Over the last 2 decades (1988-2007), poverty in Jamaica has fallen by 67.5%, and this is within the context of a 194.7% increase in inflation for 2007 over 2006. It does not abate there, as Jamaicans are reporting mor...Over the last 2 decades (1988-2007), poverty in Jamaica has fallen by 67.5%, and this is within the context of a 194.7% increase in inflation for 2007 over 2006. It does not abate there, as Jamaicans are reporting more health conditions in a 4-week period (15.5% in 2007) and at the same time this corresponds to a decline in the percentage of people seeking medical care. Older people’s health status is of increasing concern, given the high rates of prostate cancer, genitourinary disorders, hypertension, diabetes mellitus and the presence of risk factors such as smoking. Yet, there is a dearth of studies on the health status of older people in the two poor quintiles. This study examined 1) the health status of those elderly Jamaicans who were in the two poor quintiles and 2) factors that are associated with their health status. A sample of 1,149 elderly respondents, with an average age of 72.6 years (SD = 8.7 years) were extracted from a total survey of 25,018 Jamaicans. The initial survey sample was selected from a stratified probability sampling frame of Jamaicans. An administered questionnaire was used to collect the data. Descriptive statistics were used to examine background information on the sample, and stepwise logistic regression was used to ascertain the factors which are associated with health status. The health status of older poor people was influenced by 6 factors, and those factors accounted for 26.6% of the variability in health status: Health insurance coverage (OR = 13.90;95% CI: 7.98-24.19), age of respondents (OR = 7.98;95% CI: 1.02-1.06), and secondary level education (OR=1.82;95% CI: 1.35-2.45). Males are less likely to report good health status than females (OR = 0.56;95% CI: 0.42-0.75). Older people in Jamaica do not purchase health insurance coverage as a preventative measure but as a curative measure. Health insurance coverage in this study does not indicate good health but is a proxy of poor health status. The demand of the health services in Jamaica in the future must be geared towards a particular age cohort and certain health conditions, and not only to the general population, as the social determinants which give rise to inequities are not the same, even among the same age cohort.展开更多
An appropriate health care financing scheme can improve the efficient, equitable, and effective use of health care resources;however, each popular health care financing scheme has some advantages and disadvantages. Th...An appropriate health care financing scheme can improve the efficient, equitable, and effective use of health care resources;however, each popular health care financing scheme has some advantages and disadvantages. The designing of health care financing strategy to fit with the country specific features is not straightforward. In resource poor country, allocation of resources for health care services are always critical and frequently unstable due to nuances annual budget process, small fiscal space, uncertainties in contributions of external development partners. Considerable quantities of country specific researches require for the choice of an appropriate health care financing scheme. The paper illustrates possible better options for the government to pursue the goal of ensuring that the poor receive more benefits. The paper compares the benefit incidences and cost of services with different options purposed for primary health care services by utilizing recently collected data from different hospitals in Nepal. The paper offers an alternative policy such as a universal free care below the district level services;but in the district level which is top level of primary care, “extended targeted free health care” may be an efficient, fair, and relatively simple approach.展开更多
Carrying out health poverty alleviation and ensuring the security of basic medical care for the poor are important contents for China to implement the strategy of targeted poverty alleviation and win the battle to get...Carrying out health poverty alleviation and ensuring the security of basic medical care for the poor are important contents for China to implement the strategy of targeted poverty alleviation and win the battle to get rid of poverty. Xundian Hui and Yi Autonomous County in Yunnan Province is a national poor county integrating ' nationality,poverty,mountainous area and old revolutionary base area'. In recent years,based on the actual situation,Xundian County has explored an effective way of health poverty alleviation. It has effectively prevented the phenomenon of poverty caused by illness and returning to poverty due to illness,and effectively ensured that Xundian County has successfully achieved the goal of getting rid of poverty. Xundian County finally got rid of the shadow of ' poverty' for more than 30 years to become one of the first batch of counties in Yunnan Province to get rid of poverty. This paper makes great efforts to analyze and summarize the specific methods,main achievements,successful experience,lessons and reference about health poverty alleviation in Xundian County. At the same time,it also studies and analyzes the main problems existing in the model,and puts forward the corresponding measures and suggestions,in order to provide a reference for health poverty alleviation in other poor areas.展开更多
This paper analyzes the state of health and access to health services among the urban poor in India. Analysis is based on data from a primary survey conducted among 2000 households, covering 10,929 individuals from fo...This paper analyzes the state of health and access to health services among the urban poor in India. Analysis is based on data from a primary survey conducted among 2000 households, covering 10,929 individuals from four cities of India. Summary statistics and regressions (using STATA) are used for data analysis. Results show lack of government facilities and services, a very high preference for private health facilities, high expenses especially in private but also in public facilities, and a perception that private facilities are offering high quality services as important concerns. An econometric analysis of the determinants of acute illness indicates the insufficiency of basic amenities like sanitation, garbage disposal and potable water. Together with the lack of availability of government health facilities in the vicinity, these results indicate continued vulnerability of the urban poor, and the need for urgent government action.展开更多
