Universal coverage but unmet need: National and regional estimates of attrition across the diabetes care continuum in Thailand

Yan, Lily; Hanvoravongchai, Piya; Aekplakorn, Wichai; Chariyalertsak, Suwat; Kessomboon, Pattapong; Assanangkornchai, Sawitri; Taneepanichskul, Surasak; Neelapaichit, Nareemarn; Stokes, Andrew

doi:10.1371/journal.pone.0226286

Cited by 19 publications

(18 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Even though Indonesia has implemented universal health coverage as mentioned earlier, critical challenges in providing equitable access, ensuring quality services and financial protection for people still persist (Ardiana, Ekoriano & Fathonah, 2019). Similar findings about universal health coverage from the health perspective have been reported from Thailand and even Europe (Reeves, Mckee & Stuckler, 2015;Yan et al, 2020).…”

Section: Discussionsupporting

confidence: 62%

Underlying the Factors of Unmet Need for Family Planning in Indonesia: A Spatial Analysis

Irma¹,

Ekoriano²

2020

GJHS

View full text Add to dashboard Cite

Unmet need for family planning remains a challenge in Indonesia. The Government has incorporated into the 2020-2024 National Medium-term Development Plan, an ambitious target to reduce unmet need from 12,4% in 2018 to 7.4% in 2024. This will require significant effort, while systematic and updated studies explaining the underlying causes are scarce, especially those that look at the level within the diverse characteristics of Indonesia. This study therefore aimed to investigate the fundamental factors contributing to unmet need for family planning, categorized into five dimensions (D): D.1). weak or ambivalent fertility preferences; D.2). generic disapproval of pregnancy prevention; D.3). method-specific barriers to use; D.4). perceived low risk of getting pregnant; and D.5). partner-related factors. This study also mapped the pattern at the sub-national level namely Java-Bali (region 1/R1), outside Java–Bali 1 (region 2/R2) and outside Java-Bali 2 (region 3/R3). Findings show that the level of unmet need is highest in R3 which consists of provinces that started implementing their family planning program much later than provinces in the other two regions.  The study also shows that women between 20-29 years old, with educated husband and larger family size, who consider smaller family size as ideal, are more likely to have unmet need compared to their counterparts in all regions. The likelihood of unmet need is most prominent in the region with the most mature program. The study emphasizes the importance of designing appropriate targeted interventions that are tailored to the local context and not apply a ‘one-size-fits-all’ policy.

show abstract

Section: Discussionsupporting

confidence: 62%

Underlying the Factors of Unmet Need for Family Planning in Indonesia: A Spatial Analysis

Irma¹,

Ekoriano²

2020

GJHS

View full text Add to dashboard Cite

show abstract

“…In cases in which older participants could not communicate or had cognitive problems, information was collected from their informant caregivers. The details of this survey are described elsewhere [25]. A total of 23,760 individuals were invited to participate in the NHES-V, among whom 8,640 were aged 60 years and older.…”

Section: Study Design and Study Populationmentioning

confidence: 99%

“…This adjustment accounted for clustering and weighting of older participants by using a set of Svy commands in STATA [30]. This study used weighting based on the sampling probability against the 2014 registered Thai population [25]. Chi-squared tests were used to compare the background characteristics of participants who were excluded from the analysis with those of the final sample.…”

Section: Data Analysesmentioning

confidence: 99%

See 1 more Smart Citation

Socio-demographic characteristics associated with the dietary diversity of Thai community-dwelling older people: results from the national health examination survey

