Access and Cost of Education and Health Services

of the countries that have the same economic and social conditions, and according to results of the last and recent Labour Survey conducted by the Central Agency for Public Mobilization and Statistics (CAPMAS) in collaboration with the International Labour Organization (ILO) with the sample 20 thousands households) in 2010, the number of working children in the age group ( 5-17 years) is about 1.6 million and the increasing number of these working children in rural areas is clearly ( 83.8 % ) than in urban areas (16.2%). This study aimed to identify the phenomenon of child labour and its relationship to the availability and quality of education and health services in both rural Upper and Lower Egypt. The study asked what causes the phenomenon of child labour, the importance of the availability of education and health services with child labour, what perception proposed to solve the problem of child labour? The assumptions are there is a relationship between child labour and the economic situation of the household, there is a relationship between child labour and the availability and quality of educational services, and there is a relationship between child labour and the availability of health services. Child Labour is a person who is aged ( 7-17 ) years ' male or female , carries on the activity contributing to the production regularly full-time or part-time. Random sample of 409 households was conducted in rural of both the Lower and Upper Egypt. One child was selected from each household (311 working children and 98 children does not work). Some other surveys are used such as Income, Expenditure & Consumption Household Survey, Child Labour Survey conducted by CAPMAS and other administrative sources (Statistical Yearbook issued by the Ministry of Education, Ministry of Health and Population). The results of the field study confirmed what has been concluded by the previous studies in identifying poverty as the essential reason to the spread of child labour. The region which registered the highest poverty rate is characterized by the highest rate of child labour, There is relationship between child labour and the level of educational services as measured by density class and the teacher's share of pupils and this is shown in rural areas more than urban. The region, which is characterized by high employment rates for children, is characterized with not good educational services; Dropping out of education is an important reason for increasing child labour, so regions characterized by high dropping out of education rates are also characterized by high child labour rates Child labour supposed to accompany the availability of health services, but the administrative data did not show this relationship, for example Upper Egypt is characterized by highest employment rate of the children and less of the availability of health services as measured by the rate of hospital beds and the rate of medical doctors per ten thousand of the population. For the field study, the data showed that the high rates of child labour are in places which are close to places of treatment and this confirms how important to work in these places .

Young people’s Sexual and Reproductive Health (SRH) services in Nigeria are limited and there are issues of affordability and accessibility of these health services. Also, there are limited studies in Nigeria on the barriers to accessing and utilizing SRHS in the Nigerian healthcare sector. Furthermore, even when the services are provided they are not sensitive to the needs of young people. Hence, this study aims to assess the barriers to the availability and accessibility of sexual reproductive health services (SRHS) for young people living with sexually transmitted infections (STIs) in Abia State, Nigeria. Study Aim: To make recommendations for removing assess barriers to effective sexual and reproductive health services for young people living with STIs in southeast Nigeria. Methodology: A systematic review of 14 studies comprising 9 qualitative studies, 3 mixed methods, 1 quantitative and 1 cross-sectional study. The inclusion criteria were primary studies written in the English language which assessed barriers to SRH services while the exclusion criteria were the secondary studies and primary studies which did not access barriers to accessibility and availability of SRHS for young people. A total of 4, 705 participants from different African countries formed the sample size. Findings: Results showed that young people have little or no insight into STIs and their services. Moreover, they experienced different levels of barriers ranging from the negative and judgmental attitude of healthcare providers, stigma, cost, availability and accessibility of healthcare services as well as lack of integration of services and privacy and confidentiality. These are the major barriers that discourage young people from accessing SRH services. Also, experiences of fear and shame were reported as common barriers to utilizing care. Conclusion: Sensitizing the SRH needs of young people can enhance access to healthcare services. Therefore, there is a need to improve uptake and address the negative attitude of healthcare providers, as well as the issue of confidentiality, which will help to improve SRH service utilization among young people. Also, it is recommended that teaching health care professionals about these STI prevention centers will be the main solution to improve the preventive practice to reduce STI incidence in young people in Nigeria.