文摘Over the last 2 decades (1988-2007), poverty in Jamaica has fallen by 67.5%, and this is within the context of a 194.7% increase in inflation for 2007 over 2006. It does not abate there, as Jamaicans are reporting more health conditions in a 4-week period (15.5% in 2007) and at the same time this corresponds to a decline in the percentage of people seeking medical care. Older people’s health status is of increasing concern, given the high rates of prostate cancer, genitourinary disorders, hypertension, diabetes mellitus and the presence of risk factors such as smoking. Yet, there is a dearth of studies on the health status of older people in the two poor quintiles. This study examined 1) the health status of those elderly Jamaicans who were in the two poor quintiles and 2) factors that are associated with their health status. A sample of 1,149 elderly respondents, with an average age of 72.6 years (SD = 8.7 years) were extracted from a total survey of 25,018 Jamaicans. The initial survey sample was selected from a stratified probability sampling frame of Jamaicans. An administered questionnaire was used to collect the data. Descriptive statistics were used to examine background information on the sample, and stepwise logistic regression was used to ascertain the factors which are associated with health status. The health status of older poor people was influenced by 6 factors, and those factors accounted for 26.6% of the variability in health status: Health insurance coverage (OR = 13.90;95% CI: 7.98-24.19), age of respondents (OR = 7.98;95% CI: 1.02-1.06), and secondary level education (OR=1.82;95% CI: 1.35-2.45). Males are less likely to report good health status than females (OR = 0.56;95% CI: 0.42-0.75). Older people in Jamaica do not purchase health insurance coverage as a preventative measure but as a curative measure. Health insurance coverage in this study does not indicate good health but is a proxy of poor health status. The demand of the health services in Jamaica in the future must be geared towards a particular age cohort and certain health conditions, and not only to the general population, as the social determinants which give rise to inequities are not the same, even among the same age cohort.
文摘An appropriate health care financing scheme can improve the efficient, equitable, and effective use of health care resources;however, each popular health care financing scheme has some advantages and disadvantages. The designing of health care financing strategy to fit with the country specific features is not straightforward. In resource poor country, allocation of resources for health care services are always critical and frequently unstable due to nuances annual budget process, small fiscal space, uncertainties in contributions of external development partners. Considerable quantities of country specific researches require for the choice of an appropriate health care financing scheme. The paper illustrates possible better options for the government to pursue the goal of ensuring that the poor receive more benefits. The paper compares the benefit incidences and cost of services with different options purposed for primary health care services by utilizing recently collected data from different hospitals in Nepal. The paper offers an alternative policy such as a universal free care below the district level services;but in the district level which is top level of primary care, “extended targeted free health care” may be an efficient, fair, and relatively simple approach.
基金Supported by Project of the Office of the Leading Group of Rural Work of Kunming Municipal Party Committee
文摘Carrying out health poverty alleviation and ensuring the security of basic medical care for the poor are important contents for China to implement the strategy of targeted poverty alleviation and win the battle to get rid of poverty. Xundian Hui and Yi Autonomous County in Yunnan Province is a national poor county integrating ' nationality,poverty,mountainous area and old revolutionary base area'. In recent years,based on the actual situation,Xundian County has explored an effective way of health poverty alleviation. It has effectively prevented the phenomenon of poverty caused by illness and returning to poverty due to illness,and effectively ensured that Xundian County has successfully achieved the goal of getting rid of poverty. Xundian County finally got rid of the shadow of ' poverty' for more than 30 years to become one of the first batch of counties in Yunnan Province to get rid of poverty. This paper makes great efforts to analyze and summarize the specific methods,main achievements,successful experience,lessons and reference about health poverty alleviation in Xundian County. At the same time,it also studies and analyzes the main problems existing in the model,and puts forward the corresponding measures and suggestions,in order to provide a reference for health poverty alleviation in other poor areas.
文摘This paper analyzes the state of health and access to health services among the urban poor in India. Analysis is based on data from a primary survey conducted among 2000 households, covering 10,929 individuals from four cities of India. Summary statistics and regressions (using STATA) are used for data analysis. Results show lack of government facilities and services, a very high preference for private health facilities, high expenses especially in private but also in public facilities, and a perception that private facilities are offering high quality services as important concerns. An econometric analysis of the determinants of acute illness indicates the insufficiency of basic amenities like sanitation, garbage disposal and potable water. Together with the lack of availability of government health facilities in the vicinity, these results indicate continued vulnerability of the urban poor, and the need for urgent government action.
