The Covid-19 cascade of care in Mexico: symptoms, positivity, and health care seeking decisions amid the pandemic

Objective. The study describes health care services utilization contextualized by the needs of the Mexican population during the Covid-19 pandemic. Materials and methods. We used data from the National Health and Nutrition Survey, Covid-19. Among the population with symptoms compatible with Covid-19, we describe the proportion who sought care, received care, were tested, were diagnosed positive, and survived, and whether they received care in public or private services. We estimated factors associated with the probability of seeking and receiving care. Results. Out of 7.1% of the population with symptoms compatible with Covid-19, 64.4% received care, and 15.4% tested positive; 74.5% received care in the private sector, even among the population with social security. Those with social security, in contact with a suspected or confirmed Covid-19 case, and with at least one comorbidity had a higher probability of seeking and receiving care. Conclusions. The most relevant finding of our study is the large proportion of the population with Covid-19 symptoms who sought and received care in private facilities an essential aspect for decision-makers to consider as the current health reform moves forward in Mexico.

Health Care Services Utilization of Persons with Direct, Indirect and without Migration Background in Germany: A Longitudinal Study Based on the German Socio-Economic Panel (SOEP)

There is ambiguous evidence with regard to the inequalities in health care services utilization (HCSU) among migrants and non-migrants in Germany. The aim of this study was to analyze the utilization of doctors and hospitalization of persons with direct and indirect migration background as well as those without in Germany. This study was based on data of the German Socio-Economic Panel using the adult sample of the years 2013 to 2019. HCSU was measured by self-reported utilization of doctors and hospitalization. Associations between HCSU and migration background were examined using multilevel mixed-effects logistic regression and zero-truncated multilevel mixed-effects generalized linear models. The odds ratios of utilization of doctors and hospitalization for persons with direct migration background compared with persons without migration background were 0.73 (p < 0.001) and 0.79 (p = 0.002), respectively. A direct migration background was associated with a 6% lower number of doctoral visits within three months compared with no migration background (p = 0.023). Persons with direct migration background still have a lower HCSU than persons without migration background in Germany. Access to health care needs to be ensured and health policy-makers are called upon to keep focus on the issue of inequalities in HCSU between migrants and non-migrants in Germany.

Maternal health care services utilization amidstCOVID-19 pandemic in West Shoa zone, central Ethiopia

The novel coronavirus (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Despite strong efforts that have been taking place to control the pandemic globally, the virus is on the rise in many countries. Hence, this study assessed the maternal health care services utilization amidst the COVID-19 pandemic in West Shoa zone, Central Ethiopia. A community-based cross-sectional study was conducted among 844 pregnant women or those who gave birth in the last 6 months before the study. A multi-stage sampling technique was used to select the study participants. The data were collected through face-to-face interviews using a semi-structured questionnaire. Logistic regressions were performed to identify the presence of significant associations, and an adjusted odds ratio with 95%CI was employed for the strength and directions of association between the independent and outcome variables. A P-value of <0.05 was used to declare statistical significance. The prevalence of maternal health service utilization during the COVID-19 pandemic was 64.8%. The odds of maternal health service utilization was higher among mothers who had primary (AOR = 2.16, 95%CI: 1.29–3.60), secondary (AOR = 1.97, 95%CI: 1.13–3.44), and college and above education (AOR = 2.89, 95%CI: 1.34–6.22) than those who could not read and write. Besides, mothers who did travel 30–60 minutes (AOR = 0.37, 95%CI: 0.23–0.59) and 60-90minutes (AOR = 0.10, 95%CI: 0.05–0.19) to reach the health facility had a lower odds of maternal health service utilization than those who did travel <30 minutes. Moreover, mothers who earn 1000–2000 (AOR = 3.10, 95%CI: 1.73–5.55) and > 2000 birrs (AOR = 2.66 95%CI: 1.52–4.64) had higher odds of maternal health service utilization than those who earn <500 birrs. Similarly, the odds of utilizing maternal health service were higher among mothers who did not fear COVID-19 infection (AOR = 2.79, 95%CI: 1.85–4.20), who had not had to request permission from husband to visit the health facility (AOR = 7.24, 95%CI: 2.65–19.75), who had practicedCOVID-19 prevention measure (AOR = 5.82, 95%CI: 3.87–8.75), and used face mask (AOR = 2.06, 95% CI: 1.28–3.31) than their counterpart. Empowering mothers and creating awareness on COVID-19 preventionis recommended to improve maternal health service utilization during the COVID-19 pandemic.

Maternal health care services utilization in the amid of COVID-19 pandemic in West Shoa Zone, Central Ethiopia

The novel coronavirus (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Despite strong efforts that have been taking place to control the pandemic globally, the virus is on the rise in many countries. Hence, this study assessed the maternal health care services utilization in the amid of the COVID-19 pandemic in West Shoa Zone, Central Ethiopia. Community-based cross-sectional study was conducted among 844 pregnant women or those gave birth in the last 6 months before the study. A multi-stage sampling technique was used to select the study participants. The data were collected through face-to-face interview using a semi-structured questionnaire. Logistic regressions were performed to identify the presence of significant associations, and adjusted odds ratio with 95%CI was employed for the strength and directions of association between the independent and outcome variables. A P-value of <0.05 was used to declare statistical significance. The prevalence of maternal health service utilization during the COVID-19 pandemic was 64.8%. The odds of maternal health service utilization was higher among mothers who had primary (AOR=2.16, 95%CI: 1.29-3.60), secondary (AOR=1.97, 95%CI: 1.13-3.44), and college and above education (AOR=2.89, 95%CI: 1.34-6.22) than those who could not read and write. In addition, mothers who did travel 25-74 km (AOR= 0.37, 95%CI: 0.23-0.59) and 75-99 km (AOR= 0.10, 95%CI: 0.05-0.19) to reach health facility had a lower odds of maternal health service utilization than those who did travel < 24 km. Moreover, mothers who earn 1000-2000 (AOR= 3.10, 95%CI: 1.73-5.55) and > 2000 birr (AOR=2.66 95%CI: 1.52-4.64) had higher odds of maternal health service utilization than those who earn <500 birr. Similarly, the odds of utilizing maternal health service were higher among mothers who did not fear COVID-19 infection (AOR= 2.79, 95%CI: 1.85-4.20), who had not had to request permission from husband to visit the health facility (AOR= 7.24, 95%CI: 2.65-19.75), who had practiced COVID-19 prevention measure (AOR=5.82, 95%CI: 3.87-8.75), and used face mask (AOR= 2.06, 95% CI: 1.28-3.31) than their counterpart. Empowering mothers and creating awareness on the COVID-19 prevention is recommended to improve maternal health service utilization during the COVID-19 pandemic.