This study examines the level and distribution of service costs-and their association with functional impairment at baseline and over time-for persons with mental disorder receiving integrated primary mental health care. The study was conducted over a 12-month follow-up period in five low- and middle-income countries participating in the Programme for Improving Mental health carE study (Ethiopia, India, Nepal, South Africa and Uganda). Data were drawn from a multi-country intervention cohort study, made up of adults identified by primary care providers as having alcohol use disorders, depression, psychosis and, in the three low-income countries, epilepsy. Health service, travel and time costs, including any out-of-pocket (OOP) expenditures by households, were calculated (in US dollars for the year 2015) and assessed at baseline as well as prospectively using linear regression for their association with functional impairment. Cohort samples were characterized by low levels of educational attainment (Ethiopia and Uganda) and/or high levels of unemployment (Nepal, South Africa and Uganda). Total health service costs per case for the 3 months preceding baseline assessment averaged more than US$20 in South Africa, $10 in Nepal and US$3-7 in Ethiopia, India and Uganda; OOP expenditures ranged from $2 per case in India to $16 in Ethiopia. Higher service costs and OOP expenditure were found to be associated with greater functional impairment in all five sites, but differences only reached statistical significance in Ethiopia and India for service costs and India and Uganda for OOP expenditure. At the 12-month assessment, following initiation of treatment, service costs and OOP expenditure were found to be lower in Ethiopia, South Africa and Uganda, but higher in India and Nepal. There was a pattern of greater reduction in service costs and OOP spending for those whose functional status had improved in all five sites, but this was only statistically significant in Nepal.

Autism requires individualized services to maximize full and effective participation in society. Legal mandates facilitate coordination of health and education services for children with autism. Descriptive correlation was utilized to describe the health and education services initiated by the parents of children with autism in an urban locality in the Philippines, which has no legal framework for services specific to them. Likert-type questionnaires gathered data from purposively sampled respondents. There is selective utilization of health and education services for children with autism. The parent’s number of children, income, and level of education significantly varied how they perceived educational programs and health services. Different aspects of educational services correlated with the availed health services. Accessibility and availability of health and educational services must be improved. Study more on health and education services’ impact on children with disabilities at different levels of education and health care system.

Background. The Urban Family Physician Program (UFPP) has been implemented in Fars and Mazandaran provinces of Iran since 2013 with the aim of improving access and utilization of health services, with a particular focus on children and adolescents. In order to evaluate the effectiveness of the program in achieving this goal, this study aimed to compare the access and utilization of health services among children living in areas covered by the UFPP with those living in other regions of Iran. Methods. A secondary analysis was performed using data from the 2015 National Health Utilization Survey. The data of people aged under 18 were extracted and indicators on the use of health services based on three main models of health service provisions were compared: (1) cities in Fars and Mazandaran provinces (UFPP implemented); (2) cities in other Iranian provinces (excluding Fars and Mazandaran); and (3) villages and cities with a population under 20,000. Results. The study included 20,689 children. The outpatient and inpatient visits in children living in Fars and Mazandaran provinces were higher than in children from other provinces and smaller towns (11.89 vs. 7.92 and 7.21 for outpatient and 4.74 vs. 3.51 and 4.27 for inpatient, respectively). Furthermore, UFPP was found to be associated with a higher utilization of health services in children residing in cities (odds ratio=1.50 (1.98-1.15)). Additionally, the cost of outpatient and inpatient health services in areas where the UFPP was implemented was lower compared to other parts of the country. Conclusion. The urban family physician program has been successful in increasing the access to health services and reducing health costs in children. Practical Implications. The findings suggest that the urban family physician program can be an effective strategy for improving healthcare access and reducing costs, especially in areas with high population density. Policymakers and healthcare providers can use the results of this study to inform the development and implementation of similar programs in other countries, with the aim of improving healthcare access and reducing healthcare costs in children and adolescents.

IntroductionEpilepsy places a large burden on health systems, with hospitalisations for seizures alone occurring more frequently than those related to diabetes. However, the cost of epilepsy to the Australian health...

To present first findings of a cost-of-illness (COI) information system implemented in Nouna health district, Burkina Faso. The entire project will include household and provider tangible COI, whereas this article concentrates on the development of a provider cost information system in rural first-line health facilities. Special forms and reports are prepared to routinely collect capital and recurrent costs of first-line facilities. Inventory lists are designed, and buildings and equipment are assessed by engineers. Total, fixed, variable and average costs are calculated for 15 rural health centres with five cost centres: general outpatient consultation, ambulatory nursing care, deliveries, immunization and other services (neonatal consultation, child care and family planning). In 2003, the average costs per service unit were 1.34 US$ for a general consultation, 0.51 US$ for ambulatory nursing care, 6.73 US$ per delivery, 3.64 US$ per vaccination and 1.11 US$ per service unit of other care. On average, a health centre consumes 29,900 US$ per year for a catchment population of 10,000 inhabitants. The major share of costs is fixed and does not depend on the workload of the health centre. Consequently, the costs of first-line facilities will hardly increase if the demand for health services rises. These findings can be used to improve the health financing in Nouna health district, Burkina Faso.

