Household Residents Research Articles

Implementation and acceptance of government-sponsored malaria control interventions in Meghalaya, India

BackgroundIndia has made considerable progress in malaria reduction over the past two decades, with government-sponsored indoor residual spraying (IRS) and insecticide-treated bed net (ITN) or long-lasting insecticidal nets (LLIN) distribution being the main vector-related prevention efforts. Few investigations have used non-participant observational methods to assess malaria control measures while they were being implemented, nor documented people’s perceptions and acceptance of IRS or LLINs in India, and none have done so in the northeast region. This study evaluated household (HH)-level operation of IRS and distribution of LLINs by India’s National Vector Borne Disease Control Programme (NVBDCP) in 50 villages of Meghalaya state, and documented their acceptance and use.MethodsStudy field teams accompanied the government health system teams during August-October, 2019 and 2020 to observe deployment of LLINs, and record HH-level data on LLIN numbers and use. In addition, NVBDCP spray teams were followed during 2019–2021 to observe IRS preparation and administration. HH members were interviewed to better understand reasons for acceptance or refusal of spraying.ResultsA total of 8386 LLINs were distributed to 2727 HHs in 24 villages from five Primary Health Centres, representing 99.5% of planned coverage. Interviews with 80 HH residents indicated that they appreciated the LLIN dissemination programme, and generally made regular and appropriate use of LLINs, except during overnight travel or when working in agricultural fields. However, HH-level IRS application, which was observed at 632 HHs, did not always follow standard insecticide preparation and safety protocols. Of 1,079 occupied HHs visited by the spray team, 632 (58.6%) refused to allow any spraying. Only 198 (18.4%) HHs agreed to be sprayed, comprising 152 (14.1%) that were only partly sprayed, and 46 (4.3%) that were fully sprayed. Reasons for refusal included: inadequate time to rearrange HH items, young children were present, annoying smell, staining of walls, and threat to bee-keeping or Eri silk moth cultivation.ConclusionsThese findings are among the first in India that independently evaluate people's perceptions and acceptance of ongoing government-sponsored IRS and LLIN programmes for malaria prevention. They represent important insights for achieving India's goal of malaria elimination by 2030.

Residents' perception of living environments and self-rated health status

The relationship between health status and living environment conditions among residents of high-rise housing massifs and individual households was assessed by means of a questionnaire survey-interviewing. Results determined that residents of multi-story buildings had a greater number of individuals classified as frequently ill, but the differences were not significant because of the wide variation in age and gender: 40.9±12.9% (multi-story buildings) and 21.5±2.4% (Individual households), t=1.4, P>0.05. Responding to the question about what citizens attribute the likelihood of their illnesses to, the majority of respondents answered that it is related to unfavorable living conditions (53.8±13.0% of residents of multi-story buildings and 54.8±14.2% of residents of individual houses, P>0.05). The greatest number of respondents considered it necessary to improve recreational opportunities, ranging from 46.8% to 60.6%, with such wishes being more common among those over 55 years of age. Individuals of younger age, especially those living in an array of multi-story buildings, more often express the need for sports fields or complexes.

Housing Instability in an Era of Mass Deportations

The current era of mass deportation has disrupted a record number of families and households in immigrant communities. In most cases, when a parent is deported, the rest of the family stays in the United States. Among those who remain in the US, deportations can have broad ramifications for housing stability. I use linear regression models with metro area and year-fixed effects to examine metro residents responding to the Current Population Survey (2013–2016) and merge these observations with contextual, administrative data from the implementation of a national immigration enforcement program (Secure Communities). I find metro residents in shared households (i.e., households with multiple families) are more likely to experience housing instability in high deportation areas. The positive association between instability and deportations holds only among residents in Hispanic households where noncitizens are present. By contrast, other residents—including those living with non-Hispanic noncitizens, Hispanic U.S. citizens, or non-Hispanic U.S. citizens—are not more likely to report instability in high deportation metros. I discuss possible explanations for these findings and the implications of this study for housing inequality.

