Absence Of Health Insurance Research Articles

Rural health care access and financing among cooperative members in rural Nigeria

Rural areas in developing countries have limited access to inclusive healthcare delivery and financing. Membership in cooperatives has been suggested as a pathway to rural health inclusiveness. However, whether cooperative membership supports rural health access and financing remains unclear. This study appraises rural healthcare access and financing, and whether membership in cooperative societies offers healthcare advantages to rural households in Nigeria. Primary data were collected in 45 rural communities consisting of 900 households as respondents. Healthcare access is limited among rural households with only 1.1% of pregnant women having access to maternity healthcare. Traditional healthcare access and self-medication exist (27%), in addition to the use of medicine stores (23.2%) and poorly equipped private medical facilities (13.8%) in rural areas. Cooperative organisations provide limited support to healthcare access (74%) for the members. Similarly, rural health financing support from the cooperative is almost non-existent (73.6%). There is a near absence of health insurance (90.8%) in rural areas. However, rural healthcare financing support for the employed exists (31.7%). Rural households find support for healthcare access from family (1.3%), personal savings, and sales of assets (16.2%) while the majority (82.5%) use herbs at no quantifiable cost to meet healthcare needs. Cooperative societies must be educated on the need to incorporate healthcare packages into their products for members. Rural healthcare policies should pay significant attention to how long it takes rural inhabitants to reach existing healthcare facilities.

Period poverty, reuse needs, and depressive symptoms among refugee menstruators in Jordan’s camps: a cross-sectional study

BackgroundPeriod poverty is a significant issue that impacts the physical and psychological well-being of menstruators worldwide which can further contribute to poor mental health outcomes. For menstruators living in refugee camps, access to menstrual hygiene products is often limited or non-existent, leading to increased anxiety, shame, and embarrassment. Therefore, this study aimed to assess the prevalence of the period poverty and to comprehensively analyze the association between period poverty, reusing menstrual products, and depressive symptoms among menstruators living in refugee camps in Jordan.MethodsA cross-sectional study surveyed refugee menstruators living in camps in Jordan, aged post-menarche to pre-menopause. Data collection included socio-demographics, menstrual practices, and depressive symptoms using the Patient Health Questionnaire (PHQ-9). Period poverty was assessed through affordability and frequency of struggles with menstrual products. Chi-squared test, independent sample t-test, One Way Analysis of variance (ANOVA) followed by Post hoc, and logistic regression models were used in the analysis.ResultsThe study included a diverse sample of 386 refugee menstruators living in camps in Jordan (mean age 32.43 ± 9.95, age range 13–55). Period poverty was highly prevalent, with 42.0% reporting monthly struggles to afford menstrual products, and 71.5% reusing menstrual products. Univariate analysis revealed that experiencing period poverty was significantly associated with a younger age of marriage, increased number of children, lower education level, lower mother and father education levels, unemployment, decreased monthly income, absence of health insurance, lower reuse need score, and increased PHQ-9 score (p < 0.05). Menstruators experiencing monthly period poverty were 2.224 times more likely to report moderate to severe depression compared to those without period poverty (95% CI 1.069–4.631, P = 0.033).ConclusionThis study highlights a significant association between period poverty and depressive symptoms among refugee menstruators in living in camps in Jordan, as high rates of period poverty were associated with a 2.2-fold increased likelihood of reporting moderate to severe depression. Addressing period poverty in refugee settings is crucial for mitigating depression risks and enhancing overall well-being.

The association between glaucoma treatment adherence with disease progression and loss to follow-up

Prospective cohort study from Brazil to evaluate glaucoma treatment adherence using a medication event monitoring system (MEMS) device and correlate with glaucoma progression and loss to follow-up (LTF) after one year of follow up. We included primary open glaucoma (POAG) patients treated with at least one ocular hypotensive eye drop. MEMS devices was used to monitor adherence for 60 days and evaluate the percentage of doses prescribed taken within the 60-day period. We classified patients according to rates of adherence: low adherence (less than 75% from MEMS measurements) and high adherence (more than 75% from MEMS measurements). We applied a questionnaire to investigated self-reported behavior towards treatment behaviors (glaucoma treatment compliance assessment tool, GTCAT). We also correlated rates of treatment adherence with clinical, demographical variables and the occurrence of glaucoma progression or LTF after one year of observation. We included 110 POAG patients and found that 28.18% of them were considered low adherent. We identify several variables associated with poor adherence such as glaucoma progression, LTF, younger age, low educational and income levels, absence of health insurance, years of disease and peak intraocular pressure. Several constructs from the self-reported GTCAT were also correlated with the rates of treatment adherence. To date, this is the first study in Latin America to evaluate glaucoma treatment adherence with MEMS devices and correlate adherence rates with glaucoma progression and LTF. We found a low-adherence rate of 28.18% and several additional risk factors were statistically associated with poor adherence.

