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Maximiano-Barreto MA, Leal LR, Pessoa RMDP, Bomfim AJDL, Morais DD, Luchesi BM, Chagas MHN. Factors associated with happiness among community-dwelling older adults: a systematic review. Geriatr Nurs 2024; 56:124-137. [PMID: 38340433 DOI: 10.1016/j.gerinurse.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/12/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To identify factors associated with self-reported happiness among community-dwelling older adults. METHODS A systematic review of the literature was conducted. Searches were conducted in the PsycInfo, Web of Science, Scopus and Pubmed databases for relevant articles published in English, Spanish or Portuguese using the following search strategy and Boolean operators: (happiness*) AND (elder* OR (old adult*)). No restriction was imposed with regards to year of publication. This review was registered in PROSPERO (CRD42018107302). RESULTS Forty-six articles met the eligibility criteria and were included in the review. Economic, social and health-related factors were associated with happiness among community-dwelling older adults. The sociodemographic characteristics of older adults, such as the female sex, being married, an older age, a higher level of schooling and having a religion, were also associated with happiness. CONCLUSIONS The articles included in the present systematic review demonstrate that social, economic and health-related aspects have an association with happiness in community-dwelling older adults.
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Affiliation(s)
| | - Lívio Rodrigues Leal
- Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Rebeca Mendes de Paula Pessoa
- Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil; Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ana Julia de Lima Bomfim
- Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil; Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Daiene de Morais
- Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Bruna Moretti Luchesi
- Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil; Três Lagoas Campus, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil
| | - Marcos Hortes Nisihara Chagas
- Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil; Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, SP, Brazil
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Zamani N, Izadi-Avanji FS, Safa A, Azizi-Fini I, Mohammadnejad E. Aesthetics of everyday life and its related factors among older adults in Kashan (2021-2022). BMC Geriatr 2023; 23:764. [PMID: 37993782 PMCID: PMC10666309 DOI: 10.1186/s12877-023-04412-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 10/16/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Aesthetics of everyday life are associated with the physical, mental, and social health of older adults, leading them to experience a successful old age. This study aimed to examine the aesthetics of everyday life and its related factors among older adults in Kashan from 2021 to 2022. METHODS This cross-sectional study consisted of 350 older adults who were referred to Urban Comprehensive Health Service Centers (UCHSC) in Kashan. Sampling was done by a two-stage method (cluster, random). The data collection was performed with a background information questionnaire and the Elderly's Perception of Everyday Aesthetics scale (EPEA-S). Data were analyzed using an independent t-test, analysis of variance, Pearson's correlation coefficient, and multiple linear regression tests in the SPSS software. RESULTS The mean age of the participants was 69.56 ± 6.63 years. The mean score of aesthetics of everyday life in older adults was 133.02 ± 14.73, with the family and others subscale receiving the highest score. The univariate test indicated a statistically significant correlation between age, employment status, education, income, smoking, social activities, physical activities, interest in artistic works, and the aesthetics of everyday life in older adults (P < 0.01). Multivariate linear analysis showed that age, employment status, smoking, income, social activities, physical activities, and interest in artistic works predicted and explained 28% of the variance of life aesthetics in older adults (R2 = 0.28). CONCLUSIONS The aesthetics of everyday life of the Iranian older adults were in a good range. Healthcare providers and families of older adults can use this concept to enhance the elderly's physical, mental, and social health.
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Affiliation(s)
- Nafise Zamani
- Department of Adults and Geriatric Nursing, School of Nursing, Kashan University of Medical Sciences, Kashan, IR, Iran
| | - Fatemeh Sadat Izadi-Avanji
- Department of Adults and Geriatric Nursing, Trauma Nursing Research Center, School of Nursing, Kashan University of Medical Sciences, Kashan, Iran.
