Socio-economic Determinants of Women Access to Healthcare Services in Sub-Saharan Africa

2017 ◽  
Author(s):  
Dominic Azuh ◽  
Adeyemi Adefioye Ogundipe
Keyword(s):  
Healthcare Services ◽  
Access To Healthcare ◽  
Sub Saharan Africa ◽  
Economic Determinants ◽  
Sub Saharan

scholarly journals Determinants of Women Access to Healthcare Services in Sub-Saharan Africa

2019 ◽  
Vol 12 (1) ◽  
pp. 504-514 ◽  
Author(s):  
Azuh Dominic ◽  
Adeyemi Ogundipe ◽  
Oluwatomisin Ogundipe
Keyword(s):  
Health Service ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Generalized Method Of Moments ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Sub Saharan Africa ◽  
Service Availability ◽  
Healthcare Facilities ◽  
Sub Saharan

Background: The study examined the socio-economic determinants of women access to healthcare services in Sub-Saharan Africa for the period 1995-2015. Methods: The study adopted the dynamic panel model and estimated it using the System Generalized Method of Moments in a bid to overcome the endogeneity problem inherent in the model of study. Result: The study harmonized the theoretical strands in the literature by describing the measure of access determinants as three main components; i. Health service availability, ii. Health service utilization and iii. Health service decision. Conclusion: The indicators of health service availability such as community health workers, physicians, nurses and midwives and hospital beds improve women's access to healthcare facilities in Africa. Also, health service utilization indicators such as population density worsen the quality of healthcare services available to women while electricity access and private health expenditure enhance women’s access to quality healthcare delivery. Health service decision indicators such as female bank account ownership, female labour force participation, attainment of basic education and female household headship were important in enhancing women's access to healthcare facilities. Generally, women's health outcomes were more responsive to health service utilization; implying that service utilization is an important proof of healthcare access in Africa.

scholarly journals Mapping physical access to healthcare for older adults in sub-Saharan Africa: A cross-sectional analysis with implications for the COVID-19 response

2020 ◽  
Author(s):  
Pascal Geldsetzer ◽  
Marcel Reinmuth ◽  
Paul O Ouma ◽  
Sven Lautenbach ◽  
Emelda A Okiro ◽  
...  
Keyword(s):  
Older Adults ◽  
Travel Time ◽  
Healthcare Facility ◽  
Access To Healthcare ◽  
Sub Saharan Africa ◽  
Travel Times ◽  
Healthcare Resources ◽  
Healthcare Facilities ◽  
Sub Saharan ◽  
Physical Access

Background: SARS-CoV-2, the virus causing coronavirus disease 2019 (COVID-19), is rapidly spreading across sub-Saharan Africa (SSA). Hospital-based care for COVID-19 is particularly often needed among older adults. However, a key barrier to accessing hospital care in SSA is travel time. To inform the geographic targeting of additional healthcare resources, this study aimed to determine the estimated travel time at a 1km x 1km resolution to the nearest hospital and to the nearest healthcare facility of any type for adults aged 60 years and older in SSA. Methods: We assembled a unique dataset on healthcare facilities' geolocation, separately for hospitals and any type of healthcare facility (including primary care facilities) and including both private- and public-sector facilities, using data from the OpenStreetMap project and the KEMRI Wellcome Trust Programme. Population data at a 1km x 1km resolution was obtained from WorldPop. We estimated travel time to the nearest healthcare facility for each 1km x 1km raster using a cost-distance algorithm. Findings: 9.6% (95% CI: 5.2% - 16.9%) of adults aged 60 and older years had an estimated travel time to the nearest hospital of longer than six hours, varying from 0.0% (95% CI: 0.0% - 3.7%) in Burundi and The Gambia, to 40.9% (95% CI: 31.8% - 50.7%) in Sudan. 11.2% (95% CI: 6.4% - 18.9%) of adults aged 60 years and older had an estimated travel time to the nearest healthcare facility of any type (whether primary or secondary/tertiary care) of longer than three hours, with a range of 0.1% (95% CI: 0.0% - 3.8%) in Burundi to 55.5% (95% CI: 52.8% - 64.9%) in Sudan. Most countries in SSA contained populated areas in which adults aged 60 years and older had a travel time to the nearest hospital of more than 12 hours and to the nearest healthcare facility of any type of more than six hours. The median travel time to the nearest hospital for the fifth of adults aged 60 and older years with the longest travel times was 348 minutes (IQR: 240 - 576 minutes) for the entire SSA population, ranging from 41 minutes (IQR: 34 - 54 minutes) in Burundi to 1,655 minutes (IQR: 1065 - 2440 minutes) in Gabon. Interpretation: Our high-resolution maps of estimated travel times to both hospitals and healthcare facilities of any type can be used by policymakers and non-governmental organizations to help target additional healthcare resources, such as new make-shift hospitals or transport programs to existing healthcare facilities, to older adults with the least physical access to care. In addition, this analysis shows precisely where population groups are located that are particularly likely to under-report COVID-19 symptoms because of low physical access to healthcare facilities. Beyond the COVID-19 response, this study can inform countries' efforts to improve care for conditions that are common among older adults, such as chronic non-communicable diseases.