Pediatric traumatic brain injury in chad: about 256 cases

PurposePediatric traumatic brain injury (PTBI) is a frequent pathology in the pediatric environment and remains a public health concern in the world. PTBI is the leading cause of death and severe disability in children in countries with limited pediatric trauma legislation. The objective is to report the experience of the management of PTBI in children in Chad.MethodsThis report is a prospective study of 256 patients admitted for PTBI over a year period.ResultThe incidence was 19.09%. The mean age was 6.2 years with extremes of 1 day and 15 years. The male represented 68.8% with a ratio of 2.2. The transport of the injured patients to health facilities using other means than ambulances in 87.5%. Initial loss of consciousness (IOL) accounted for 79.1% and coma seizures for 34.37%. Public road accidents accounted for 64.5% of causes. Severe traumatic brain injury (TBI) accounted for 24.2%. The cerebral scanner was performed in 37.9% of cases and had shown the association of craniocerebral lesions in 10.1% of cases. Craniocerebral wound trimming was the most common surgical procedure performed in 21.8% of cases, followed by removal of the depressed fracture of skull in 6.2% of cases. Mortality rate was 9% and sequelae 5.4%.ConclusionPTBI is a frequent neurosurgical pathology in the pediatric setting in Chad. The absence of health insurance in our context makes access to care and radiological examinations very difficult. The prognosis was conditioned by the rapidity of the management and the initial loss of consciousness.

Gestational Diabetes and Poor Healthcare Affordability Among Pregnant Women: A Double Whammy!

The prevalence of Gestational Diabetes Mellitus (GDM) is increasing at a rapid pace globally. This is concerning because GDM can lead to serious health problems like Type 2 Diabetes, Cardiovascular Diseases, and Depression in both the mother and her baby. GDM also increases healthcare expenditure during and after pregnancy and this is particularly worrisome for women belonging to households with poor healthcare affordability. Given the rising prevalence of GDM and its adverse impact, it is crucial to identify its risk factors and explore the factors associated with healthcare affordability among pregnant women. Our work attempts to identify the association between lifestyle (exercise, fruit, and vegetable consumption), sociodemographic factors, and Gestational Diabetes. Second, attempts to investigate the determinants of Health care affordability among pregnant women. Multivariate stepwise logistic regression is used for investigation purposes. We found Depression, higher BMI, and lower fruit intake to be associated with higher odds of GDM among pregnant women. Whereas the presence of GDM, lower socioeconomic position, absence of health insurance, and single motherhood were found to be associated with poor healthcare affordability. Lifestyle and mental health are associated with the GDM risk in pregnant women. Marital status, health insurance, and socioeconomic position are associated with healthcare affordability among pregnant women. The study can aid in better health outcomes for pregnant women and the creation of inclusive health policies.

Health and Demographic Factors for Chronic Obstructive Pulmonary Disease Among Hispanic Adults in the United States: Analysis of Behavioral Risk Factor Surveillance System Survey Data.

Introduction: Appropriate diagnosis and regular primary care appointments are markers of quality chronic obstructive pulmonary disease (COPD) care. Underdiagnosis of COPD has been associated with an absence of health insurance, lower socioeconomic status, and race and ethnicity. Methods: This study examined predictors of COPD using data from the Behavioral Risk Factor Surveillance System (BRFSS, 2021) to provide information for prevention messaging and interventions. Participants included Hispanic adults (n = 17,782) aged 45 years and older. Chi-square tests and a multinomial logistic regression analysis (adjusted with the BRFSS weighting variable) were used to understand how sex, income, health status, smoking behaviors, asthma morbidity, and health insurance coverage were related to having COPD. Results: Patients with poor health, lower income level, current smokers, former smokers, or asthma were more likely to report COPD. Females were more likely to report COPD than males. Patients with COPD were more likely to be without health insurance when compared to those who did not have COPD, indicating unmet medical needs. Conclusion: Studies such as this one, aiming to evaluate the relationship between COPD prevalence and predictors of health and outcomes among Hispanic patients in the United States will remain important for developing health messaging to attenuate disease progression.

