| 1. |
- Blomstedt, Yulia, et al.
(författare)
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Measuring self-reported health in low-income countries : piloting three instruments in semi-rural Burkina Faso
- 2012
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Ingår i: Global Health Action. - Järfälla : Co-Action Publishing. - 1654-9716 .- 1654-9880. ; 5, s. 8488-
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Tidskriftsartikel (refereegranskat)abstract
- Background: National surveys in low-income countries increasingly rely on self-reported measures of health. The ease, speed, and economy of collecting self-reports of health make such collection attractive for rapid appraisals. However, the interpretation of these measures is complicated since different cultures understand and respond to the same question in different ways. Objective: The aim of this pilot study was to develop a culturally sensitive tool to study the self-reported health (SRH) of the local adult population in Burkina Faso. Design: The study was carried out in the 2009 rainy season. The sample included 27 men and 25 women aged 18 or older who live in semi-urban Nouna, Burkina Faso. Three culturally adapted instruments were tested: a SRH question, a wooden visual analogue scale (VAS), and a drawn VAS. Respondents were asked to explain their answers to each instrument. The narratives were analyzed with the content analysis technique, and the prevalence of poor SRH was estimated from the quantitative data by stratification for respondent background variables (sex, age, literacy, education, marital status, ethnicity, chronic diseases). The correlation between the instruments was tested with Spearman's correlation test. Results: The SRH question showed a 38.5% prevalence of poor SRH and 44.2% prevalence with both VAS. The correlation between the VAS was 0.89, whereas the correlation between the VAS and the SRH question was 0.60-0.64. Nevertheless, the question used as the basis of each instrument was culturally sensitive and clear to all respondents. Analysis of the narratives shows that respondents clearly differentiated between the various health statuses. Conclusion: In this pilot, we developed and tested a new version of the SRH question that may be more culturally sensitive than its non-adapted equivalents. Additional insight into this population's understanding and reporting of health was also obtained. A larger sample is needed to further study the validity and reliability of the SRH question and the VAS and understand which instrument is best suited to study SRH in the low-income setting of semi-rural Burkina Faso.
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| 2. |
- Murray, Natasha, et al.
(författare)
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Acceptability of impregnated school uniforms for dengue control in Thailand : a mixed methods approach
- 2014
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 7, s. 24887-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: As current dengue control strategies have been shown to be largely ineffective in reducing dengue in school-aged children, novel approaches towards dengue control need to be studied. Insecticide-impregnated school uniforms represent an innovative approach with the theoretical potential to reduce dengue infections in school children.OBJECTIVES: This study took place in the context of a randomised control trial (RCT) to test the effectiveness of permethrin-impregnated school uniforms (ISUs) for dengue prevention in Chachoengsao Province, Thailand. The objective was to assess the acceptability of ISUs among parents, teachers, and principals of school children involved in the trial.METHODOLOGY: Quantitative and qualitative tools were used in a mixed methods approach. Class-clustered randomised samples of school children enrolled in the RCT were selected and their parents completed 321 self-administered questionnaires. Descriptive statistics and logistic regression were used to analyse the quantitative data. Focus group discussions and individual semi-structured interviews were conducted with parents, teachers, and principals. Qualitative data analysis involved content analysis with coding and thematic development.RESULTS: The knowledge and experience of dengue was substantial. The acceptability of ISUs was high. Parents (87.3%; 95% CI 82.9-90.8) would allow their child to wear an ISU and 59.9% (95% CI 53.7-65.9) of parents would incur additional costs for an ISU over a normal uniform. This was significantly associated with the total monthly income of a household and the educational level of the respondent. Parents (62.5%; 95% CI 56.6-68.1) indicated they would be willing to recommend ISUs to other parents.CONCLUSIONS: Acceptability of the novel tool of ISUs was high as defined by the lack of concern along with the willingness to pay and recommend. Considering issues of effectiveness and scalability, assessing acceptability of ISUs over time is recommended.
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| 3. |
- Parmar, Divya, et al.
