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
Urinary incontinence(UI)is a disease that quietly yet seriously impacts women's health and represents a global health burden that is often neglected.This study aims to systematically assess the prevalence and dyna...Urinary incontinence(UI)is a disease that quietly yet seriously impacts women's health and represents a global health burden that is often neglected.This study aims to systematically assess the prevalence and dynamics of female UI in China,and can inform further policies and have international implications.This study used three nationwide investigations:A national cross-sectional survey in 2021;another nationwide cross-sectional survey in 2006;and data regarding the institutions and physicians providing pelvic floor rehabilitation services from 2005 to 2019.The weighted prevalence of female UI and its subtypes,including stress UI(SUI),urgency UI(UUI),and mixed UI(MUI),were estimated as primary outcomes.Knowledge,attitude and care-seeking behaviors of UI were evaluated.It was found that the weighted prevalence of female UI was 16.0%(95%CI,13.3%–19.1%)with SUI remaining the predominant subtype(7.0%)in 2021,followed by MUI(6.5%)and UUI(1.9%).The estimated absolute number of Chinese adult women with UI was 85.8 million in 2021.52.7%(95%CI,45.9%–59.4%)of women were aware that UI was a medical condition,and only 10.1%of women with UI sought health care.After 15 years of development,there were 8400 pelvic floor rehabilitation institutions and nearly 10,000 relevant physicians in ChinaDthey were found to be associated with UI prevalence.The UI prevalence in China was significantly lower in 2021 compared to that in 2006.Despite the achievement,UI remains a public health problem,especially given China's fast aging and three-child policy.More innovations,especially those that can facilitate care seeking,are needed to address this prevalent yet treatable condition.展开更多
AIM To investigate the effects of direct to colonoscopy pathways on information seeking behaviors and anxiety among colonoscopy-na?ve patients.METHODS Colonoscopy-na?ve patients at two tertiary care hospitals complete...AIM To investigate the effects of direct to colonoscopy pathways on information seeking behaviors and anxiety among colonoscopy-na?ve patients.METHODS Colonoscopy-na?ve patients at two tertiary care hospitals completed a survey immediately prior to their scheduled outpatient procedure and before receiving sedation.Survey items included clinical pathway(direct or consult),procedure indication(cancer screening or symptom investigation),telephone and written contact from the physician endoscopist office,information sources,and pre-procedure anxiety.Participants reported pre-procedure anxiety using a 10 point scale anchored by "very relaxed"(1) and "very nervous"(10).At least three months following the procedure,patient medical records were reviewed to determine sedative dose,procedure indications and any adverse events.The primary comparison was between the direct and consult pathways.Given the very different implications,a secondary analysis considering the patient-reported indication for the procedure(symptoms or screening).Effects of pathway(direct vs consult) were compared both within and between the screening and symptom subgroups.RESULTS Of 409 patients who completed the survey,34% followed a direct pathway.Indications for colonoscopy were similar in each group.The majority of the participants were women(58%),married(61%),and internet users(81%).The most important information source was family physicians(Direct) and specialist physicians(Consult).Use of other information sources,including the internet(20% vs 18%) and Direct family and friends(64% vs 53%),was similar in the Direct and Consult groups,respectively.Only 31% of the 81% who were internet users accessed internet health information.Most sought fundamental information such as what a colonoscopy is or why it is done.Pre-procedure anxiety did not differ between care pathways.Those undergoing colonoscopy for symptoms reported greater anxiety [mean 5.3,95%CI: 5.0-5.7(10 point Likert scale)] than those for screening colonoscopy(4.3,95%CI: 3.9-4.7).CONCLUSIO展开更多
Background:Health policy formulations in India have witnessed a shift from a reactive approach to a more proactive approach over the last decade.It is therefore important to understand the effectiveness of recent nati...Background:Health policy formulations in India have witnessed a shift from a reactive approach to a more proactive approach over the last decade.It is therefore important to understand the effectiveness of recent national health policies(such as the National Rural Health Mission and the National Urban Health Mission)in addressing the varied needs of the heterogeneous population of India.Methods:We use datasets from the National Sample Surveys carried out in 2004 and 2014 to understand the change in the health seeking behavior as a result of these policies.The choice of health care facilities and the associated expenditures are compared through descriptive analyses.A multinomial logistic regression is used to identify the significant