Support for a vaccination documentation mandate in British Columbia, Canada

BackgroundIn recent years, Canadian provinces have been discussing, implementing, and tightening vaccination “mandate” policies for school enrolment. British Columbia (BC), Canada’s westernmost province, implemented a Vaccination Status Reporting Regulation (VSRR) in September 2019, which requires the vaccination status of children in public, private, and home schooling be reported to a provincial vaccination registry and education for parents who refuse to vaccinate. Legal vaccination mandates can carry the risk of backlash, thereby making it important to monitor public attitudes across policy implementation windows. The present study aimed to evaluate public support for this new provincial mandate following implementation. MethodsAn online panel of BC adults (n = 1301) was surveyed about 15 vaccine-promotion policy options in April 2020 following mandate implementation. Respondents were representative of the provincial population by gender, age, geographic residence, and percentage of households with children younger than 19 years of age. Poisson regression was used to estimate predictors of policy endorsement, and support for the VSRR. ResultsStrong support existed for the VSRR with 88.2% of respondents agreeing or strongly agreeing that parents should be required to provide their children’s immunization records at school entry, and 74.6% supporting required education sessions for parents who refuse to vaccinate their children. Overall, the sample was supportive of vaccination, and pro-vaccine attitudes were associated with strong agreement for nearly all vaccine policy options. Policies to impose rewards (e.g., tax credits) and penalties (e.g., fines) were the least likely to receive strong agreement from respondents. ConclusionsNear the end of the first school year in British Columbia subject to the Vaccination Status Reporting Regulation, support for both the mandated documentation and mandated education elements of the policy are high, and associated with pro-vaccine attitudes. There are not marked differences in strong support based on gender, age, parenting, education level, or income.

Spatial Analysis of Socioeconomic Inequality of Opportunity in Access to Skilled Birth Attendant in Punjab, Pakistan

Maternal mortality is a critical global public health issue, particularly in developing countries like Pakistan. Interventions to improve mothers’ usage of skilled birth attendant (SBA) may reduce maternal mortality. The aim of this work to conduct the spatial analysis of socioeconomic inequality of opportunity in access to SBA in districts of Punjab, Pakistan and explore the circumstance variables that contribute the most to the socioeconomic inequality. The study is conducted by using Punjab's Multiple Indicator Cluster Survey 2017-18 and the data analyzed are taken from women of 15 to 49 years with a live birth in the last 2 years. The Human Opportunity Index is used to measure the coverage rate, inequality, and universal access of opportunity across the districts of Punjab. Further, Shapley Decomposition is utilized to identify the contribution of the circumstance factors to the inequality. It is noted that most of the southern districts of Punjab have poor coverage rates and low universal access to SBA and northern districts have high coverage and universal access for the SBA. There is also higher inequality in southern districts of Punjab. Further, in decomposition analysis, it is found that household wealth status, ANC, birth order, birth interval, household head education, ethnicity, media access and residence were the most significant factors leading to socioeconomic inequality of opportunity across the districts of Punjab. Based on the findings, it is suggested that the government should prioritize equitable resource allocation, particularly in southern Punjab.

The Effect of the Image of Destinations on Household Income and Distribution: Evidence From China’s Tourist Cities

This paper examines the effect of the image of destinations on the wage income of resident households, and the corresponding income inequality, from a novel perspective. This work uses China’s excellent tourism city image program, which is an urban planning policy implemented by the central government across cities to enhance the image of the city destination in the minds of tourists, and then promote tourist motivation and local tourism development to assess the effect on household wage income and its distribution. Results show that the program significantly increases household wage income by increasing employment opportunities, promoting business and population agglomeration, and improving urban infrastructure. Additionally, the image of the city destination promotion causes an increase in income inequality among households.