(författare)
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Does community-based health insurance protect household assets? Evidence from rural Africa
- 2012
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Ingår i: Health Services Research. - : Wiley. - 0017-9124 .- 1475-6773. ; 47:2, s. 819-839
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate whether community-based health insurance (CBHI) protects household assets in rural Burkina Faso, Africa. DATA SOURCES: Data were used from a household panel survey that collected primary data from randomly selected households, covering 41 villages and one town, during 2004-2007(n = 890). STUDY DESIGN: The study area was divided into 33 clusters and CBHI was randomly offered to these clusters during 2004-2006. We applied different strategies to control for selection bias-ordinary least squares with covariates, two-stage least squares with instrumental variable, and fixed-effects models. DATA COLLECTION: Household members were interviewed in their local language every year, and information was collected on demographic and socio-economic indicators including ownership of assets, and on self-reported morbidity. PRINCIPAL FINDINGS: Fixed-effects and ordinary least squares models showed that CBHI protected household assets during 2004-2007. The two-stage least squares with instrumental variable model showed that CBHI increased household assets during 2004-2005. CONCLUSIONS: In this study, we found that CBHI has the potential to not only protect household assets but also increase household assets. However, similar studies from developing countries that evaluate the impact of health insurance on household economic indicators are needed to benchmark these results with other settings.
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| 4. |
- Robyn, Paul Jacob, et al.
(författare)
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Econometric analysis to evaluate the effect of community-based health insurance on reducing informal self-care in Burkina Faso
- 2012
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Ingår i: Health Policy and Planning. - : Oxford University Press (OUP). - 0268-1080 .- 1460-2237. ; 27:2, s. 156-165
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE This study examines the role of community-based health insurance (CBHI) in influencing health-seeking behaviour in Burkina Faso, West Africa. Community-based health insurance was introduced in Nouna district, Burkina Faso, in 2004 with the goal to improve access to contracted providers based at primary- and secondary-level facilities. The paper specifically examines the effect of CBHI enrolment on reducing the prevalence of seeking modern and traditional methods of self-treatment as the first choice in care among the insured population. METHODS Three stages of analysis were adopted to measure this effect. First, propensity score matching was used to minimize the observed baseline differences between the insured and uninsured populations. Second, through matching the average treatment effect on the treated, the effect of insurance enrolment on health-seeking behaviour was estimated. Finally, multinomial logistic regression was applied to model demand for available health care options, including no treatment, traditional self-treatment, modern self-treatment, traditional healers and facility-based care. RESULTS For the first choice in care sought, there was no significant difference in the prevalence of self-treatment among the insured and uninsured populations, reaching over 55% for each group. When comparing the alternative option of no treatment, CBHI played no significant role in reducing the demand for self-care (either traditional or modern) or utilization of traditional healers, while it did significantly increase consumption of facility-based care. The average treatment effect on the treated was insignificant for traditional self-care, modern self-care and traditional healer, but was significant with a positive effect for use of facility care. Discussion While CBHI does have a positive impact on facility care utilization, its effect on reducing the prevalence of self-care is limited. The policy recommendations for improving the CBHI scheme's responsiveness to population health care demand should incorporate community-based initiatives that offer attractive and appropriate alternatives to self-care.
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| 5. |
- Yrjö-Koskinen, Jaakko, et al.
(författare)
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The Influence of Organizational Culture on Information Use in Decision Making within Government Health Services in Rural Burkina Faso
- 2010
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Ingår i: Nordic Journal of African Studies. - 1235-4481 .- 1459-9465. ; 19:4, s. 250-273
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Tidskriftsartikel (refereegranskat)abstract
- Efforts to build statistical capacity in the developing world have often failed to produce the expected increases in information use in management and planning. The ways in which culture influences evidence-informed and results-oriented decision making in organizations in low- and middle-income countries are not well understood. In this explorative study, a sample of health managers working in the public sector in a rural district in Burkina Faso was interviewed to elucidate the relationships between cultural dimensions at the organizational level, organizational practices, and the use of routine health information in decision making. Based on the results, a conceptual framework for these relationships is proposed, and strategies are suggested for overcoming cultural constraints to information use.
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