Envisioning a National e-Medicine Network Architecture in a Developing Country

2011 ◽  
pp. 35-53
Author(s):  
Fikreyohannes Lemma ◽  
Mieso K. Denko ◽  
Joseph K. Tan ◽  
Samuel Kinde Kassegne
Keyword(s):  
Developing Countries ◽  
Developing Country ◽  
Health Professionals ◽  
Network Architecture ◽  
Healthcare Services ◽  
Sub Saharan Africa ◽  
Policy Makers ◽  
Effective Delivery ◽  
Sub Saharan ◽  
Medical And Healthcare

Poor infrastructures in developing countries such as Ethiopia and much of Sub-Saharan Africa have caused these nations to suffer from lack of efficient and effective delivery of basic and extended medical and healthcare services. Often, such limitation is further accompanied by low patient-doctor ratios, resulting in unwarranted rationing of services. Apparently, e-medicine awareness among both governmental policy makers and private health professionals is motivating the gradual adoption of technological innovations in these countries. It is argued, however, that there still is a gap between current e-medicine efforts in developing countries and the existing connectivity infrastructure leading to faulty, inefficient and expensive designs. The particular case of Ethiopia, one such developing country where e-medicine continues to carry significant promises, is investigated and reported in this article.

scholarly journals How men who have sex with men experience HIV health services in Kampala, Uganda

2020 ◽  
Vol 5 (4) ◽  
pp. e001901
Author(s):  
Rachel King ◽  
Zubayiri Sebyala ◽  
Moses Ogwal ◽  
George Aluzimbi ◽  
Rose Apondi ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Health Services ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Sub Saharan Africa ◽  
Health Staff ◽  
Structural Factors ◽  
Structural Barriers ◽  
Sub Saharan ◽  
Sex With Men

In sub-Saharan Africa, men who have sex with men (MSM) are socially, largely hidden and face disproportionate risk for HIV infection. Attention to HIV epidemics among MSM in Uganda and elsewhere in sub-Saharan Africa has been obscured by repressive governmental policies, criminalisation, stigma and the lack of basic epidemiological data describing these epidemics. In this paper, we aim to explore healthcare access, experiences with HIV prevention services and structural barriers to using healthcare services in order to inform the acceptability of a combination HIV prevention package of services for men who have sex with men in Uganda. We held focus group discussions (FGDs) with both MSM and healthcare providers in Kampala, Uganda, to explore access to services and to inform prevention and care. Participants were recruited through theoretical sampling with criteria based on ability to answer the research questions. Descriptive thematic coding was used to analyse the FGD data. We described MSM experiences, both negative and positive, as they engaged with health services. Our findings showed that socio-structural factors, mediated by psychological and relational factors impacted MSM engagement in care. The socio-structural factors such as stigma, homophobia and policy issues emerged strongly as did the mediating factors such as relations with specific health staff and a social support structure. A combination intervention addressing structural, social and psychological barriers could have an impact even in the precarious policy environment where this study was conducted.