| | - Azade Safa
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Ismail Azizi-Fini
- Department of Intensive care and Emergency Nursing, School of Nursing, Kashan University of Medical Sciences, Kashan, Iran
| | - Esmaeil Mohammadnejad
- Department of Medical-Surgical Nursing and Basic Sciences, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Darboe A, Hawthorne L, Scott A, McGrail M. Exploring life satisfaction difference between domestic and international medical graduates: Evidence from a national longitudinal study. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2130641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Amadou Darboe
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Lesleyanne Hawthorne
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Anthony Scott
- Melbourne Institute, Applied Economic and Social Research, The University of Melbourne, Melbourne, Australia
| | - Matthew McGrail
- Rural Clinical School, University of Queensland, Queensland, Australia
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Roles of Indulgence versus Restraint Culture and Ability to Savor the Moment in the Link between Income and Subjective Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19126995. [PMID: 35742244 PMCID: PMC9223203 DOI: 10.3390/ijerph19126995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 11/17/2022]
Abstract
Over the past few decades, various academic fields have reported contradictory findings regarding whether income is positively or negatively associated with subjective well-being (SWB). To reconcile the inconclusive observations, researchers tend to use various mediators and moderators that could explain why income is more strongly associated with SWB for certain groups of people and why income could be negatively associated with SWB for other groups. This study endeavored to first test additional mediation roles of financial satisfaction and a sense of control in the link between income and three related yet distinct measures of SWB: life satisfaction, happiness, and emotional well-being (EWB), at both cross-national and individual levels. We further investigated the direct and moderating impacts of national difference in Indulgence versus Restraint (IVR) cultural orientations over two mediating mechanisms (income → financial satisfaction → SWB; income → a sense of control → SWB) using data from 49,097 participants in the 2017–2020 World Values Survey. Additionally, we conducted a moderated mediation analysis of individual difference in ability to savor the moment (ASM) for these two mediating mechanisms based on surveys with 796 respondents from China. Analyses at both national level and individual level confirmed the partial mediating roles of financial satisfaction and a sense of control. We further find a positive, direct impact of IVR on SWB such that people in more indulgence cultures report a higher SWB than those in more restraint cultures. The mediating effects of financial satisfaction were found to be weaker in more indulgence cultures than in more restraint ones, while the mediating effects of a sense of control remain the same. Finally, we find that individuals’ ASM does not only directly lead to a higher SWB, but also amplifies the mediation impact of financial satisfaction in the link between income and life satisfaction and in the link between income and EWB. Implications of these findings are offered for public policy makers, employers, and citizens, as well as researchers from different fields.
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Kudrna L, Kushlev K. Money Does Not Always Buy Happiness, but Are Richer People Less Happy in Their Daily Lives? It Depends on How You Analyze Income. Front Psychol 2022; 13:883137. [PMID: 35719460 PMCID: PMC9199446 DOI: 10.3389/fpsyg.2022.883137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/08/2022] [Indexed: 11/18/2022] Open
Abstract
Do people who have more money feel happier during their daily activities? Some prior research has found no relationship between income and daily happiness when treating income as a continuous variable in OLS regressions, although results differ between studies. We re-analyzed existing data from the United States and Germany, treating household income as a categorical variable and using lowess and spline regressions to explore nonlinearities. Our analyses reveal that these methodological decisions change the results and conclusions about the relationship between income and happiness. In American and German diary data from 2010 to 2015, results for the continuous treatment of income showed a null relationship with happiness, whereas the categorization of income showed that some of those with higher incomes reported feeling less happy than some of those with lower incomes. Lowess and spline regressions suggested null results overall, and there was no evidence of a relationship between income and happiness in Experience Sampling Methodology (ESM) data. Not all analytic approaches generate the same results, which may contribute to explaining discrepant results in existing studies about the correlates of happiness. Future research should be explicit about their approaches to measuring and analyzing income when studying its relationship with subjective well-being, ideally testing different approaches, and making conclusions based on the pattern of results across approaches.
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Affiliation(s)
- Laura Kudrna
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- *Correspondence: Laura Kudrna,
| | - Kostadin Kushlev
- Department of Psychology, Georgetown University, Washington, DC, United States
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Sasaki Y, Shobugawa Y, Nozaki I, Takagi D, Nagamine Y, Funato M, Chihara Y, Shirakura Y, Lwin KT, Zin PE, Bo TZ, Sone T, Win HH. Association between Happiness and Economic Status among Older Adults in Two Myanmar Regions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3216. [PMID: 35328904 PMCID: PMC8951419 DOI: 10.3390/ijerph19063216] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 12/04/2022]
Abstract
Few studies have examined whether objective or subjective economic status (ES) has a greater association with the happiness of older adults, despite concerns regarding the growing economic cost of morbidity and their functional dependence in developing countries with aging populations. Thus, this study examined whether objective/subjective ES was associated with happiness in older adults in two Myanmar regions. A multistage random sampling procedure and face-to-face interviews were conducted in the urban and rural areas of Myanmar. The happiness of 1200 participants aged >60 years was evaluated using a single happiness score ranging from 0 (very unhappy) to 10 (very happy). The wealth index, used as an objective ES, was calculated from 17 household asset items, such as radio, washing machines, and television. Subjective ES was assessed by asking “Which of the following best describes your current financial situation in light of general economic conditions?” Responses ranged from “very difficult” to “very comfortable”. Both low objective and subjective ES were negatively associated with happiness, after adjusting for confounding variables and stratification by region (urban and rural areas). Although objective and subjective ES had similar associations with happiness in urban areas, subjective ES had a stronger association in rural areas.
