Objectives This paper aims to investigate the effects of enrollment in the Ethiopian community-based health insurance(CBHI)scheme on household preventive care activities and the timing of treatment-seeking behavior fo...Objectives This paper aims to investigate the effects of enrollment in the Ethiopian community-based health insurance(CBHI)scheme on household preventive care activities and the timing of treatment-seeking behavior for illness symptoms.There is growing concern about the financial sustainability of CBHI schemes in developing countries.However,few empirical studies have identified potential contributors,including ex-ante and ex-post moral hazards.Methods We implement a household fixed-effect panel data regression model,drawing on three rounds of household survey data collected face to face in districts where CBHI scheme is operational and in districts where it is not operational in Ethiopia.Results The findings show that enrolment in CBHI does not significantly influence household behaviour regarding preventive care activities such as water treatment before drinking and handwashing before meals.However,CBHI significantly increases delay in treatment-seeking behaviour for diseases symptoms.Particularly,on average,we estimate about 4-6 h delay for malaria symptoms,a little above 4 h for tetanus,and 10-11 h for tuberculosis among the insured households.Conclusions While there is evidence that CBHI improve the utilization of outpatient or primary care services,our study suggests that insured members may wait longer before visiting health facilities.This delay could be partly due to moral hazard problems,as insured households,particularly those from rural areas,may consider the opportunity costs associated with visiting health facilities for minor symptoms.Overall,it is essential to identify the primary causes of delays in seeking medical services and implement appropriate interventions to encourage insured individuals to seek early medical attention.展开更多
In Uganda, there is still insufficient comprehension of malaria as a lethal disease especially in rural areas despite universal bed-net distribution coverage and effective anti-malarial treatment. <strong>Aim:&l...In Uganda, there is still insufficient comprehension of malaria as a lethal disease especially in rural areas despite universal bed-net distribution coverage and effective anti-malarial treatment. <strong>Aim:</strong> To get evidence-based knowledge to establish the contribution of an individuals’ knowledge from various health communications that could increase their active involvement in health care especially seeking timely appropriate treatment for malaria or suspected malaria. <strong>Method:</strong> A cross-sectional survey using a correlational design was employed on a clustered sample of 380 rural households in 05 sub-counties of Kanungu district. Data were corrected between October 2016-January 2017 using researcher-administered questionnaires, key-informant interviews and focus group discussions. Correlation analysis was done. <strong>Result:</strong> There is a significant positive relationship between knowledge of health communications and treatment-seeking behavior (r = 0.312;<em>p</em> ≤ 0.01). <strong>Conclusion:</strong> Exposure to consistent Behavioral Change Communications messages influences treatment-seeking behaviour. Thus, in malaria-prone communities, it appears that other factors including sufficient targeted persuasive health communication are lacking in influencing personal orientations towards treatment-seeking behaviour. Therefore, proper Health Communications management supplements efforts from other disciplines and players, against malaria in Uganda.展开更多
Background: Late diagnosis of Human Immunodeficiency Virus (HIV) infection and delayed commencement of antiretroviral therapy (ART) in sub-Saharan Africa is known to contribute to high morbidity and mortality. It is t...Background: Late diagnosis of Human Immunodeficiency Virus (HIV) infection and delayed commencement of antiretroviral therapy (ART) in sub-Saharan Africa is known to contribute to high morbidity and mortality. It is therefore, prudent to develop innovative approaches to ensure early HIV diagnosis because patients with low immunity will usually develop opportunistic infections and seek some remedial action. A treatment and health care seeking behavior survey was carried out in semi-urban communities in Malaba and Busia in Kenya and Uganda to evaluate the treatment and healthcare seeking behavior among patients visiting randomly selected drugstores. Methodology: Random sampling was applied and questionnaires were used to collect information from 165 interviewees who visited drugstores seeking health information, treatment and other health related services. Results: The results indicated that among this group of people, 67% visited drugstores before any other health facility. 72.2% sought treatment for various illnesses and services ranging from headaches, body fever, gastro-intestinal disturbances, family planning pills, sexually transmitted infections and chronic medications. Among the patients interviewed, there were a number of factors that affected treatment choice. These included the distance to the facility as well as the absence of a consultation fee or fee for service. Conclusion: With proper support, drugstores can play a major role in the implementation of health interventions that seek to promote early diagnosis and treatment as well as play a pivotal role in educating the population on disease prevention and management. In Sub-Saharan Africa, drugstores can play a major role in HIV and AIDS interventions where most patients seek medical intervention for opportunistic infection.展开更多
基金The authors acknowledge the financial support of the Dutch Research Council(NWO-WOTRO)(Grant No.W07.45.103.00)and the support of D.P.Hoijer Fonds,Erasmus Trustfonds,Erasmus University Rotterdam.