Introduction: A sexually transmitted infection (STI) is an infection caused by viruses, bacteria, fungi, or parasites that people can acquire through unprotected sexual contact. Sexually transmitted infections (STIs) continue to pose a significant public health challenge, particularly impacting young individuals and men who have sex with men. Sexually transmitted infections (STIs) present a danger to all demographic groups, with those aged 20–24 being particularly vulnerable. While abstinence is the only method that offers complete protection against STIs and unplanned pregnancies, consistently using condoms is the most effective alternative. Globally, it is estimated that 374 million sexually transmitted infections occur annually. Over 30 different bacteria, viruses, and parasites are known to be transmitted through sexual contact, including vaginal, anal, and oral sex. Additionally, some STIs can be passed from mother to child during pregnancy, labour, childbirth, and breastfeeding. Sexually Transmitted Infections (STIs) remain a significant public health challenge, particularly in developing regions such as Monze District, Zambia. Objectives: This study aims to investigate the behavioral risk factors associated with the transmission of sexually transmitted infections (STIs) among sexually active people in Monze District, Zambia. It also seeks to assess the availability and accessibility of sexual health services, including testing and treatment, within the Monze District of Zambia. Methods: This study utilized a cross-sectional study design to assess transmission dynamics and healthcare responses to sexually transmitted infections among sexually active people in Monze district, Zambia. Ethical approval for this study was sought from CHRESO University Research and Ethics Committee, Texila American University, and Monze District Health Office respectively. Apart from that, a simple random sampling technique was utilized to select 271 respondents in randomly selected health facilities to participate in the study. Participants who voluntarily gave their consent were given a questionnaire to fill out. A structured questionnaire was used for data collection, which was then analyzed using Statistical Package for Social Sciences (SPSS) version 28.0 and presented in tables. Multivariate logistic regression analysis was applied to examine the relationships between socio-demographic characteristics and the parameters for the transmission dynamics and healthcare response to sexually transmitted infections among sexually active people in Monze district. Results: The study disclosed that, most of the respondents (82.3%) believed that having sex while drunk or having multiple sexual partners (86%) increases the risk of acquiring STIs. The study also disclosed that, only 43.2% of respondents are in monogamous relationships, and 25.5% reported having three or more sexual partners in the past year, suggesting potential for increased risk behaviors. The findings from this study also exposed that, only 19.2% of respondents reported always using condoms during sexual intercourse. The study also demonstrated that, 81.9% of study participants were aware of common modes of STIs transmission, while 18.1% were unaware of common modes of STI transmission in Monze district of Zambia. The study further revealed that, most of the respondents (67.9%) have sought sexual health services while a good proportion of study participants (32.1%) did not seek health services in the health facilities in Monze district. This is an indication of a significant engagement with the healthcare system. The findings from this study also demonstrate that, the perceptions of the availability of sexual health services vary, with a notable portion of study participants rating it as good (41%) while 9.6% of study participants rated them as poor. In addition, despite the majority (65.3%) finding sexual health services affordable, a non-negligible proportion (15.9%) of respondents perceive them as expensive. Not only that, a good proportion of study participants (18.8%) were not sure whether the sexual health services were affordable or not. A good proportion (75.3%) of study participants were aware of the locations of STI testing and treatment centers. Not only that, more than half of the respondents (55.7%) report facing barriers when seeking sexual health services. The most common barriers to sexual health services faced by the people in Monze district include lack of information (49.5%), negative attitudes of healthcare providers towards patients and clients (27.8%), cost of health services (10.3%), and stigma and discrimination (9.2%). Conclusion: All in all, the study disclosed that, a substantial majority of respondents (82.3%) believe that engaging in sexual activities while intoxicated and having multiple sexual partners (86%) increases the risk of acquiring sexually transmitted infections (STIs), yet only 43.2% are in monogamous relationships, with 25.5% having had three or more sexual partners in the past year. Only 19.2% consistently use condoms during sexual intercourse, indicating a need for public health intervention. While 81.9% of participants are aware of common STI transmission modes, 18.1% still lack this crucial knowledge. More so, the majority (67.9%) of study participants have sought sexual health services, though 32.1% have not, highlighting varied engagement levels with the healthcare system. Perceptions of sexual health services are mixed, with 41% rating them as good and 9.6% as poor. The study further disclosed that 65.3% find services affordable while 15.9% perceive them as expensive, and 18.8% are unsure about the costs. A significant proportion (75.3%) of respondents are aware of STI testing and treatment centers' locations; however, more than half (55.7%) face barriers in accessing these services, primarily due to lack of information (49.5%), negative attitudes of healthcare providers (27.8%), cost (10.3%), and stigma and discrimination (9.2%). The author recommends that, there is need to enhance public health awareness campaigns via radio, television, and social media platforms to disseminate messages that challenge myths and misconceptions about STIs and promote positive attitudes among healthcare providers towards the respondents. This can also be done through health fairs, workshops, and community theater performances to increase awareness about STI transmission and prevention, and to promote consistent condom use. Additionally, developing community-based initiatives such as peer education and support groups formation is vital to combat stigma and discrimination and create a supportive environment for all the people in the community.