parameters which contribute towards the share of health care providers in India.The health status of two economically disparate Indian states(Bihar and Kerala)are also compared through specific metrics of performance.Results:It is seen that due to increased availability of facilities in close proximity,both rural and urban residents prefer to avail of those facilities which will result in minimization of transportation cost.The effectiveness of national health policies is found to vary on a regional scale.Literacy and health status have a strong correlation,thereby reinforcing that Bihar still lags far behind Kerala in terms of access to equitable health care.Conclusion:Therefore,a hierarchical system,incorporating medical pluralism and tailor-made policies targeted at diverse health care demands,needs to be put in place to achieve Goal 3 of the Sustainable Development Goals as decreed by the United Nations,i.e.,“health for all”.展开更多
<strong>Introduction:</strong> For seriously ill women of childbearing age, perceived health warning signs may influence decision of whether or not to seek care. Inaccurate perceptions of patients and thos...<strong>Introduction:</strong> For seriously ill women of childbearing age, perceived health warning signs may influence decision of whether or not to seek care. Inaccurate perceptions of patients and those around them may lead to attitudes that delay seeking care. This study analyzes perceptions of danger and related delays to seek care in Kinshasa. <strong>Methods:</strong> Sixty deceased women who died between March and April 2004 were taken away from two Kinshasa mortuaries. History of disease and deaths were reconstructed through medical records and semi-structured interviews of family members and leaders. The Qualitative Software Research was used to conduct a qualitative analysis. <strong>Results:</strong> Perceived health warning signs had five manifestations: Specific clinical health warning signs, aggravation of non-specific signs, persistence of signs, indirect danger signs and superstitious signs. The incorrect perception of the signs was an important cause of late awareness of the danger and delayed decision to seek care. <strong>Conclusion: </strong>Misunderstandings of signs often delayed awareness of danger as well as decisions to seek appropriate care. Educational programs teaching health warning signs should be designed to promote the timely use of facilities.展开更多
<strong>Background:</strong> Puerperal sepsis (PS) is one of the major causes of maternal death, contributing to 26,000 deaths per year in developing countries. Early recognition and treatment are essentia...<strong>Background:</strong> Puerperal sepsis (PS) is one of the major causes of maternal death, contributing to 26,000 deaths per year in developing countries. Early recognition and treatment are essential to managing PS, but numerous social, cultural and technical barriers prevent or delay access to care and necessary medical attention. Through this qualitative study, we identified barriers to care seeking for puerperal sepsis among recently delivered women in Matiari, Pakistan. <strong>Methods: </strong>We conducted 20 in-depth interviews among recently delivered women with and without sepsis and their family members in September 2012. Key informant interviews were conducted with 14 healthcare providers and traditional birth attendants. The themes used for content analysis were knowledge of danger signs, factors affecting care seeking and local treatment practices for postpartum sepsis. <strong>Results: </strong>A total of 34 interviews were conducted. Recently delivered women, their family members and traditional birth attendants were unaware of the word PS or the local translated term for PS. However, they were familiar with most of the individual symptoms associated with PS. Healthcare providers were aware of the condition and the associated symptoms. The healthcare providers’ understanding of the seriousness of PS was directly proportional their age and clinical experience. The most common barriers to care seeking was the division of labor within the household, obtaining permission from the primary decision maker, access to transportation, lack of financial resources and support from family members. <strong>Conclusion:</strong> To improve maternal care seeking behaviors for PS, interventions focusing on increasing knowledge of PS, addressing gender inequality, implementing an affordable community transport service and enhancing TBA’s knowledge and skills to manage PS need to be implemented.展开更多