文摘Objectives This paper aims to investigate the effects of enrollment in the Ethiopian community-based health insurance(CBHI)scheme on household preventive care activities and the timing of treatment-seeking behavior for illness symptoms.There is growing concern about the financial sustainability of CBHI schemes in developing countries.However,few empirical studies have identified potential contributors,including ex-ante and ex-post moral hazards.Methods We implement a household fixed-effect panel data regression model,drawing on three rounds of household survey data collected face to face in districts where CBHI scheme is operational and in districts where it is not operational in Ethiopia.Results The findings show that enrolment in CBHI does not significantly influence household behaviour regarding preventive care activities such as water treatment before drinking and handwashing before meals.However,CBHI significantly increases delay in treatment-seeking behaviour for diseases symptoms.Particularly,on average,we estimate about 4-6 h delay for malaria symptoms,a little above 4 h for tetanus,and 10-11 h for tuberculosis among the insured households.Conclusions While there is evidence that CBHI improve the utilization of outpatient or primary care services,our study suggests that insured members may wait longer before visiting health facilities.This delay could be partly due to moral hazard problems,as insured households,particularly those from rural areas,may consider the opportunity costs associated with visiting health facilities for minor symptoms.Overall,it is essential to identify the primary causes of delays in seeking medical services and implement appropriate interventions to encourage insured individuals to seek early medical attention.
文摘In Uganda, there is still insufficient comprehension of malaria as a lethal disease especially in rural areas despite universal bed-net distribution coverage and effective anti-malarial treatment. <strong>Aim:</strong> To get evidence-based knowledge to establish the contribution of an individuals’ knowledge from various health communications that could increase their active involvement in health care especially seeking timely appropriate treatment for malaria or suspected malaria. <strong>Method:</strong> A cross-sectional survey using a correlational design was employed on a clustered sample of 380 rural households in 05 sub-counties of Kanungu district. Data were corrected between October 2016-January 2017 using researcher-administered questionnaires, key-informant interviews and focus group discussions. Correlation analysis was done. <strong>Result:</strong> There is a significant positive relationship between knowledge of health communications and treatment-seeking behavior (r = 0.312;<em>p</em> ≤ 0.01). <strong>Conclusion:</strong> Exposure to consistent Behavioral Change Communications messages influences treatment-seeking behaviour. Thus, in malaria-prone communities, it appears that other factors including sufficient targeted persuasive health communication are lacking in influencing personal orientations towards treatment-seeking behaviour. Therefore, proper Health Communications management supplements efforts from other disciplines and players, against malaria in Uganda.
文摘Background: Late diagnosis of Human Immunodeficiency Virus (HIV) infection and delayed commencement of antiretroviral therapy (ART) in sub-Saharan Africa is known to contribute to high morbidity and mortality. It is therefore, prudent to develop innovative approaches to ensure early HIV diagnosis because patients with low immunity will usually develop opportunistic infections and seek some remedial action. A treatment and health care seeking behavior survey was carried out in semi-urban communities in Malaba and Busia in Kenya and Uganda to evaluate the treatment and healthcare seeking behavior among patients visiting randomly selected drugstores. Methodology: Random sampling was applied and questionnaires were used to collect information from 165 interviewees who visited drugstores seeking health information, treatment and other health related services. Results: The results indicated that among this group of people, 67% visited drugstores before any other health facility. 72.2% sought treatment for various illnesses and services ranging from headaches, body fever, gastro-intestinal disturbances, family planning pills, sexually transmitted infections and chronic medications. Among the patients interviewed, there were a number of factors that affected treatment choice. These included the distance to the facility as well as the absence of a consultation fee or fee for service. Conclusion: With proper support, drugstores can play a major role in the implementation of health interventions that seek to promote early diagnosis and treatment as well as play a pivotal role in educating the population on disease prevention and management. In Sub-Saharan Africa, drugstores can play a major role in HIV and AIDS interventions where most patients seek medical intervention for opportunistic infection.
