Equity in health care: An urban and rural, and gender perspective; the Suriname Health Study

Smits, Ccf; Toelsie, JR; Eersel, Marthelise; Krishnadath, Ingrid S K

doi:10.3934/publichealth.2018.1.1

Cited by 7 publications

(9 citation statements)

References 40 publications

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“…The results point to greater inequalities in disability between men and women and urban and rural residents 2 , 3 . The education, wealth and infrastructure inequality that exists between urban and rural India is also important in influencing the health of older persons 35 , 36 .…”

Section: Discussionmentioning

confidence: 96%

“…Women live longer with higher rates of functional limitation and disability compared to men 1 , 2 . They have also reported more utilization of health services compared to men in higher-income countries 3 , 4 . The aging in low-middle income countries like India has just started and the above 60 yr of age population is estimated to double by 2030 5 .…”

Section: Introductionmentioning

confidence: 97%

“…The aging in low-middle income countries like India has just started and the above 60 yr of age population is estimated to double by 2030 5 . Further, India has been going through the rapid urbanization, moving from an agricultural-based economy to industrial and technological driven market while there are health disparities which exits between urban and rural areas 3 , 6 . Less physical activity, changing family and social systems present a challenge in realising the functional health problems of older persons.…”

Section: Introductionmentioning

confidence: 99%

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Understanding Frailty, Functional Health and Disability among Older Persons in India: A Decomposition Analysis of Gender and Place of Resident

Anand

et al. 2020

J Res Health Sci

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Background: We estimated and compared the differences in frailty, disability, and functional limitation among men and women, and among urban and rural dwellers. Further, this study also provides the analysis of key factors influencing frailty, functional limitation and disability among older persons in India. Study design: Two cross-sectional surveys. Methods: WHO-SAGE (2007-10) and BKPAI-2011 (Building Knowledgebase for Population Ageing in India) (2007-10) were used. Oaxaca decomposition method was used to decompose the gender and place of resident differentials. Statistical software RStudio (Version 1.2.1335) was used to perform these analyses Results: The decomposition model was able to explain 46.5%, 41.6% and 46.4% of the difference between frailty, functional limitation and disability among older persons respectively. The key factors, which significantly ( P <0.05) explained the gap for both frailty and functional limitation, were Education (0.009 &1.24), working status (0.018 & 1.93), physical activity (0.001 & 0.15) and migration (0.018 & 1.98). Higher educational attainment (0.008 & 1.10) and wealth quintile (0.009 & 1.18) in urban areas might be a factors resulting in the lowering of frailty and functional limitations. Conclusion: The poorer functional health among older women can largely be explained by gender differentials in socioeconomic status and consequent empowerment (such as less control of their mobility and financial independence). This implies that efforts to improve gender disadvantages in earlier life stages might get reflected in better health for females in older age.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Understanding Frailty, Functional Health and Disability among Older Persons in India: A Decomposition Analysis of Gender and Place of Resident

Anand

et al. 2020

J Res Health Sci

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“…10 , 43 , 44 In Suriname, government policies in place since the 1960s provide free access to primary and secondary health care for rural populations. 45 Most of the indigenous population live in rural areas where free health services are available through the Medical Mission , a publicly subsidised non-governmental organisation.…”

Section: Discussionmentioning

confidence: 99%

Ethnic group inequalities in coverage with reproductive, maternal and child health interventions: cross-sectional analyses of national surveys in 16 Latin American and Caribbean countries

Mesenburg

Restrepo‐Méndez

Amigo

et al. 2018

The Lancet Global Health

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SummaryBackgroundLatin American and Caribbean populations include three main ethnic groups: indigenous people, people of African descent, and people of European descent. We investigated ethnic inequalities among these groups in population coverage with reproductive, maternal, newborn, and child health interventions.MethodsWe analysed 16 standardised, nationally representative surveys carried out from 2004 to 2015 in Latin America and the Caribbean that provided information on ethnicity or a proxy indicator (household language or skin colour) and on coverage of reproductive, maternal, newborn, and child health interventions. We selected four outcomes: coverage with modern contraception, antenatal care coverage (defined as four or more antenatal visits), and skilled attendants at birth for women aged 15–49 years; and coverage with three doses of diphtheria-pertussis-tetanus (DPT3) vaccine among children aged 12–23 months. We classified women and children as indigenous, of African descent, or other ancestry (reference group) on the basis of their self-reported ethnicity or language. Mediating variables included wealth quintiles (based on household asset indices), woman's education, and urban-rural residence. We calculated crude and adjusted coverage ratios using Poisson regression.FindingsEthnic gaps in coverage varied substantially from country to country. In most countries, coverage with modern contraception (median coverage ratio 0·82, IQR 0·66–0·92), antenatal care (0·86, 0·75–0·94), and skilled birth attendants (0·75, 0·68–0·92) was lower among indigenous women than in the reference group. Only three countries (Nicaragua, Panama, and Paraguay) showed significant gaps in DPT3 coverage between the indigenous and the reference groups. The differences were attenuated but persisted after adjustment for wealth, education, and residence. Women and children of African descent showed similar coverage to the reference group in most countries.InterpretationThe lower coverage levels for indigenous women are pervasive, and cannot be explained solely by differences in wealth, education, or residence. Interventions delivered at community level—such as vaccines—show less inequality than those requiring access to services, such as birth attendance. Regular monitoring of ethnic inequalities is essential to evaluate existing initiatives aimed at the inclusion of minorities and to plan effective multisectoral policies and programmes.FundingThe Bill & Melinda Gates Foundation (through the Countdown to 2030 initiative) and the Wellcome Trust.

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“…In the Republic of Suriname, a study conducted showed that equitable resource distribution for primary healthcare services was comparable in rural and urban areas. However, factors like perceived need, female gender, and socioeconomic status contributed to inequity for services related to chronic healthcare-related issues within the Republic of Suriname's rural areas [31].…”

Section: Equitymentioning

confidence: 99%

Healthcare Delivery Systems in Rural Areas

Jacob¹

2022

Rural Health

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Health care is a fundamental right of every human being. About half of the world’s population (An estimated 3.4 billion of the world’s 7.6 billion in 2018) lived in rural areas. Individuals in rural areas often have poor access to healthcare because of poor accessibility and availability of standard healthcare systems and socio-cultural factors affecting their perception of health compared to the urban population. Though there is a projected decrease in the absolute percentage of the world’s population dwelling in rural areas by 2050, there is also a projected increase projected increase needing of prioritizing rural health. This chapter shall discusses the critical factors that disadvantage the rural population. It also considers the methods used to work out rural healthcare delivery strategies to decrease this disparity in rural areas’ health care facilities.

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Equity in health care: An urban and rural, and gender perspective; the Suriname Health Study

Cited by 7 publications

References 40 publications

Understanding Frailty, Functional Health and Disability among Older Persons in India: A Decomposition Analysis of Gender and Place of Resident

Understanding Frailty, Functional Health and Disability among Older Persons in India: A Decomposition Analysis of Gender and Place of Resident

Ethnic group inequalities in coverage with reproductive, maternal and child health interventions: cross-sectional analyses of national surveys in 16 Latin American and Caribbean countries

Healthcare Delivery Systems in Rural Areas

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