Assessment of Out-of-Pocket Expenditure on Noncommunicable Diseases in Urban Slum of Mysuru City

Abstract Background: Noncommunicable diseases (NCDs) are the leading cause of death and disability globally, and the burden is expected to grow rapidly in developing countries. In the absence of health insurance, public provisioning, and donor funds, the management and treatment of NCDs such as hypertension and diabetes might result in very large out-of-pocket expenditures (OOPEs) for households. Objectives: The objectives were as follows: to estimate OOPE and to study the association between sociodemographic characteristics and OOPE among patients suffering from NCDs. Materials and Methods: The sample size was estimated based on a mean OOPE of 63.5 Indian rupees (INR), with a standard deviation (SD) of 110 INR, a sample size of 464 was obtained, and individuals with NCDs were interviewed. Results: Of the total 464 participants, 325 (70%) were female and 139 (30%) were male, with a mean (SD) age of 55.78 ± 13.204. Three hundred and two (65.1%) participants were having hypertension and 232 (50%) were having diabetes. The mean total OOPE was 1173.0603 (INR), with a SD of 1424.54108 (INR), and the mean direct cost incurred was 1141.03. The mean (SD) direct cost spent for medication was 895.61 ± 1100.32, for the laboratory was 148.38 ± 440.7, and for consultation was 97.04 ± 113.86. Only 34 (7.7%) participants were having health insurance. There was an association between the OOPE and sociodemographic profiles such as occupation, educational status, and economic status where the P (&lt;0.05) was noted as P = 0.004, P = 0.024, and P &lt; 0.001, respectively. Conclusion: Knowledge and awareness about health insurance scheme and their benefits help in reducing the OOPE.

Mortality due to traffic accidents in Colombia: Profiles of pedestrians and cyclists, 1998-2019

Background: Traffic accidents are an important issue for public health and a threat for sustainable development, with pedestrians and cyclists having been recognized as the most vulnerable actors on the streets. The objective of this study was to analyze the profiles of pedestrians and cyclists who died as a result of traffic accidents in Colombia during the 1998-2019 period. Methods: An observational and descriptive study, with the deaths due to traffic accidents in Colombia between 1998 and 2019 as data source. Secondary data were taken from the Vital statistics of Colombia (EEVV), published by Departamento Administrativo Nacional de Estadística (DANE). A trend analysis of the number of deaths during the period under study was performed, and such number was examined against sex to identify potential differences. Multiple correspondence analysis was employed to elaborate the profile of pedestrians and cyclists who die due to traffic accidents. Three profiles were prepared for each road actor: a global profile, one for 1998, and another for 2019. Results: The mortality profiles are different for pedestrians and cyclists, and, in turn, there are also demographic, geographic, and socioeconomic conditions in each type of road actor, which determine higher mortality risks. High population density, younger age group in the cyclists and adults among the pedestrians, low schooling levels and absence of health insurance are suggested as key factors in these profiles. Related to sex, for men is not possible to establish a profile. Women's cases are commonly related to health insurance, age, and population density. Conclusions: Several contextual and demographic characteristics in pedestrians and cyclists allow delimiting mortality profiles. The profiles that were identified suggest the need to articulate road safety policies with other social and development policies in order to coordinate and integrate intersectoral actions that reduce mortality in these road actors.

Association between medication regimen complexity and glycemic control among patients with type 2 diabetes