Envisioning a National E-Medicine Network Architecture in a Developing Country

2011 ◽  
pp. 306-326
Author(s):  
Fikreyohannes Lemma ◽  
Mieso K. Denko ◽  
Joseph K. Tan ◽  
Samuel Kinde Kassegne
Keyword(s):  
Developing Countries ◽  
Developing Country ◽  
Health Professionals ◽  
Network Architecture ◽  
Healthcare Services ◽  
Sub Saharan Africa ◽  
Policy Makers ◽  
Effective Delivery ◽  
Sub Saharan ◽  
Medical And Healthcare

Poor infrastructures in developing countries such as Ethiopia and much of Sub-Saharan Africa have caused these nations to suffer from lack of efficient and effective delivery of basic and extended medical and healthcare services. Often, such limitation is further accompanied by low patient-doctor ratios, resulting in unwarranted rationing of services. Apparently, e-medicine awareness among both governmental policy makers and private health professionals is motivating the gradual adoption of technological innovations in these countries. It is argued, however, that there still is a gap between current e-medicine efforts in developing countries and the existing connectivity infrastructure leading to faulty, inefficient and expensive designs. The particular case of Ethiopia, one such developing country where emedicine continues to carry significant promises, is investigated and reported in this article.

Envisioning a National e-Medicine Network Architecture in a Developing Country

2011 ◽  
pp. 1322-1341
Author(s):  
Fikreyohannes Lemma ◽  
Mieso K. Denko ◽  
Joseph K. Tan ◽  
Samuel Kinde Kassegne
Keyword(s):  
Developing Countries ◽  
Developing Country ◽  
Health Professionals ◽  
Network Architecture ◽  
Healthcare Services ◽  
Sub Saharan Africa ◽  
Policy Makers ◽  
Effective Delivery ◽  
Sub Saharan ◽  
Medical And Healthcare

Poor infrastructures in developing countries such as Ethiopia and much of Sub-Saharan Africa have caused these nations to suffer from lack of efficient and effective delivery of basic and extended medical and healthcare services. Often, such limitation is further accompanied by low patient-doctor ratios, resulting in unwarranted rationing of services. Apparently, e-medicine awareness among both governmental policy makers and private health professionals is motivating the gradual adoption of technological innovations in these countries. It is argued, however, that there still is a gap between current e-medicine efforts in developing countries and the existing connectivity infrastructure leading to faulty, inefficient and expensive designs. The particular case of Ethiopia, one such developing country where emedicine continues to carry significant promises, is investigated and reported in this article.

scholarly journals Utilization of healthcare services among Chinese migrants in Kenya: a qualitative study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jialing Qiu ◽  
Duo Song ◽  
Juan Nie ◽  
Mengyi Su ◽  
Chun Hao ◽  
...  
Keyword(s):  
Health Services ◽  
Language Translation ◽  
Healthcare Services ◽  
Sub Saharan Africa ◽  
Local Health ◽  
Quality Healthcare ◽  
Healthcare Facilities ◽  
Chinese Migrants ◽  
Sub Saharan ◽  
Local Healthcare

Abstract Background The number of Chinese migrants in Sub-Saharan Africa (SSA) is increasing, which is part of the south-south migration. The healthcare seeking challenges for Chinese migrants in Africa are different from local people and other global migrants. The aim of this study is to explore utilization of local health services and barriers to health services access among Chinese migrants in Kenya. Methods Thirteen in-depth interviews (IDIs) and six focus group discussions (FGDs) were conducted among Chinese migrants (n = 32) and healthcare-related stakeholders (n = 3) in Nairobi and Kisumu, Kenya. Data was collected, transcribed, translated, and analyzed for themes. Results Chinese migrants in Kenya preferred self-treatment by taking medicines from China. When ailments did not improve, they then sought care at clinics providing Traditional Chinese Medicine (TCM) or received treatment at Kenyan private healthcare facilities. Returning to China for care was also an option depending on the perceived severity of disease. The main supply-side barriers to local healthcare utilization by Chinese migrants were language and lack of health insurance. The main demand-side barriers included ignorance of available healthcare services and distrust of local medical care. Conclusions Providing information on quality healthcare services in Kenya, which includes Chinese language translation assistance, may improve utilization of local healthcare facilities by Chinese migrants in the country.