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Affiliation(s)
- Yuri Sasaki
- Department of International Health and Collaboration, National Institute of Public Health, Wako City 351-0197, Japan
| | - Yugo Shobugawa
- Graduate School of Medical and Dental Sciences, Niigata University, Niigata City 951-8510, Japan; (Y.S.); (Y.C.); (Y.S.)
| | - Ikuma Nozaki
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan;
| | - Daisuke Takagi
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan;
| | - Yuiko Nagamine
- Department of Family Medicine, Tokyo Medical and Dental University, Tokyo 113-8510, Japan;
| | - Masafumi Funato
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
| | - Yuki Chihara
- Graduate School of Medical and Dental Sciences, Niigata University, Niigata City 951-8510, Japan; (Y.S.); (Y.C.); (Y.S.)
| | - Yuki Shirakura
- Graduate School of Medical and Dental Sciences, Niigata University, Niigata City 951-8510, Japan; (Y.S.); (Y.C.); (Y.S.)
| | - Kay Thi Lwin
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon 245, Myanmar; (K.T.L.); (P.E.Z.); (T.Z.B.); (H.H.W.)
| | - Poe Ei Zin
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon 245, Myanmar; (K.T.L.); (P.E.Z.); (T.Z.B.); (H.H.W.)
| | - Thae Zarchi Bo
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon 245, Myanmar; (K.T.L.); (P.E.Z.); (T.Z.B.); (H.H.W.)
| | - Tomofumi Sone
- National Institute of Public Health, Wako City 351-0197, Japan;
| | - Hla Hla Win
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon 245, Myanmar; (K.T.L.); (P.E.Z.); (T.Z.B.); (H.H.W.)
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Camargos MGD, Paiva BSR, Oliveira MAD, Almeida CSLD, Giacomoni CH, Paiva CE. Predictors of happiness and satisfaction with life in individuals from the Brazilian general population who use social networks: a cross-sectional study. CAD SAUDE PUBLICA 2021; 37:e00164020. [PMID: 34909930 DOI: 10.1590/0102-311x00164020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 03/04/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to identify possible conditions associated with the perception of happiness and satisfaction with life in a sample of the Brazilian population who use social networks. This was a cross-sectional study with participants recruited online in five regions of Brazil via Facebook and WhatsApp. Data were collected from October 2015 to October 2016. The instruments used were the Pemberton Happiness Index, the Satisfaction with Life Scale, and a questionnaire regarding sociodemographic and clinical characteristics and issues potentially associated with the feeling of happiness. In total, 2,151 participants were included. A total of five variables exerted the greatest influence on higher levels of happiness and satisfaction with life in the multiple linear regression model, in the multiple logistic regression analysis, and in the decision tree model. Being satisfied with financial circumstances, having a positive self-evaluation of health, having frequent family gatherings, engaging in physical activity ≥ 3 times a week, and having no previous psychological/psychiatric diagnosis are variables that "seem" to positively influence Brazilians' perception of happiness and satisfaction with life. We identified some predictors of happiness and satisfaction with life, which were mainly related to the social activities and personal satisfaction of the participating individuals. Encouraging people to seek strategies for increasing levels of happiness and life satisfaction based on modifiable variables, such as those found, can be helpful in this context.