IntroductionType 2 diabetes mellitus (T2DM) and comorbid conditions require patients to take complex medication regimens. Greater regimen complexity has been associated with poorer T2DM management; however, the relationship between overall regimen complexity and glycemic control is unclear. ObjectivesOur objectives were: (1) to examine associations between regimen complexity (with the Medication Regimen Complexity Index [MRCI]) and glycemic control (A1C), and (2) to compare overall MRCI with other measures of regimen complexity (overall and diabetes-specific medication count) and diabetes-specific MRCI. MethodsThis was a secondary data analysis of cross-sectional data from a parent trial. Participants were patients with T2DM taking at least 3 chronic medications followed in safety net clinics in the Chicago area. The MRCI measures complexity based on dosing frequency, route of administration, and special instructions for prescribed medications. MRCI scores were created for overall regimens and diabetes-specific medications. Sociodemographics and outpatient visit utilization were included in models as covariates. Linear regression was used to examine the associations between variables of interest and hemoglobin A1C. ResultsParticipants (N = 432) had a mean age of 56.9 years, most were female (66.0%), and Hispanic or Latino (73.3%). Regimen complexity was high based on overall medications (mean = 6.6 medications, SD: 3.09) and MRCI (mean = 21.4, SD: 11.3). Higher diabetes-specific MRCI was associated with higher A1C in bivariate and multivariable models. In multivariable models, overall MRCI greater than 14, fewer outpatient health care visits, male gender, and absence of health insurance were independently associated with higher A1C. The variance in A1C explained by MRCI was higher compared to medication count for overall and diabetes-specific regimen complexity. ConclusionsMore complex regimens are associated with worse A1C and measuring complexity with MRCI may have advantages. Deprescribing, increasing insurance coverage, and promoting engagement in health care may improve A1C among underserved populations with complex regimens.

Glycaemic control among type 2 diabetes patients in sub-Saharan Africa from 2012 to 2022: a systematic review and meta-analysis

BackgroundThere is an increased burden of diabetes globally including in sub-Saharan Africa. The literature shows that glycaemic control among type 2 diabetes patients is poor in most countries in sub-Saharan Africa. Understanding the factors influencing glycaemic control in this region is therefore important to develop interventions to optimize glycaemic control. We carried out a systematic review to determine the prevalence and factors associated with glycaemic control in sub-Saharan Africa to inform the development of a glycaemic control framework in the Democratic Republic of the Congo.MethodsWe searched five databases (African Index Medicus, Africa-Wide Information, Global Health, PubMed, and Web of Science) using the following search terms: type-2 diabetes, glycaemic control, and sub-Saharan Africa. Only peer-reviewed articles from January 2012 to May 2022 were eligible for this review. Two reviewers, independently, selected articles, assessed their methodological quality using Joanna Briggs checklists, and extracted data. A meta-analysis was performed to estimate the prevalence of glycaemic control. Factors associated with glycaemic control were presented as a narrative synthesis due to heterogeneity as assessed by the I2.ResultsA total of 74 studies, involving 21,133 participants were included in the review. The pooled prevalence of good glycaemic control was 30% (95% CI:27.6–32.9). The glycaemic control prevalence ranged from 10–60%. Younger and older age, gender, lower income, absence of health insurance, low level of education, place of residence, family history of diabetes, longer duration of diabetes, pill burden, treatment regimen, side effects, use of statins or antihypertensives, alcohol consumption, smoking, presence of comorbidities/complications, and poor management were associated with poor glycaemic control. On the other hand, positive perceived family support, adequate coping strategies, high diabetes health literacy, dietary adherence, exercise practice, attendance to follow-up, and medication adherence were associated with good glycaemic control.ConclusionSuboptimal glycaemic control is pervasive among patients with type-2 diabetes in sub-Saharan Africa and poses a significant public health challenge. While urgent interventions are required to optimize glycaemic control in this region, these should consider sociodemographic, lifestyle, clinical, and treatment-related factors. This systematic review and meta-analysis protocol is registered in PROSPERO under CRD 42021237941.

Access to health services and health inequalities in remote and rural areas

ABSTRACT&#x0D; Access to health care includes the availability, accessibility, awareness, accommodation or adequacy, affordability, and acceptability of health services. Scarce health facilities, long distances to health facilities, shortages of medicine, level of poverty, shortages of doctors, dentists, and other health professionals, level of education and knowledge among populace on orthodox treatment practices are factors that affects access to health care. Level of awareness among the populace of preventive and curative services offered by health facilities, absence of health insurance, and inability to afford the cost of health services are obstacles limiting rural people from recognizing and achieving the health and social related Sustainable Development Goals (SDGs), that requires that access to good quality healthcare is improved significantly in rural areas and under-served population.&#x0D; Health inequalities exist both between and within developed and developing countries, both between and within urban, semi-urban and rural areas. Health inequalities are determined by various socioeconomic factors: such as age, sex, race, ethnicity, education, income, social status, unemployment and place of residence of the population. The factors that give rise to, and worsen, inequalities in health are multidimensional. Interventions in addressing health inequalities would involve economic policies, strategic health planning, health education on avoidable risk factors for poor health, use of telemedicine/tele dentistry, and reduction of unmet healthcare needs among various population groups. Other interventions are poverty eradication interventions especially in remote and rural areas, healthcare financing through budgetary allocation, and improving access to health service through universal health coverage, with an organized and efficient health system.

