health service utilization among older population in a terai region of nepal

Abstract Introduction The world is heading towards a larger proportion of older population, indicating an increased risk of diseases, disability, and advanced ageing before death as well as the demand for the health system. Methods This study is a community based cross-sectional study, total 329 older people aged 60 years and above were surveyed. Two stage cluster-sampling technique was used. Semi structured questionnaire was used for data collection. Results Current study showed that 63.3% of the older population have utilized health services in the past one year. Multivariate analysis showed that, respondents with basic education and secondary education are 0.3(AOR: 0.31, 95% CI: 0.17-0.56) and 0.14 (AOR: 0.14, 95% CI: 0.83-0.26) times less likely to utilize health services, respectively. Similarly, respondents reporting current personnel income above forty thousand are 2.8 (AOR:2.81 95% CI:1.84-4.31) times more likely to utilize health services. Respondents at risk of malnutrition are 2.1(AOR: 2.18, 95% CI: 1.14-4.17) times more likely to utilize health services, similarly undernourished respondents are 3.3 (AOR:3.35,95% CI:1.50-7.51) times more likely to utilize health services as compared to respondents with normal nutritional status. Respondents with chronic disease condition are 11.8 (AOR: 11.89, 95% CI: 6.81-20.74) times more likely to utilize health services as compared to those with no chronic disease condition when holding other variables constant. Conclusions There is urgent need to highlight the problems faced by the older population as regards health service utilization and dealing with the identified factors associated with health service utilization among the older population should receive high priority. Key messages • Municipality and health facilities should create enabling environment for older population to get necessary health services. • Awareness program targeting the underprivileged ethnic groups and poor houses are recommended.


Background:
Cardiovascular diseases (CVD) and diabetes, referred to as ''cardiometabolic diseases'' (CMD), are a growing health issue in developing countries like Burkina Faso. As the first contact point with the national health system, primary health care must play a crucial role in CMD prevention and control. This study aimed to analyse the primary health care (PHC) system readiness for CMD prevention and treatment in Burkina Faso from 2012 to 2018. Methods: We performed repeated cross-sectional data analysis from health facility-based surveys, conducted in 2012, 2014, 2016, and 2018. These surveys were conducted using the World Health Organisation (WHO) Service Availability and Readiness Assessment (SARA) tool. The readiness of PHC for CMD was defined according to the SARA manual.

Results:
A total of 586 healthcare facilities were included in 2012, 659 in 2014, 567 in 2016, and 653 in 2018. Between 2012 and 2018, the percentage of healthcare facilities providing CMD specific care significantly increased (66.2% to 92.0% for CVD and 39.4% to 46.6% for diabetes). However, the mean readiness index of the PHC system to manage CVD decreased from 26.0% to 21.6% (p for trend<0.001). For diabetes, the overall readiness index increased significantly (from 34.2% to 37.5%, p = 0.005). The readiness index of PHC for CVD significantly decreased in all health regions particularly in the Sahel region (from 31.7% to 20.8%, p < 0.001). While, for diabetes, it increased in all the health regions excepted the Centre-Sud region (from 37.8% to 32.2%, p < 0.001).

Conclusions:
There is a low level of preparedness of PHC system to provide CMD in Burkina Faso. Although improvements for diabetes, this is not enough (80% availability of affordable basic technologies and essential medicines recommended by the WHO). Strengthening of the primary healthcare system considering the geographical disparities is urgently required for early detection and management of CMD.

Key messages:
There is a low level of readiness of PHC system to provide cardiometabolic healthcare in Burkina Faso. Public health policy makers must pay more attention to strengthening of the primary healthcare system to address the rising burden of CMD.

Background:
There is substantial evidence that infectious disease knowledge (IDK) predicts people's behavioral intentions and preventive practices. Since level of IDK varies across socio-economic contexts and imposes a substantial burden on vulnerable groups, we aimed to assess the relationship between sociodemographic factors and IDK in the adult population of Armenia.

Methods:
A cross-sectional nationwide phone survey was conducted in the capital Yerevan and all Armenian provinces in 2021, using a stratified two-stage cluster sampling to complete a sample of 3,483 respondents. The questions on socio-demographic characteristics and IDK were included in a multi-domain structured survey questionnaire. Four questions measured IDK; a summative IDK score (0-4) was used in bivariate and multivariate linear regression analysis.

Results:
Females constituted 71.0% of the sample. The mean age was 49.5 years. About 68% of the study participants had some vocational (12-13 years) or university degree education and 54.4% were employed. About one fifth of the respondents reported family monthly expenditures of less than 100,000 Armenian drams (AMD) $200, while the majority reported spending 101,000AMD to 400,000 AMD per month. The mean IDK score was 2.48. In the adjusted analysis, being female, holding a higher education level, being employed, having younger age and higher family monthly expenditures were positively associated with IDK score.