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Affiliation(s)
- Mayara Goulart de Camargos
- Hospital de Clínicas da Universidade Federal do Triângulo Mineiro, Uberaba, Brasil.,Hospital de Câncer de Barretos, Barretos, Brasil
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Deji-Abiodun O, Ferrandiz-Mont D, Mishra V, Chiao C. A multilevel analysis of the social determinants associated with symptoms of acute respiratory infection among preschool age children in Pakistan: A population-based survey. PLoS One 2021; 16:e0260658. [PMID: 34914709 PMCID: PMC8675759 DOI: 10.1371/journal.pone.0260658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/12/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND As advocated by WHO in "Closing the Health Gap in a Generation", dramatic differences in child health are closely linked to degrees of social disadvantage, both within and between communities. Nevertheless, research has not examined whether child health inequalities include, but are not confined to, worse acute respiratory infection (ARI) symptoms among the socioeconomic disadvantaged in Pakistan. In addition to such disadvantages as the child's gender, maternal education, and household poverty, the present study also examined the linkages between the community environment and ARI symptoms among Pakistan children under five. Furthermore, we have assessed gender contingencies related to the aforementioned associations. METHODS Using data from the nationally representative 2017-2018 Pakistan Demographic and Health Survey, a total of 11,908 surviving preschool age children (0-59 months old) living in 561 communities were analyzed. We employed two-level multilevel logistic regressions to model the relationship between ARI symptoms and individual-level and community-level social factors. RESULTS The social factors at individual and community levels were found to be significantly associated with an increased risk of the child suffering from ARI symptoms. A particularly higher risk was observed among girls who resided in urban areas (AOR = 1.42; p<0.01) and who had a birth order of three or greater. DISCUSSIONS Our results underscore the need for socioeconomic interventions in Pakistan that are targeted at densely populated households and communities within urban areas, with a particular emphasis on out-migration, in order to improve unequal economic underdevelopment. This could be done by targeting improvements in socio-economic structures, including maternal education.
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Affiliation(s)
- Oluwafunmilade Deji-Abiodun
- Department of Medicine and Center for Global Health, University of Chicago, Chicago, IL, United States of America
| | - David Ferrandiz-Mont
- Public Health Surveillance and Emergency Response Department of Vallès Occidental and Vallès Oriental, Public Health Agency of Catalonia, Sant Cugat del Vallès, Barcelona, Spain
| | - Vinod Mishra
- United Nations Population Division, New York City, NY, United States of America
| | - Chi Chiao
- Institute of Health and Welfare Policy, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Inequity of healthcare access and use and catastrophic health spending in slum communities: a retrospective, cross-sectional survey in four countries. BMJ Glob Health 2021; 6:bmjgh-2021-007265. [PMID: 34844998 PMCID: PMC8633995 DOI: 10.1136/bmjgh-2021-007265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/23/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Tracking the progress of universal health coverage (UHC) is typically at a country level. However, country-averages may mask significant small-scale variation in indicators of access and use, which would have important implications for policy choice to achieve UHC. Methods We conducted a retrospective cross-sectional household and individual-level survey in seven slum sites across Nigeria, Kenya, Bangladesh and Pakistan. We estimated the adjusted association between household capacity to pay and report healthcare need, use and spending. Catastrophic health expenditure was estimated by five different methods. Results We surveyed 7002 households and 6856 adults. Gini coefficients were wide, ranging from 0.32 to 0.48 across the seven sites. The total spend of the top 10% of households was 4–47 times more per month than the bottom 10%. Households with the highest budgets were: more likely to report needing care (highest vs lowest third of distribution of budgets: +1 to +31 percentage points (pp) across sites), to spend more on healthcare (2.0 to 6.4 times higher), have more inpatient and outpatient visits per year in five sites (1.0 to 3.0 times more frequently), spend more on drugs per visit (1.1 to 2.2 times higher) and were more likely to consult with a doctor (1.0 to 2.4 times higher odds). Better-off households were generally more likely to experience catastrophic health expenditure when calculated according to four methods (−1 to +12 pp), but much less likely using a normative method (−60 to −80 pp). Conclusions Slums have a very high degree of inequality of household budget that translates into inequities in the access to and use of healthcare. Evaluation of UHC and healthcare access interventions targeting these areas should consider distributional effects, although the standard measures may be unreliable.
