Understanding the Influence of Socioeconomic Environment on Paediatric Antiretroviral Treatment Coverage: Towards Closing Treatment Gaps in Sub-Saharan Africa

Adeyinka, Daniel A; Evans, Meirion Rhys; Ozigbu, Chamberline E; Woerden, H. van; Adeyinka, Esther F; Oladimeji, Olanrewaju; Aimakhu, Chris; Odoh, Deborah; Chamla, Dick

doi:10.21101/cejph.a4479

Cited by 2 publications

(1 citation statement)

References 16 publications

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“…Ecological studies are used to measure population-level variables and to influence policy at a regional and national scale. 41 Recognising gender social norms as pervasive in the environment and influential beyond the individual, an ecological study was deemed an appropriate design for this research question. However, it is well recognised that associations at the ecological level may not be seen at an individual level.…”

Section: Discussionmentioning

confidence: 99%

Association between gender social norms and cardiovascular disease mortality and life expectancy: an ecological study

Lyell¹,

Khan²,

Limmer³

et al. 2023

BMJ Open

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ObjectiveExamine the association between country-level gender social norms and (1) cardiovascular disease mortality rates; (2) female to male cardiovascular disease mortality ratios; and (3) life expectancy.DesignEcological study with the country as the unit of analysis.SettingGlobal, country-level data.ParticipantsGlobal population of countries with data available on gender social norms as measured by the Gender Social Norms Index (developed by the United Nations Development Programme).Main outcome measuresCountry-level female and male age-standardised cardiovascular disease mortality rates, population age-standardised cardiovascular disease mortality rates, female to male cardiovascular disease mortality ratios, female and male life expectancy at birth. Outcome measure data were retrieved from the WHO and the Institute for Health Metrics and Evaluation. Multivariable linear regression models were fitted to explore the relationship between gender social norms and the outcome variables.ResultsHigher levels of biased gender social norms, as measured by the Gender Social Norms Index, were associated with higher female, male and population cardiovascular disease mortality rates in the multivariable models (β 4.86, 95% CIs 3.18 to 6.54; β 5.28, 95% CIs 3.42 to 7.15; β 4.89, 95% CIs 3.18 to 6.60), and lower female and male life expectancy (β −0.07, 95% CIs −0.11 to −0.03; β −0.05, 95% CIs −0.10 to −0.01). These results included adjustment within the models for potentially confounding country-level factors including gross domestic product per capita, population mean years of schooling, physicians per 1000 population, year of Gender Social Norms Index data collection and maternal mortality ratio.ConclusionsOur analysis suggests that higher levels of biased gender social norms are associated with higher rates of population cardiovascular disease mortality and lower life expectancy for both sexes. Future research should explore this relationship further, to define its causal role and promote public health action.

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Section: Discussionmentioning

confidence: 99%

Association between gender social norms and cardiovascular disease mortality and life expectancy: an ecological study

Lyell¹,

Khan²,

Limmer³

et al. 2023

BMJ Open

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Universal Health Coverage for Antiretroviral Treatment: A Review

Endalamaw

Gilks

Ambaw

et al. 2022

Infectious Disease Reports

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Universal health coverage is essential for the progress to end threats of the acquired immunodeficiency syndrome epidemic. The current review assesses the publication rate, strategies and barriers for antiretroviral therapy (ART) coverage, equity, quality of care, and financial protection. We searched Web of Science, PubMed, and Google Scholar. Of the available articles, 43.13% were on ART coverage, 40.28% were on financial protection, 10.43% were on quality of care, and 6.16% were on equity. A lack of ART, fear of unwanted disclosure, lack of transportation, unaffordable health care costs, long waiting time to receive care, and poverty were barriers to ART coverage. Catastrophic health care costs were higher among individuals who were living in rural settings, walked greater distances to reach health care institutions, had a lower socioeconomic status, and were immunocompromised. There were challenges to the provision of quality of care, including health care providers’ inadequate salary, high workload and inadequate health workforce, inappropriate infrastructure, lack of training opportunities, unclear division of responsibility, and the presence of strict auditing. In conclusion, ART coverage was below the global average, and key populations were disproportionally less covered with ART in most countries. Huge catastrophic health expenditures were observed. UHC contexts of ART will be improved by reaching people with poor socioeconomic status, delivering appropriate services, establishing a proper health workforce and service stewardship.

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Understanding the Influence of Socioeconomic Environment on Paediatric Antiretroviral Treatment Coverage: Towards Closing Treatment Gaps in Sub-Saharan Africa

Abstract: Low paediatric ART coverage continues to hamper progress towards eliminating AIDS-related deaths in HIV-infected children. Achieving this requires full commitment to a broad range of socioeconomic development goals.

Cited by 2 publications

References 16 publications

Association between gender social norms and cardiovascular disease mortality and life expectancy: an ecological study

Association between gender social norms and cardiovascular disease mortality and life expectancy: an ecological study

Universal Health Coverage for Antiretroviral Treatment: A Review

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