The objective this study was to estimate the cost of cancer treatment services for 5 common types of cancer (Breast, Esophageal, Colorectal, Stomach and lung) by the public sector and patients. This study was a cross-sectional study that conducted using the medical records of patients who were registered in the Jamhuriyat Hospital from 1, 2020 to 12, 2020. The prevalence-based approach was used to estimate the costs of five major cancer types. The data of 769 patients were eligible to include for the analysis. The considered cost of services was obtained from the average cost in 3 private hospitals in Kabul. Also all costs converted in to US dollar using the exchange rate of each USD equaling to AFN 77 in 2020. The data was analyzed using Ms. Excel Program. The total number of patients with 5 types of cancer were 769. Of these, female, in the age group of 40-60 years and were illiterate. The most common cancers based on the cancer treatment services’ costs of health services was breast cancer, followed by esophagus, colorectal, stomach and lung. Moreover, the most common cancers based on the cancer treatment services’ costs of health services which cancer patients needed was breast cancer, followed by esophagus, colorectal, stomach and lung. Moreover, total cost of cancer treatment is US$590,662.98, in which Patients paid USD 82,537 of it out-of-pocket. The costs of cancer treatment services for 5 common types of cancer are high which a considerable portion are paid by patients. There is a need for the government to pay more attention to the provision of these services and to increase the centers providing these services and the existing facilities. Also, support of the international community in this process can enable more people to access these services and reduce the economic burden on patients.

Issues in Medicaid Policy and System Transformation: Recommendations From the President's Commission

The National Health Insurance (JKN) program aims to improve access to health services and achieve universal health coverage for all Indonesians. However, there are still several issues related to access and quality of health services that have not been resolved, one of which is health service seeking behavior, which is one of the important principles of the JKN program. The method used in this research is a literature study by collecting and processing previous research data with a range of 2018-2022, consisting of 5 national articles and 1 international article. The search process was carried out through the Central Bureau of Statistics database, Google Scholar, and PubMed. The results of this study are the factors that influence people's behavior in seeking health services in the JKN program in Indonesia are divided into 3 main factors, namely predisposing factors, enabling factors, and need factors. In addition, there are other factors such as sociocultural beliefs, perceptions of disease and its causality, cost, and accessibility and availability of health services, especially in rural areas.

Educational risk, recidivism, and service access among youth involved in both the child welfare and juvenile justice systems

Health and access to health services of rural-to-urban migrant populations in Viet Nam

ObjectivesOur Health Counts (OHC) methods are designed to address gaps in urban-based Indigenous health information. In partnership with local Indigenous health service providers, we have successfully implemented OHC in six Ontario cities. The aim of this study is to summarize findings regarding Indigenous population undercount, health inequities, and health service access barriers across study sites.MethodsWe estimated Indigenous population size using OHC census participation survey responses and a multiplier approach. Health inequities between Indigenous populations and overall populations in each city were examined using respondent-driven sampling (RDS), adjusted OHC survey results, and existing public data. Measures included health status outcomes; determinants of health; barriers to health service access, including discrimination by health service providers; and unmet health needs.ResultsIndigenous social networks were strong and extensive, and the urban populations demonstrate resilience and cultural continuity across multiple measures. Self-reported rates of census participation for Indigenous populations were markedly lower than those for the general population in each city, and OHC Indigenous population size estimates were consistently 2‒4 times higher than reported in the census. Indigenous to general population health inequities cut across measures of chronic disease, determinants of health, and unmet health needs. Indigenous populations experienced multiple barriers to health services access, including racial discrimination by health service providers.ConclusionThe Canadian census appears to markedly underestimate Indigenous population size in urban areas. Indigenous health inequities and service access barriers are striking and cross-cutting. Timely adaptation of health policies, services, and funding allocations in response to these findings is recommended.

Using the nationally representative Gender Productivity Survey (GPS) of 2007/08 conducted by the Uganda Bureau of Statistics (UBoS), the paper examines gender biases in school attainment, returns to education, expenditure on health and education, access to health services. While Uganda has recorded progress on MDG 3: promote gender equality and empower women, the paper reveals that significant gender biases still exist with a regional dimension. These biases are more pronounced in Northern Uganda, which is the poorest region. In other words, interventions in this part of the country should be able to address these biases if the region is to catch up with the rest of the country. These findings further suggest that free education both at primary and secondary level; and abolition of user fees in public health facilities is not sufficient for elimination of gender bias. Policies should be based on a better understanding of the household’s decision making process.