Introduction:Fever is one of the most frequent reasons for paediatric consultations in Burkina Faso,but health care-seeking behaviours and the factors associated with health care-seeking in the event of childhood feve...Introduction:Fever is one of the most frequent reasons for paediatric consultations in Burkina Faso,but health care-seeking behaviours and the factors associated with health care-seeking in the event of childhood fever are poorly documented.This study aims to analyse the health care-seeking behaviours and the factors associated with health care-seeking for childhood fever in Burkina Faso.Methods:This study used the data from the baseline and endline surveys conducted to evaluate the impact of the Performance-Based Financing program in Burkina Faso.Univariate and multivariate binary logistic regression analyses were used to identify the factors associated with appropriate healthcare-seeking for childhood fever.Odds ratios were estimated to assess the strength of associations and 95%confidence intervals(CIs)were used for significance tests.Data were cleaned,coded and analysed using Stata software version 16.1.Results:Among the children under five who had a fever,75.19%and 79.76%sought appropriate health care in 2013 and 2017,respectively.Being 24-59 months old(AOR:0.344,95%CI 0.182-0.649 in 2013 and AOR:0.208,95%CI 0.115-0.376 in 2017),living in a very wealthy household(AOR:2.014,95%CI 1.149-3.531 in 2013 and AOR:2.165,95%CI 1.223-3.834 in 2017),having a mother with a secondary or higher level of education or having made at least four antenatal care visits were significantly associated with seeking appropriate health care for childhood fever.Living in an area where the health facility is safe was also significantly associated with seeking appropriate care for childhood fevers.Conclusions:The findings underscore the need to concentrate efforts aiming at sensitizing the population(especially women of childbearing age)to improve sanitation and the use of family planning(household composition),skilled antenatal care and postnatal care to help reduce the prevalence of fever in children under five and improve the use of medical healthcare for childhood fever.展开更多
Despite the very high burden of malaria among children in Borno state, the proportion of those who receive standard treatment has been very low. This study aimed to determine malaria knowledge, attitude towards preven...Despite the very high burden of malaria among children in Borno state, the proportion of those who receive standard treatment has been very low. This study aimed to determine malaria knowledge, attitude towards prevention, and health care seeking behaviours of parents or caregivers of children presenting with fever at the paediatric clinic of a secondary-level hospital in Maiduguri, Borno state, Nigeria. A cross-sectional study design was used to obtain information from the respondents. Data were collected using a structured questionnaire, from the parents or caregivers of children presented to the Paediatric clinic with history of fever, and analysed in SPSS. A total of 331 respondents were finally recruited into the study. The ages of the children ranged from one to fourteen years. Some of them (15.3%) were internally displaced persons (IDPs). As many as 90.7% and 91.9% of the respondents believed that malaria is a life-threatening illness, and ITNs could prevent malaria, respectively. Less than a half of them (42.3%) had immediately brought their children to the hospital once they detected the fever. At the hospital, only 202 (60.7%) of the children had had malaria parasite test done on them, of which 89.1% tested positive. Permanent residents were more likely to promptly take their children to the hospital, one they detected fever, compared to IDPs ( 2=12.401, df =1, p=0.002). There is the need for promoting early presentation of febrile children to health centres, and also promoting routine malaria tests for febrile persons.展开更多
Hypertension and obesity are two prevalent conditions that often simultaneously affect the same individual and can increase one＇s chances of cardiovascular morbidity. In Thailand, older people often seek medical atte...Hypertension and obesity are two prevalent conditions that often simultaneously affect the same individual and can increase one＇s chances of cardiovascular morbidity. In Thailand, older people often seek medical attention at times when they are extremely ill. Healthy lifestyle behaviors are essential in order for one to maintain their health. Certain regimens can be initiated to manage and control health problems. However, very few know about how the elderly maintain their subjective physical well-being, while living with obesity and hypertension. This qualitative study focuses on describing health care practices and behaviors of overweight and hypertensive older people in everyday Thai society. Ten elderly people have participated in this study through purposive sampling. Qualitative data was gathered via in-depth interviews and was analyzed by using a content analysis method. The findings illustrate that health care seeking behaviors emerged from an understanding to seek health care; acting behaviors based on knowledge, and seeking health care support. Most overweight and hypertensive elderly people in Thai cultures have the desire to maintain their everyday lives by continuing their routines or traditions that were in place before seeking professional attention. This knowledge is useful in developing health care practices with wider implications such as holistic care to elderly people for alleviating their suffering by promoting healthy lifestyles and maintaining healthy blood pressure.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.