Direct Cost of Primary Open Angle Glaucoma Management

Background: There are few studies on the cost of glaucoma management in developing country, especially in Togo, there are no data on the cost of POAG management. Aims: To determine the annual direct cost of the management of POAG, to evaluate the annual economic weight of the management of POAG and to determine the factors associated with the annual economic weight of the management. Methods: We conducted a retrospective and descriptive study over a period of 12 months from January 1 to December 31, 2019 based on the records of patients followed for POAG in AFIA Eye Clinic in Lomé-Togo. The annual direct cost was defined by the sum of the costs of consultations, explorations and treatments. We defined the direct cost per patient and per year and related to the average annual income. It was said to be catastrophic at 20% or more of the estimated annual income. Chi 2 and Fisher tested the comparison of proportions. We conducted univariate and multivariate logistic regression to search correlations. Results: During the study period, 150 patient records were included. The average age was 47.24 ± 17.09 years and the sex ratio was 0.82. The cost of the diagnosis was 112.18 ± 22.26 €. The average cost of consultations was 19.46 ± 11.35 € and that of explorations was 92.71 ± 10.91 €. The annual cost of treatment per patient was 165.52 ± 110.16 €. The annual global direct cost of POAG management per patient was 277.69 ± 132.42 €. Compared to the annual income of 1166.29 €, the economic weight of the glaucoma management was 23.8%. This direct cost was catastrophic for 32.1% of patients in the study (44/150 of people with no care). Compared to the guaranteed inter-professional minimum wage (SMIG) of 640.30 €, the economic direct cost weight was 43.3%. Risk factors significantly associated with the direct cost were age over 40 (OR = 1.05 and p = 0.032), liberal profession (OR = 4.72 and p = 0.04), the absence of health insurance (OR = 6.68 and p = 0.017) and the use carbonic anhydrase inhibitors (OR = 7.4 and p = 0.012) and prostaglandin analogues (OR of 38.2 and p < 0.001). Conclusion: This first study on the direct cost of POAG management in Lomé showed that the economic burden glaucoma represents for the patient, his family and society. The data from this study will allow health decision-makers to adopt strategies to mitigate the effects of glaucoma on the economy.

DEVELOPING AN ADVANCED MACHINE LEARNING AND INTERNET OF THINGS (IOT) BASED SYSTEM TO DEVISE AN EFFECTIVE HEALTHCARE MONITORING SYSTEM

An absence of health insurance every day likewise disguises medical problems. These issues often establish a danger to public wellbeing, which is generally ignored until past the point of no return. Subsequently, we have encouraged many standards to address and tackle the previously-mentioned issues. We constantly screen the essential organs in our framework impart information to cloud-based specialists, and ready patients for likely risks. We have designed and IOT Based framework that links various sensors to a microcomputer and stores data on to cloud server for SGD algorithm with a deep learning combination. If the specialist thinks of a medical condition, they might give a warning using our gadget in the wake of finishing the assessment. Our proposed approach works for Health Monitoring in IoT frameworks.

Determinants of Delayed Treatment-seeking for Diarrheal Diseases among Mothers with under-five Children in North Western Ethiopia, 2020: A case-control Study

Delays in seeking timely proper care pay a large number of deaths from diarrhea in children. Timely and appropriate health care seeking in under-five children with diarrhea reduces life-threatening complications. This study aimed to investigate determinants of delayed treatment-seeking for diarrheal diseases among mothers with under-five children. In Debre Markos public health facilities, a facility-based case-control study was conducted among 412 mothers ((137 cases and 274 controls) from September 1 to October 15, 2020. Consecutive sampling was employed to select cases and controls. Data was collected using a semi-structured interviewer-administered questionnaire. Data were entered into Epi- Data version 4.2.1 and exported to STATA version 14 for analysis. Predictors with P-value <0.25 in the bivariable logistic regression model were candidates for multivariable logistic regression. Pvalue <0.05 was used to declare statistical significance. Finally, results were presented in the form of texts and tables. From 412 selected participants, 408 mothers (136 cases and 272 controls) were included. Female children [AOR 1.85(95% CI 1.15-2.98)], Child age < 24 months [AOR 1.64 (95% CI 1.01-2.65)], mothers'/caregivers without formal education [AOR 4.61 (95% CI 2.03-10.44)], poorest wealth index category [AOR 4.24 (95% CI 1.90-9.48)], absence of health insurance [AOR 3.04 (95% CI 1.60-5.78)], and self-medication [AOR 3.6 (95% CI 1.75-7.4)] were determinants of delayed treatment-seeking. Being female, young age, educational status of the mother, lowest wealth index category, self-medication, and absence of health insurance were determinants of delayed treatment-seeking for diarrheal diseases. Preventive care programs should target age, low socioeconomic status, and a low educational class of the mother.