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Traumatic impact of the COVID-19 pandemic in an international sample: Contribution of fatalism to psychological distress and behavior change. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2021. [PMID: 37521947 PMCID: PMC9767364 DOI: 10.1016/j.ejtd.2021.100219] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to assess the traumatic impact of the COVID-19 outbreak and to explore the contribution of fatalism to a) psychological distress and b) pandemic-related behavior change. Data for the study were collected via an anonymous online survey. The survey included questions about demographic characteristics, health status, pandemic-related stress, impact of COVID-19 on health and behavior, posttraumatic stress symptoms (PTSS), and fatalism. The sample included 465 participants from 30 countries (mean age = 36.87, SD = 13.39, age range = 18 - 76; 80% female). While none of the study participants have been diagnosed with COVID-19, almost 25% knew someone who had received the diagnosis. The overwhelming majority (79%) had to make changes to their daily routine, and 48.82% of the sample reported moderate to severe PTSS. Fatalism was found to be a statistically significant predictor of PTSS in a multiple regression model and was also associated with lack of behavior changes in response to the pandemic. Our findings indicate that the COVID-19 pandemic is a traumatic event with a potential to affect mental health and well-being of individuals and communities. Fatalism may contribute to severity of psychological distress and diminish individuals' ability to engage in health-protective behaviors.
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Beogo I, Darboe A, Adesanya OA, Rojas BM. Choosing between nurse-led and medical doctor-led from private for-profit versus non-for-profit health facilities: A household survey in urban Burkina Faso. PLoS One 2018; 13:e0200233. [PMID: 30044796 PMCID: PMC6059411 DOI: 10.1371/journal.pone.0200233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Accepted: 06/22/2018] [Indexed: 11/29/2022] Open
Abstract
Background Providers’ qualification (Medical doctor [MD] or nurse); type of care facility ownership (for-profit [FP] or not-for-profit [NFP]) may all influence individuals’ healthcare-seeking behavior and therefore merits empirical assessment to provide valuable evidence-informed policy orientation in the present context of private health system development. Previous studies have not examined these factors in combination, especially within the urban context of sub-Sahara Africa, where the private sector is rapidly growing. This study aims to explore factors associated with urban residents’ preferences between private MD-led and private nurse-led outpatient care and how these factors vary by type of private health facility ownership (FP and NFP) and levels of disease severity (severe and non-severe cases). Methods A cross-sectional household survey was conducted in July-November 2011 on a random final sample of 2064 adults (646 households). We used a face-to-face interview to capture participants’ choice of provider and their associated factors. A multivariable logistic regression was applied. Results For severe conditions, participants, almost equally sought FP and NFP facilities, only 36.4% preferred nurses compared to MDs, while for non-severe cases 53.2% preferred FP facilities and only 29.2% patronized nurses. For non-severe conditions, university educated were more likely to use MDs-led FP compared to nurse-led FP facilities (Odds Ratio [OR] = 4.66, 95% confidence interval [CI] = 2.62–8.30) and MD-led FP over MD-led NFP facilities (OR = 1.03, 95%CI = 1.01–1.04), for severe health conditions. Having insurance predicted MD-led FP preference over nurse-led FP. Furthermore, insurance predicted the preference for MD-led FP over MD-led NFP facilities. Employment did not distinguish participants’ choice of provider. Conclusion The findings suggest that, at different levels, MDs and nurses from FP and NFP facilities importantly contribute to health services delivery regardless of the severity of health conditions. The results offer some valuable evidence for policy orientation in the current rising tide of the private system, including workforce development, and practitioners' role definition. We suggested that health insurance mechanism would reinforce the private health services utilization and could enhance progress towards the attainment of Sustainable Development Goals.
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Affiliation(s)
- Idrissa Beogo
- Centre de recherche en gestion des services de santé, FSA-ULaval-CHU de Québec UL–IUCPQ-UL, Pavillon Palasis-Prince, Université Laval, Québec (Qc), Canada
- École Nationale de Santé Publique, Ouagadougou, Ouagadougou, Burkina Faso
- * E-mail:
| | - Amadou Darboe
- The University of Melbourne, School of Population and Global Health, Parkville, Victoria, Australia
| | - Oluwafunmilade A. Adesanya
- Institute of Public Health, International Health Program, National Yang Ming University, Beitou District, Taipei, Taiwan
| | - Bomar Mendez Rojas
- Institute of Public Health, International Health Program, National Yang Ming University, Beitou District, Taipei, Taiwan
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