about COVID-19 in the study area. To resolve these misconceptions, health sectors and stakeholders need to improve the residents' knowledge by delivering COVID-19-related information from credible sources on a routine basis.
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Adachi M, Murakami M, Yoneoka D, Kawashima T, Hashizume M, Sakamoto H, Eguchi A, Ghaznavi C, Gilmour S, Kaneko S, Kunishima H, Maruyama-Sakurai K, Tanoue Y, Yamamoto Y, Miyata H, Nomura S. Factors associated with the risk perception of COVID-19 infection and severe illness: A cross-sectional study in Japan. SSM Popul Health 2022; 18:101105. [PMID: 35493404 PMCID: PMC9040447 DOI: 10.1016/j.ssmph.2022.101105] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 12/12/2022] Open
Abstract
Understanding COVID-19 risk perception may help inform public health messaging aimed at encouraging preventive measures and improving countermeasures against the pandemic. We conducted an online survey of 29,708 Japanese adults in February 2021 and estimated the associations between COVID-19 risk perception and a broad array of individual factors. Two logistic regressions were constructed to estimate factors associated with the risk perception of COVID-19 (defined as responding that one might become infected within the next 6 months), and of severe illness among those who responded that they might become infected (defined as responding that one would become severely ill). After adjusting for covariates, those with a higher perceived risk of the COVID-19 vaccine had higher odds of risk perception for both infection and severe illness. Interestingly, those with higher odds of risk perception of being infected were more likely to report obtaining their information from healthcare workers whereas those with lower odds were more likely to report obtaining their information from the Internet or the government; those with lower odds of risk perception of being severely ill were more likely to report obtaining their information from the Internet. The higher the trust level in the government as a COVID-19 information source, the lower the odds of both risk perception of being infected and becoming severely ill. The higher the trust levels in social networking services as a COVID-19 information source, the higher the odds of risk perception of becoming severely ill. Public health messaging should address the factors identified in our study.
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Affiliation(s)
- Megumi Adachi
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Michio Murakami
- Division of Scientific Information and Public Policy, Center for Infectious Disease Education and Research, Osaka University, Osaka, Japan
| | - Daisuke Yoneoka
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takayuki Kawashima
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Mathematical and Computing Science, Tokyo Institute of Technology, Tokyo, Japan
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Haruka Sakamoto
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
- Department of Hygiene and Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Akifumi Eguchi
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Cyrus Ghaznavi
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Medical Education Program, Washington University School of Medicine in St Louis, Saint Louis, USA
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Satoshi Kaneko
- Department of Ecoepidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Hiroyuki Kunishima
- Department of Infectious Diseases, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Keiko Maruyama-Sakurai
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Yuta Tanoue
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Institute for Business and Finance, Waseda University, Tokyo, Japan
| | | | - Hiroaki Miyata
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Shuhei Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
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Umar S, Chybisov A, McComb K, Nyongesa C, Mugo-Sitati C, Bosire A, Muya C, Leach CR. COVID-19 and Access to Cancer Care in Kenya: Patient Perspective. Int J Cancer 2021; 150:1497-1503. [PMID: 34927724 PMCID: PMC9303218 DOI: 10.1002/ijc.33910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/18/2021] [Accepted: 12/10/2021] [Indexed: 11/13/2022]
Abstract
COVID‐19 disruptions severely impacted access to health services for noncommunicable diseases, including cancer, but few studies have examined patient perspectives of COVID‐19‐induced barriers to care in low/middle‐income countries. Data come from a survey completed online, over the phone or in person of 284 adult people with cancer in Kenya. One‐third (36%) of participants had primary or no education and 34% had some or complete secondary education. Half of the participants (49%) were aged 40 to 59, 21% were 18 to 39 and 23% were 60 or older. Two‐thirds were female (65%) and most visited a national referral hospital in Nairobi to receive care (84%). Mean travel time to Nairobi from the respondent county of residence was 2.47 hours (±2.73). Most participants reported decreased household income (88%) and were worried about their ability to afford cancer treatment due to COVID‐19 (79%). After covariate adjustment, participants who lost access to hospitals due to COVID‐19 travel restrictions were 15 times more likely to experience a cancer care delay (OR = 14.90, 95% CI: 7.44‐29.85) compared to those with continued access to hospitals. Every additional hour of travel time to Nairobi from their county of residence resulted in a 20% increase in the odds of a cancer care delay (OR = 1.20, 95% CI: 1.06‐1.36). Transportation needs and uninterrupted access to cancer care and medicines should be accounted for in COVID‐19 mitigation strategies. These strategies include permits for cancer patients and caregivers to travel past curfew time or through block posts to receive care during lockdowns, cash assistance and involving patient navigators to improve patient communication.
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Affiliation(s)
- Shahid Umar
- Office of Research and Implementation, American Cancer Society, Inc., New York, New York, USA
| | - Andriy Chybisov
- Office of Research and Implementation, American Cancer Society, Inc., Washington, District of Columbia, USA
| | - Kristie McComb
- Office of Research and Implementation, American Cancer Society, Inc., New York, New York, USA
| | | | | | | | - Charles Muya
- Kenyan Network of Cancer Organizations, Nairobi, Kenya
| | - Corinne R Leach
- Department of Population Science, American Cancer Society, Inc., Atlanta, Georgia, USA
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