Trading risk for ambiguity: Production versus health under pesticide application

AbstractPesticide use reduces the variation in crop yields at the expense of potentially negative consequences to farmers and their family members. This article examines the trade‐off between decreasing production risk and increasing health ambiguity because of pesticide use. We find that under ambiguity, pesticide application decreases the variation in health outcomes, whereas under risk, it decreases the expected value of health outcomes. Health insurance protects health from the pesticide damage but not from the ambiguity effect of pesticide application, and the optimal choice of pesticide application does not depend on the farmer's health preferences over risk or ambiguity. However, in the absence of health insurance, ambiguity can increase or decrease the optimal choice of pesticide compared to the risk case. This suggests that public policies around pesticide usage should be designed to reflect and account for the multitude of behavioral responses in the presence of ambiguity and risk.

Implementation of Human Rights Certification as an Application for the Protection of Human Rights to Workers in the Fisheries Industry

Introduction to the Problem: State responsibility is one of the important keys in the life of the state, one of which is in labor affairs. In its implementation, there are several records of human rights violations in the Indonesian Sea, namely Trafficking in Persons, Forced Labor/Slavery, Child Labor, Overtime, and the absence of health insurance. Objective: This research aims to analyze the regulations in Indonesia concerning the protection of human rights for workers in the fishing industry in Indonesia and whether the Fisheries Human Rights Certification under the Regulation of the Minister of Maritime Affairs and Fisheries Number 35 of 2015 has effectively grant human rights protection to workers in the field of fisheries fishing industry in Indonesia. Methodology: The research method used is juridical-normative. Findings: This study indicates that Human Rights Certification in the Fisheries Sector is one solution so that fishing companies meet the Human Rights criteria set by the Government but still need improvement in the context and implementation. Conclusion Research on Fisheries Human Rights Certification has not been effective in protecting workers in the fishing industry from a technical and conceptual perspective. Effectiveness can be improved if there is an evaluation of problems in the form of overlapping authorities between agencies, the seriousness of the Fisheries Human Rights Team in carrying out its authority. Paper Type: Research Article

Attitude and its Associated Factors among Adults towards Traditional Eye Medicine in Gondar City, Northwest Ethiopia: A Cross-sectional Study

Abstract Background: Traditional medicines are commonly practiced in Africa. It is believed to be alternative health care used in the developing world. It is a more widely available and affordable alternative to pharmaceutical drugs. In Africa, about 13.2- 82.3% of the population utilizes traditional eye medicine. This study aimed to assess attitude and its associated factors among adults towards traditional eye medicine in Gondar city, North West Ethiopia. Methods: A community-based cross-sectional study was conducted on 600 study participants using a pre-tested structured questionnaire. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 20 computer software. Association and strength between the outcome variable and independent variables were determined using the odds ratio with a 95 % confidence interval. Results: A total of 633 subjects were included in the study with a 95 % response rate. From the total study subjects, 292 (48.7 %) (95% CI: 44.7-52.7%)) had a good attitude towards traditional eye medicine use. Variables like being male (AOR=2.00(95% CI: 1.23-2.68)), family history of traditional eye medicine use (AOR=3.31(95% CI: 2.01-5.47)), availability of traditional healer (AOR=1.81(95% CI: 1.12-2.95)) and absence of health insurance (AOR=1.63(95% CI: 1.14-2.55)) were variables significantly associated with good attitude towards traditional eye medicine use. Conclusion: The result of this study shows that attitude towards traditional eye medicine use for the treatment of eye disease was fairly good. It indicates that almost half of the study participants had a good attitude towards traditional eye medicine use. Even though the attitude is fairly good, still it needs improvement. Male sex, family history of traditional eye medicine use, availability of traditional healers, and absence of health insurance had a statistically significant relationship with good attitude towards traditional eye medicine use. Community awareness creation through the joint up effort by the health ministry of Ethiopia and traditional healers about traditional eye medicine use can help to build the right perception and reduce the risk of complications. Keywords: Attitude, Traditional Eye Medicine, Gondar City, Ethiopia

Self-medication practice and contributing factors among pregnant women.