基金supported by the National Key Research and Development Program of China(2021YFC2701300,2023YFC2706000 and 2018YFC2002201)the National Natural Science Foundation of China(72104247)the National High Level Hospital Clinical Research Funding(2022-PUMCH-B-087,2022-PUMCH-A-023)。
文摘Urinary incontinence(UI)is a disease that quietly yet seriously impacts women's health and represents a global health burden that is often neglected.This study aims to systematically assess the prevalence and dynamics of female UI in China,and can inform further policies and have international implications.This study used three nationwide investigations:A national cross-sectional survey in 2021;another nationwide cross-sectional survey in 2006;and data regarding the institutions and physicians providing pelvic floor rehabilitation services from 2005 to 2019.The weighted prevalence of female UI and its subtypes,including stress UI(SUI),urgency UI(UUI),and mixed UI(MUI),were estimated as primary outcomes.Knowledge,attitude and care-seeking behaviors of UI were evaluated.It was found that the weighted prevalence of female UI was 16.0%(95%CI,13.3%–19.1%)with SUI remaining the predominant subtype(7.0%)in 2021,followed by MUI(6.5%)and UUI(1.9%).The estimated absolute number of Chinese adult women with UI was 85.8 million in 2021.52.7%(95%CI,45.9%–59.4%)of women were aware that UI was a medical condition,and only 10.1%of women with UI sought health care.After 15 years of development,there were 8400 pelvic floor rehabilitation institutions and nearly 10,000 relevant physicians in ChinaDthey were found to be associated with UI prevalence.The UI prevalence in China was significantly lower in 2021 compared to that in 2006.Despite the achievement,UI remains a public health problem,especially given China's fast aging and three-child policy.More innovations,especially those that can facilitate care seeking,are needed to address this prevalent yet treatable condition.
基金Health Sciences Centre Medical Staff Council Resident Research Award
文摘AIM To investigate the effects of direct to colonoscopy pathways on information seeking behaviors and anxiety among colonoscopy-na?ve patients.METHODS Colonoscopy-na?ve patients at two tertiary care hospitals completed a survey immediately prior to their scheduled outpatient procedure and before receiving sedation.Survey items included clinical pathway(direct or consult),procedure indication(cancer screening or symptom investigation),telephone and written contact from the physician endoscopist office,information sources,and pre-procedure anxiety.Participants reported pre-procedure anxiety using a 10 point scale anchored by "very relaxed"(1) and "very nervous"(10).At least three months following the procedure,patient medical records were reviewed to determine sedative dose,procedure indications and any adverse events.The primary comparison was between the direct and consult pathways.Given the very different implications,a secondary analysis considering the patient-reported indication for the procedure(symptoms or screening).Effects of pathway(direct vs consult) were compared both within and between the screening and symptom subgroups.RESULTS Of 409 patients who completed the survey,34% followed a direct pathway.Indications for colonoscopy were similar in each group.The majority of the participants were women(58%),married(61%),and internet users(81%).The most important information source was family physicians(Direct) and specialist physicians(Consult).Use of other information sources,including the internet(20% vs 18%) and Direct family and friends(64% vs 53%),was similar in the Direct and Consult groups,respectively.Only 31% of the 81% who were internet users accessed internet health information.Most sought fundamental information such as what a colonoscopy is or why it is done.Pre-procedure anxiety did not differ between care pathways.Those undergoing colonoscopy for symptoms reported greater anxiety [mean 5.3,95%CI: 5.0-5.7(10 point Likert scale)] than those for screening colonoscopy(4.3,95%CI: 3.9-4.7).CONCLUSIO