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background Dietary diversity (DD) is an indicator of nutrient intake and is related to health outcomes in older people. Currently, limited research exists regarding factors associated with DD in older people in developing countries, such as Thailand, despite rapid growth in this population. Therefore, this study aims to examine the association between socio-demographic characteristics and DD in Thai older people. Methods A cross-sectional study based on the fifth Thai National Health Examination Survey (NHES-V) conducted between 2013 and 2015 was performed. A total of 7,300 nationally representative older participants aged ≥ 60 years were included. The individual-level dietary diversity score (DDS) was assessed as the frequency of consumption of eight food groups using food frequency questionnaires. Each food group was scored from 0 to 4 according to the frequency of consumption. The DDS was calculated as the sum of the scores, ranging from 0 to 32. Socio-demographic characteristics, including age, sex, highest education level, wealth index, living conditions, and residential area, were assessed. Data were analyzed using multiple linear regression and adjusted for complex survey design. Results The participants had a mean age of 69.7 (SD 7.6) years. The mean DDS of participants was 18.4 (SD 3.9). In the adjusted model, a higher educational level, a higher wealth index, and living in an urban area were positively associated with DDS, with adjusted β (95% CI) values of 1.37 (1.04, 1.70) for secondary education or higher, 0.81 (0.55, 1.06) for the richest group, and 0.24 (0.10, 0.44) for living in an urban area. Nevertheless, living alone had negative associations with DDS, with a β (95% CI) of - 0.27 (- 0.53, - 0.00). Conclusions This study showed that a higher educational level, a higher wealth index, and living in an urban area had a positive association, whereas living alone had a negative association with DD among Thai older participants. Interventions aiming to improve dietary diversity among older people might benefit from targeting more vulnerable groups, particularly those with less education and wealth, those living alone, or those in rural areas.

show abstract

“…NCD care continua are theoretical frameworks used to monitor public health system performance by measuring steps of screening, diagnosis, treatment, and ultimately control of chronic diseases. 17 , 18 They are useful to benchmark the coverage or unmet need of primary and secondary prevention interventions for BP in a community. While population level estimates of HTN for Haiti have been reported in the 2016–2017 Demographic Health Survey (DHS), the survey focuses only on adults 35–64 and may not be representative of the wider population.…”

Section: Introductionmentioning

confidence: 99%

Hypertension continuum of care: Blood pressure screening, diagnosis, treatment, and control in a population‐based cohort in Haiti

Metz

Pierre

Yan

et al. 2022

J of Clinical Hypertension

View full text Add to dashboard Cite

Cardiovascular disease (CVD) is the number one cause of death in low‐income countries including Haiti, with hypertension (HTN) being the leading risk factor. This study aims to identify gaps in the HTN continuum of screening, diagnosis, treatment, and blood pressure (BP) control. Sociodemographic and clinical data were collected from a population‐based sample of adults ≥18 years in Port‐au‐Prince (PAP) from March 2019 to April 2021. HTN was defined as systolic BP ≥ 140 mmHg, diastolic BP ≥ 90 mmHg, or use of antihypertensive medication. Screening was defined as ever having had a BP measurement; diagnosis as previously being informed of a HTN diagnosis; treatment as having taken antihypertensives in the past 2 weeks; and controlled as taking antihypertensives and having BP < 140/90 mmHg. Factors associated with attaining each step in the continuum were assessed using Poisson multivariable regressions. Among 2737 participants, 810 (29% age‐standardized) had HTN, of whom 97% had been screened, 72% diagnosed, 45% treated, and 13% controlled. There were no significant differences across age groups or sex. Obesity (BMI ≥ 30) was a significant factor associated with receiving treatment compared to normal weight (BMI < 25), with a prevalence ratio (PR) of 1.5 (95% CI 1.1–2.0). Having secondary or higher education was associated with higher likelihood of controlled BP (PR 1.9 [95% CI 1.1–3.3]). In this urban Haitian population, the greatest gaps in HTN care are treatment and control. Targeted interventions are needed to improve these steps, including broader access to affordable treatment, timely distribution of medications, and patient adherence to HTN medication.

show abstract

Universal coverage but unmet need: National and regional estimates of attrition across the diabetes care continuum in Thailand

Cited by 19 publications

References 25 publications

Underlying the Factors of Unmet Need for Family Planning in Indonesia: A Spatial Analysis

Underlying the Factors of Unmet Need for Family Planning in Indonesia: A Spatial Analysis

Socio-demographic characteristics associated with the dietary diversity of Thai community-dwelling older people: results from the national health examination survey

Hypertension continuum of care: Blood pressure screening, diagnosis, treatment, and control in a population‐based cohort in Haiti

Contact Info

Product

Resources

About