The practice of self-medication during pregnancy is a global challenge that necessitates high attention as it poses a potential threat to the pregnant mother and fetus. However, little is known regarding self-medication practice and its contributors among pregnant women in our setting. The main aim of this study was to investigate the practice of self-medication and its contributing factors among pregnant women. A cross sectional study was conducted among pregnant women at antenatal care follow-up of Ayder comprehensive specialized hospital, Tigray, Ethiopia. Written informed consent was obtained from each participant before interview. Simple random sampling technique was employed to recruit participants in to the study. Data were collected by interviewing participants using the structured questionnaire. Binary logistic regressions analysis was performed to determine the contributing factors of self-medication practice during pregnancy. A p value of less than 0.05 was considered as significant. A total of 250 pregnant women were included in the study. Of the total, 40.8% practiced self-medication during the current pregnancy. Morning sickness (39.2%), headache (34.3%), and upper respiratory tract infections (29.4%) were the leading indications for self-medication. According to participant report, ease of access to medicines (25.5%), feelings that the disease is minor (21.6%) and timesaving (19.6%) were the most commonly reported reasons for self-medication practice. Absence of health insurance (AOR: 2.75, 95%CI: 1.29-5.89) and being on first trimester of pregnancy (AOR: 2.44, 95%CI: 1.02-5.86) were significant contributors of self-medication practice among pregnant women. In our study, high prevalence of self-medication was reported among pregnant women. Self-medication practice during pregnancy was higher among pregnant women on first trimester and those who were not having health insurance. Therefore, intervention programs should be designed to minimize the practice of self-medication during pregnancy.

Factors Associated With Mental Suffering in the Brazilian Population: A Multilevel Analysis.

Purpose: To analyze how individual characteristics and the social context are associated with mental distress symptoms in the Brazilian population.Method: A multilevel cross-sectional study with data from the 2013 National Health Survey. There were two dependent variables: (a) decreased vital energy and somatic symptoms, (b) the presence of depressive thoughts. The independent variables were biological characteristics, education and income, habits and lifestyle, and context variables. Bivariate analysis was performed, and Prevalence Ratios calculated in a Poisson Regression (95% CI). A multilevel Poisson Regression was performed to verify the effect of individual and contextual variables.Results: Regarding depressive thoughts, young and middle-aged individuals, low education, women, absence of partner, smokers or former smokers, and absence of health insurance were the categories at highest risk; belonging to classes D-E and living in states with lower expected years of schooling proved to be protective factors. Similar results were found for the second outcome.Conclusions: Symptoms of mental distress were associated with the individual characteristics and contextual aspects of the federation unit. These findings indicate the importance of strengthening psychosocial care aimed at vulnerable groups.

How Legal Protection of Women in Home Workers Improving Family Welfare?

Homeworkers are work that is done at home either on the basis of orders from others or doing on the basis of oneself. This type of work is referred to as informal workers, which is clearly difficult to obtain legal protection. Labor laws in Indonesia provide legal protection for both formal and informal workers, but the practice for informal workers is difficult to obtain legal protection. This program aims to describe and analyze the legal protections of women homeworkers in Semarang City in their efforts to make their families prosperous. This program uses socialization methods, interviews, observation and documentation. This program is conducted in the city of Semarang. The results of this program can be seen that the protection of homeworkers is still very minimal, especially for independent homeworkers. The implementation of statutory regulations has not been optimal, especially in manpower laws. The government is still not optimal in providing legal protection for informal workers, especially for homeworkers. Low wages, long working hours and the absence of health insurance are among the elements that homeworkers need to improve and increase in their efforts to make their families welfare. In the effort to achieve welfare for homeworkers' families, it is necessary to carry out supervision and guidance for homeworkers. Supervision and guidance can be carried out by the central government, local governments, non-governmental organizations, the academic community, observers of labor.