文摘Background:Health policy formulations in India have witnessed a shift from a reactive approach to a more proactive approach over the last decade.It is therefore important to understand the effectiveness of recent national health policies(such as the National Rural Health Mission and the National Urban Health Mission)in addressing the varied needs of the heterogeneous population of India.Methods:We use datasets from the National Sample Surveys carried out in 2004 and 2014 to understand the change in the health seeking behavior as a result of these policies.The choice of health care facilities and the associated expenditures are compared through descriptive analyses.A multinomial logistic regression is used to identify the significant parameters which contribute towards the share of health care providers in India.The health status of two economically disparate Indian states(Bihar and Kerala)are also compared through specific metrics of performance.Results:It is seen that due to increased availability of facilities in close proximity,both rural and urban residents prefer to avail of those facilities which will result in minimization of transportation cost.The effectiveness of national health policies is found to vary on a regional scale.Literacy and health status have a strong correlation,thereby reinforcing that Bihar still lags far behind Kerala in terms of access to equitable health care.Conclusion:Therefore,a hierarchical system,incorporating medical pluralism and tailor-made policies targeted at diverse health care demands,needs to be put in place to achieve Goal 3 of the Sustainable Development Goals as decreed by the United Nations,i.e.,“health for all”.
文摘<strong>Introduction:</strong> For seriously ill women of childbearing age, perceived health warning signs may influence decision of whether or not to seek care. Inaccurate perceptions of patients and those around them may lead to attitudes that delay seeking care. This study analyzes perceptions of danger and related delays to seek care in Kinshasa. <strong>Methods:</strong> Sixty deceased women who died between March and April 2004 were taken away from two Kinshasa mortuaries. History of disease and deaths were reconstructed through medical records and semi-structured interviews of family members and leaders. The Qualitative Software Research was used to conduct a qualitative analysis. <strong>Results:</strong> Perceived health warning signs had five manifestations: Specific clinical health warning signs, aggravation of non-specific signs, persistence of signs, indirect danger signs and superstitious signs. The incorrect perception of the signs was an important cause of late awareness of the danger and delayed decision to seek care. <strong>Conclusion: </strong>Misunderstandings of signs often delayed awareness of danger as well as decisions to seek appropriate care. Educational programs teaching health warning signs should be designed to promote the timely use of facilities.
文摘<strong>Background:</strong> Puerperal sepsis (PS) is one of the major causes of maternal death, contributing to 26,000 deaths per year in developing countries. Early recognition and treatment are essential to managing PS, but numerous social, cultural and technical barriers prevent or delay access to care and necessary medical attention. Through this qualitative study, we identified barriers to care seeking for puerperal sepsis among recently delivered women in Matiari, Pakistan. <strong>Methods: </strong>We conducted 20 in-depth interviews among recently delivered women with and without sepsis and their family members in September 2012. Key informant interviews were conducted with 14 healthcare providers and traditional birth attendants. The themes used for content analysis were knowledge of danger signs, factors affecting care seeking and local treatment practices for postpartum sepsis. <strong>Results: </strong>A total of 34 interviews were conducted. Recently delivered women, their family members and traditional birth attendants were unaware of the word PS or the local translated term for PS. However, they were familiar with most of the individual symptoms associated with PS. Healthcare providers were aware of the condition and the associated symptoms. The healthcare providers’ understanding of the seriousness of PS was directly proportional their age and clinical experience. The most common barriers to care seeking was the division of labor within the household, obtaining permission from the primary decision maker, access to transportation, lack of financial resources and support from family members. <strong>Conclusion:</strong> To improve maternal care seeking behaviors for PS, interventions focusing on increasing knowledge of PS, addressing gender inequality, implementing an affordable community transport service and enhancing TBA’s knowledge and skills to manage PS need to be implemented.
基金The baseline(2013)and end-line(2017)surveys for the impact evaluation of Performance-Based Financing(PBF)in Burkina Faso were supported by the World Bank through the Health Results Innovation Trust Fund(HRITF).