Twentieth-Century Transformations in Notions of Gender, Parenthood, and Marriage in Southern Ghana: A Critique of the Hypothesis of “Retrograde Steps” for Akan Women

2001 ◽  
Vol 28 ◽  
pp. 15-41 ◽  
Author(s):  
Stefano Boni
Keyword(s):  
Twentieth Century ◽  
Gender Inequality ◽  
Social Order ◽  
Gender Relations ◽  
Marxist Theory ◽  
Sub Saharan Africa ◽  
Economic Determinants ◽  
Feminist Anthropology ◽  
Labor Division ◽  
Sub Saharan

In the course of the 1970s, one of the principal focuses of the emerging feminist anthropology was the reassessment of issues of gender inequality. Drawing their inspiration from Marxist theory going back to Engels, some works historicized female oppression and analyzed its political and economic determinants. To demonstrate that gender inequality was the product of specific historical formations, the observable gender relations were, at times, opposed to a prior egalitarian social order in which value differentiation was not attached to the gendered labor division (e.g., Leacock 1981). The approach was criticized by those who believed that female subordination characterized present and past societies on which solid documentary evidence was available (e.g., Rosaldo 1974). The idea that gender realtions in some non-western societies were marked by parity prior to the degradation produced by colonization was not abandoned, however, and influenced neighboring disciplines.Recent studies concerned with the transformations of gender relations in sub-Saharan Africa over the twentieth century tend to stress the decline in social and economic position of women. Ethnographic, economic, and historical studies state that the traditional value attached to being female is threatened by the economic and political developments of the last century. Women are said increasingly to lose their previous independence, to have to cater for children and elderly by themselves, and to lose ground in productive activities (Robertson and Berger 1986; Mikell 1997a; Baerends 1998).

scholarly journals “I wish to remain HIV negative”: Pre-exposure prophylaxis adherence and persistence in transgender women and men who have sex with men in coastal Kenya

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244226
Author(s):  
Makobu Kimani ◽  
Elise M. van der Elst ◽  
Oscar Chirro ◽  
Elizabeth Wahome ◽  
Fauz Ibrahim ◽  
...  
Keyword(s):  
Risk Behaviour ◽  
Healthcare Services ◽  
Transgender Women ◽  
Situational Factors ◽  
Sub Saharan Africa ◽  
Sexual Risk Behaviour ◽  
Sub Saharan ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis

Background Transgender women (TGW) and men who have sex with men (MSM) in sub-Saharan Africa have high HIV acquisition risks and can benefit from daily pre-exposure prophylaxis (PrEP). We assessed PrEP adherence by measuring tenofovir-diphosphate (TFV-DP) levels and explore motives for PrEP persistence in TGW and MSM. Methods Participants were enrolled in a one-year PrEP programme and made quarterly visits irrespective of whether they were still using PrEP. At their month 6 visit, participants provided a dried blood spot to test for TFV-DP levels; protective levels were defined as those compatible with ≥4 pills per week (700–1249 fmol/punch). Before TFV-DP levels were available, a sub-set of these participants were invited for an in-depth interview (IDI). Semi-structured IDI topic guides were used to explore motives to uptake, adhere to, and discontinue PrEP. IDI data were analyzed thematically. Results Fifty-three participants (42 MSM and 11 TGW) were enrolled. At month 6, 11 (20.7%) participants (8 MSM and 3 TGW) were lost to follow up or stopped taking PrEP. Any TFV-DP was detected in 62.5% (5/8) of TGW vs. 14.7% of MSM (5/34, p = 0.01). Protective levels were detected in 37.5% of TGW (3/8), but not in any MSM. Nineteen IDI were conducted with 7 TGW and 9 MSM on PrEP, and 1 TGW and 2 MSM off PrEP. Unplanned or frequent risky sexual risk behaviour were the main motives for PrEP uptake. Among participants on PrEP, TGW had a more complete understanding of the benefits of PrEP. Inconsistent PrEP use was attributed to situational factors. Motives to discontinue PrEP included negative reactions from partners and stigmatizing healthcare services. Conclusion While MSM evinced greater adherence challenges in this PrEP programme, almost 40% of TGW were protected by PrEP. Given high HIV incidences in TGW these findings hold promise for TGW PrEP programming in the region.

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