Socio-Economic Inequalities and their Impact on Health in Pakistan

Vincent, Sana Sehar

doi:10.3844/ijrnsp.2016.12.18

Cited by 7 publications

(5 citation statements)

References 24 publications

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“…Although income is an important factor that affects the utilization of basic medical and health service of the elderly, it is not the most important factor. This is inconsistent with the conclusions of most previous health service utilization equity literature [ 25 , 26 ]. But this also precisely reflects the role of family doctor contracted service in alleviating the inequality in the utilization of health services for the elderly.…”

Section: Discussioncontrasting

confidence: 99%

Can the implementation of family doctor contracted service enable the elderly to utilize primary health care services more equally? empirical evidence from Shandong, China

et al. 2022

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Background While the elderly are facing greater health risks, they also face more serious inequalities in utilization of medical services. The family doctor contracted service is the core policy of the Chinese government to cope with aging and to achieve the outcome that everyone has the right to primary health care. However, previous research has neither revealed the degree of inequality in the use of contracted services among the elderly in China, nor has it revealed what factors are related to the inequality in the use of services. Objective Assess and decompose the inequality in the use of family doctors contracted services in the elderly population in China. Methods A cross-sectional study of 1037 elderly people was conducted in Shandong Province, China. According to the first consultation rate of family doctors, the physical examination rate, the healthy lifestyle guidance rate and the chronic disease management rate, the situation of elderly people’s utilization of family doctor contracted service was investigated. The concentration index is used to measure the degree of inequality in the use of family doctors contracted services by the elderly. In order to test the contribution of different factors to the inequality of utilization of family doctors contracted services, the concentration index was also decomposed. Results The first consultation rate of family doctors for the elderly in Shandong Province was 24.6%, the physical examination rate was 65.8%, the healthy lifestyle guidance rate was 13.7%, and the chronic disease management rate was 52.2%. The horizontal inequality index of the healthy lifestyle guidance rate and the chronic disease management rate were 0.451 and 0.573, respectively, indicating that there is an inequality of pro-wealth. The concentration index of physical examination rate and chronic disease management rate is negative (− 0.260, − 0.518), which means inequality to the poor. Education level is the most important factor affecting the unequal utilization of health services for the elderly, followed by income. Conclusion The family doctor contracted service has had a positive impact on alleviating the health inequality in the utilization of basic medical and health services for the elderly. Although there is still inequality in terms of pro-wealth for the elderly, the utilization of family doctor contracted service has weakened the inequality of service utilization brought about by income. Enhancing the health literacy of the elderly, narrowing the gap between the rich and the poor, bridging the gap between urban and rural areas, and building a harmonious family relationship can promote the realization of basic medical and health care services for every elderly.

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Section: Discussioncontrasting

confidence: 99%

Can the implementation of family doctor contracted service enable the elderly to utilize primary health care services more equally? empirical evidence from Shandong, China

et al. 2022

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“…The lack of locally developed clinical practice guidelines represents an urgent problem for lower-middle-income countries including Pakistan, where the practice of palliative medicine may be expected to differ due to myriad reasons. These include a lack of palliative medicine specialists [ 5 ], out-of-pocket healthcare financing [ 10 ], poor health-seeking behavior and disease-related awareness [ 11 – 13 ], poorer socioeconomic and educational backgrounds [ 12 , 13 ], and socio-religio-cultural influences [ 11 , 14 ]. It is to account for differences such as the aforementioned, that it is generally recommended that even clinical practice guidelines of the highest quality should be tailored to suit the needs of the specific setting of their use [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Development of palliative care clinical practice guidelines and referral care pathways for primary care practitioners in Pakistan

Hashmi,

Martins,

Ishtiaq

et al. 2024

BMC Palliat Care

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Background Despite a large burden of life-limitingillness, there exists a dearth of services of palliative care in Pakistan. International guidelines have questionable applicability in Pakistan due to the socioeconomic differences. We generated a protocol describing the process of developing comprehensive palliative care guidelines and palliative care referral pathways for primary care practitioners to adopt in Pakistan. Methods A GRADE-ADOLOPMENT approach with modification has been employed to create guidelines for a Pakistani context. The “National Comprehensive Cancer Network Guidelines Insights: Palliative Care, Version 2.2021” was used as the source guideline. Recommendations from the source guideline were reviewed by two local palliative care specialists to either “Adopt,” “Adapt” or “Exclude”. The finalized recommendations were incorporated into the local palliative care guideline. Clinical diagnosis and referral pathways were made from the finalized guideline. Any gaps in management found in the pathways were filled by taking existing recommendations from other credible guidelines. Results Twenty-seven recommendations were adopted without modification. No recommendations were deemed to be adapted and 15 were excluded. The referral care pathways created were reflective of the local guideline and included elements of initial assessment, preliminary management, reassessment, and referral. 6 additional recommendations were made. Conclusion The described clinical practice guidelines and primary care clinical referral pathways will aid to standardize palliative care provision in Pakistan. These can be used by other resource constrained settings to develop guidelines within their own local context.

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“…Poverty and socioeconomic inequalities are associated with poor health ( Vincent, 2016 ; Khan and Hussain, 2020 ). Disasters and displacement affect access to education, employment, and lifestyle choices and exacerbates poverty ( Du et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

One Health Paradigm to Confront Zoonotic Health Threats: A Pakistan Prospective

et al. 2022

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The emergence and re-emergence of zoonotic diseases significantly impact human health, particularly those who live in impoverished areas and have close contact with domestic or wild animals. Nearly 75% of zoonotic diseases are transmitted directly from animals to humans or indirectly via vector/agent interactions between animals and humans. Growing populations, globalization, urbanization, and the interaction of the environment with humans and livestock all play roles in the emergence and spread of zoonotic diseases. “One Health” is a multidisciplinary concept aimed at improving human, animal, and environmental health, but this concept is not widely accepted in developing countries. In Pakistan, environmental, human, and animal health are severely affected due to a lack of sufficient resources. This review article provides an overview of the most common zoonotic diseases found in Pakistan and emphasizes the importance of the “One Health” concept in managing these diseases. Given the current situation, interdisciplinary research efforts are required to implement and sustain effective and long-term control measures in animal, human, and environmental health surveillance and accurate diagnostic methods.

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Socio-Economic Inequalities and their Impact on Health in Pakistan

Cited by 7 publications

References 24 publications

Can the implementation of family doctor contracted service enable the elderly to utilize primary health care services more equally? empirical evidence from Shandong, China

Can the implementation of family doctor contracted service enable the elderly to utilize primary health care services more equally? empirical evidence from Shandong, China

Development of palliative care clinical practice guidelines and referral care pathways for primary care practitioners in Pakistan

One Health Paradigm to Confront Zoonotic Health Threats: A Pakistan Prospective

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