Background While access to healthcare has been a focus of international development, populations around the world continue to lack proper access to care. Identifying at-risk demographic groups can help advance efforts both regionally and internationally. There are only a small number of studies that previously have assessed physical barriers and attitudes in Nepal. Methods This study assessed the factors and attitudes associated with healthcare accessibility in a rural population outside of Lumbini, Nepal. This descriptive cross-sectional study used a volunteer-sampling approach to collect 585 questionnaire responses from the area formerly known as the Madhuwani Village Development Committee. Results The study found that the population was more likely to access private care than public, and reported longer times to access a hospital than the national average. Across almost all findings, those with lower than a secondary education had significantly larger barriers, lower satisfaction and higher reported difficulty in accessing healthcare. Females were shown to have significantly larger transportation barriers in accessing care and lower satisfaction compared with males. Conclusions Results identify women and the less-educated as having larger barriers to accessing healthcare. Further research should focus on how inequities in access affect health outcomes among these identified vulnerable groups.
Weather conditions, especially temperature and precipitation, play a critical role in shaping patterns of diarrhoeal diseases. They determine the frequency of outbreaks, and the spatial and seasonal distribution of cases. Not surprisingly, it is anticipated that the burden of diarrhoeal diseases will escalate with climate change, in tandem with gradual increments in mean temperatures, but also during episodic heatwaves. The degree and nature of this escalation will, however, vary with the mix of pathogens in an area, the quality of sanitation services, food hygiene regulations and their enforcement, and the age structure of the population, among other factors. Understanding these patterns can inform the design of measures to prevent and control heat-related diarrhoea. In this editorial, we sum evidence on the heat sensitivity of enteric infections in South Africa (SA) and other parts of sub-Saharan Africa (19 studies), drawing on articles located in a systematic review (methods detailed in Manyuchi et al. [1] ), and consider the implications of these findings for control of diarrhoea in SA in the context of climate change.Several mechanisms underlie the heat sensitivity of microbes. The reproduction, growth and survival rates of most microbes rise with temperature, within certain limits. Higher ambient temperatures accelerate contamination of food across the whole food chain, from preparation, processing and storage to eventual consumption. Importantly, on hot days people spend more time outdoors, and may eat food that is unrefrigerated and is raw or cold, rather than served cooked and hot. [2] Being outdoors also raises exposure to pathogens carried by birds, and farm and wild animals. Rural areas, per se, may be especially susceptible to heat-related impacts on diarrhoea. [3] Further, dust storms, especially frequent on hot and dry days, may settle dust particles with microbial contaminants onto vegetables and other fresh produce. Importantly, if power blackouts occur during hot weather -as we are currently seeing in SA and Venezuela -the integrity of food chains can be compromised, increasing risks of contamination.While 15 of the 19 papers identified in the review reported strong connections between heat exposure and cases of diarrhoea, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] 4 found negligible or even negative associations. [18][19][20][21] This inconsistency illustrates the complexity of pathways between temperature and infectious diseases. Indeed, these correlations are seldom linear and more frequently take an inverted U-shape, where diarrhoea rates rise with temperature, plateau and then decline. Relationships may also be J-shaped, where the incidence of diarrhoea remains stable below a certain temperature threshold, beyond which there is a rapid incline. Moreover, many enteric infections have seasonal patterns: rotavirus cases, for instance, classically occur in winter and campylobacteriosis peaks in spring. [18][19][20] Seasonal patterns are not solely related to climatic factors, however...
The 2015-2020 Nepali Government's National Health Sector Strategy notes that Muslims have the lowest rates of healthcare utilization in Nepal without specifications as to factors associated with the low rate. This study assessed physical barriers and attitudes towards accessing healthcare amongst a rural Muslim population in the Nepali terai. Significant results indicated that the Muslim population was more likely to utilize distant public care than closer private care, and experienced longer travel times than their Hindu counterparts. Muslims also reported significantly lower satisfaction in healthcare accessibility. Results from this study verify this gap and indicate that transportation, satisfaction, and private vs. public care may be important factors. Future research should aim to identify and address the underlying mechanisms that lead to these large equity gaps.
Obesity amongst children and adolescents is a growing problem worldwide. (1) Sport participation has been shown to increase physical activity amongst youth, and is thus a possible route to combat obesity. (2,3) The WHO European Childhood Obesity Surveillance Initiative (COSI) was established in 2008 to systematically measure childhood obesity in the European region. Ireland is one of the countries that contributes to COSI. (1) In the Irish study, data from 979 Irish primary school children who attended third class in 2010, who underwent anthropometric assessment and whose parents filled out questions on sports participation were included (response rate: 57•3 % of all children whose parents consented to the study). The objective was to identify what factors are associated with sport participation. Parents filled out a questionnaire on several factors including the child's intake frequency of several food items, physical activity/ inactivity patterns, and family's socioeconomic characteristics. Backwards stepwise binary logistic models were used to determine predictors of sport participation (no vs yes), and number of days participating in sport per week (<3 days vs ⩾3 days). All variables that were significant up to a p-value of 0•10 in Chi-square analyses were included in the regression models. Most of the children participated in sports (89•8 %) and over half did so for 3 days or more in a week (52•5 %). There was no statistically significant difference in sport participation based on gender. Children who participated in sports were statistically significantly more likely to spend ⩾2 hours playing outside over weekend days (OR[95 %CI]:1•95[1•10-3•45]), and less likely to live in rented accommodation vs owned accommodation (OR[95 %CI]:0•14[0•08-0•24]). Children who participated ⩾3 days in sports were also more likely to spend ⩾2 hours playing outside over weekend days (OR[95 %CI]:2•00[1•32-3•00]), were less likely to live in rented accommodation (OR[95 %CI]: 0•27[0•15-0•51]), less likely to live in rural areas (OR[95 %CI]:0•56[0•38-0•81]), and less likely to watch TV for ⩾2 hours per week day vs never (OR[95 %CI]:0•36[0•18-0•75]). In the current study, both physical activity and socioeconomic status factors were associated with sport participation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.