文摘Introduction:Fever is one of the most frequent reasons for paediatric consultations in Burkina Faso,but health care-seeking behaviours and the factors associated with health care-seeking in the event of childhood fever are poorly documented.This study aims to analyse the health care-seeking behaviours and the factors associated with health care-seeking for childhood fever in Burkina Faso.Methods:This study used the data from the baseline and endline surveys conducted to evaluate the impact of the Performance-Based Financing program in Burkina Faso.Univariate and multivariate binary logistic regression analyses were used to identify the factors associated with appropriate healthcare-seeking for childhood fever.Odds ratios were estimated to assess the strength of associations and 95%confidence intervals(CIs)were used for significance tests.Data were cleaned,coded and analysed using Stata software version 16.1.Results:Among the children under five who had a fever,75.19%and 79.76%sought appropriate health care in 2013 and 2017,respectively.Being 24-59 months old(AOR:0.344,95%CI 0.182-0.649 in 2013 and AOR:0.208,95%CI 0.115-0.376 in 2017),living in a very wealthy household(AOR:2.014,95%CI 1.149-3.531 in 2013 and AOR:2.165,95%CI 1.223-3.834 in 2017),having a mother with a secondary or higher level of education or having made at least four antenatal care visits were significantly associated with seeking appropriate health care for childhood fever.Living in an area where the health facility is safe was also significantly associated with seeking appropriate care for childhood fevers.Conclusions:The findings underscore the need to concentrate efforts aiming at sensitizing the population(especially women of childbearing age)to improve sanitation and the use of family planning(household composition),skilled antenatal care and postnatal care to help reduce the prevalence of fever in children under five and improve the use of medical healthcare for childhood fever.
文摘Despite the very high burden of malaria among children in Borno state, the proportion of those who receive standard treatment has been very low. This study aimed to determine malaria knowledge, attitude towards prevention, and health care seeking behaviours of parents or caregivers of children presenting with fever at the paediatric clinic of a secondary-level hospital in Maiduguri, Borno state, Nigeria. A cross-sectional study design was used to obtain information from the respondents. Data were collected using a structured questionnaire, from the parents or caregivers of children presented to the Paediatric clinic with history of fever, and analysed in SPSS. A total of 331 respondents were finally recruited into the study. The ages of the children ranged from one to fourteen years. Some of them (15.3%) were internally displaced persons (IDPs). As many as 90.7% and 91.9% of the respondents believed that malaria is a life-threatening illness, and ITNs could prevent malaria, respectively. Less than a half of them (42.3%) had immediately brought their children to the hospital once they detected the fever. At the hospital, only 202 (60.7%) of the children had had malaria parasite test done on them, of which 89.1% tested positive. Permanent residents were more likely to promptly take their children to the hospital, one they detected fever, compared to IDPs ( 2=12.401, df =1, p=0.002). There is the need for promoting early presentation of febrile children to health centres, and also promoting routine malaria tests for febrile persons.
文摘Hypertension and obesity are two prevalent conditions that often simultaneously affect the same individual and can increase one＇s chances of cardiovascular morbidity. In Thailand, older people often seek medical attention at times when they are extremely ill. Healthy lifestyle behaviors are essential in order for one to maintain their health. Certain regimens can be initiated to manage and control health problems. However, very few know about how the elderly maintain their subjective physical well-being, while living with obesity and hypertension. This qualitative study focuses on describing health care practices and behaviors of overweight and hypertensive older people in everyday Thai society. Ten elderly people have participated in this study through purposive sampling. Qualitative data was gathered via in-depth interviews and was analyzed by using a content analysis method. The findings illustrate that health care seeking behaviors emerged from an understanding to seek health care; acting behaviors based on knowledge, and seeking health care support. Most overweight and hypertensive elderly people in Thai cultures have the desire to maintain their everyday lives by continuing their routines or traditions that were in place before seeking professional attention. This knowledge is useful in developing health care practices with wider implications such as holistic care to elderly people for alleviating their suffering by promoting healthy lifestyles and maintaining healthy blood pressure.