Please sort out your rubbish! An integrated structural model approach to examine antecedents of residential households’ waste separation behaviour

A pro-environmental behaviour to solve the problem of household waste and achieve sustainable municipal solid waste management is waste separation behaviour (WSB). As part of pro-environmental behaviour, WSB is argued to be influenced by rational decision-making approach (i.e. the theory of planned behaviour [TPB]) and moral norms approach (i.e. norm activation model [NAM]). Drawing from the integration of the TPB and the NAM along with the addition of a moderator i.e. ‘local government support’ as an external predictor of WSB, a new model was developed. Using structural equation modelling, this study tested the integrated structural model amongst 1697 household residents in the city of Joondalup, Australia. The SmartPLS results indicated that the personal norm, social norms and perceived behavioural control were found to be the major factors influencing residents towards WSB while both attitudes and local government support were unexpectedly found to have no significant influence thereon. Furthermore, the perceived behavioural control was found to have the highest effect on WSB. This indicates the more Joondalup residents feel confident and capable of sorting the waste at source, they will be more driven towards sorting their waste using the three-bin system. These findings are useful for promoting and planning WSB by policy-makers to ease the waste disposal problem.

Climate variability, water supply, sanitation and diarrhea among children under five in Sub-Saharan Africa: a multilevel analysis.

Climate variability is expected to increase the risk of diarrhea diseases, a leading cause of child mortality and morbidity in Sub-Saharan Africa (SSA). The risk of diarrhea is more acute when populations have poor access to improved water and sanitation. This study seeks to determine individual and joint effects of climate variation, water supply and sanitation on the occurrence of diarrhea among children under five in SSA using multilevel mixed-effect Poisson regression including cross-level interaction. We merged 57 Demographic and Health Surveys (DHS) from 25 SSA countries covering the period 2000-2019 with climatic data from the DHS geolocation databases. The results of the research indicate that 77.7% of the variation in the occurrence of diarrhea in Sub-Saharan households is due to climatic differences between clusters. Also, a household residing in a cluster with a high incidence of diarrhea is 1.567 times more likely to have diarrhea cases than a household from a cluster with a low incidence. In addition, when average temperature and rainfall increase, households using unimproved sanitation or unimproved water have more cases of diarrhea. For SSA, the results of the multilevel analysis suggest the adoption at both levels; macro (national) and micro (household), of climate change adaption measures in the water sector to reduce the prevalence of diarrhea.

Impact of COVID-19 shocks, precarity and mediating resources on the mental health of residents of share housing in Victoria, Australia: an analysis of data from a two-wave survey

ObjectivesCOVID-19 lockdown measures have challenged people’s mental health, especially among economically vulnerable households. The objective of this study was to investigate the impact of exposure to COVID-19 shocks (defined as...

Limited access to improved drinking water, unimproved drinking water, and toilet facilities among households in Ethiopia: Spatial and mixed effect analysis.

BackgroundMost people in sub-Saharan countries had limited drinking water services and toilet facilities. The collection of water can affect the health of the whole family, particularly children. Therefore this study aims to investigate determinants of limited access to drinking water services and spatial distributions of limited access to drinking water services, unimproved drinking water sources, and toilet facilities among households in Ethiopia.MethodCross-sectional collected secondary data analysis was conducted based on the 2016 Ethiopian Demographic and Health Survey (EDHS). A mixed-effect logistic regression model was used for analysis. The total weighted sample of 10, 183 households was included in the analysis. The study population is comprised of all households who had recorded the time taken to fetch improved drinking water during the survey. The primary outcome of this study is the proportion of households that have limited access to drinking water services. Whereas the secondary outcomes are determinants of limited access to drinking water services and spatial distributions of limited drinking water services, unimproved drinking water sources, and toilet facilities among households in Ethiopia.ResultsIn this study, 39.74% [95% CI: 38.79, 40.69] of households in Ethiopia had limited access to drinking water services. This proportion ranges from 2.64% in Addis Ababa to 57.35% in the Somali region. Household head, education, residence, and regions were associated with limited access to drinking water services. The spatial analysis showed that the eastern part of Amhara, Afar and the Somali region predicted the highest limited drinking water services. The unimproved drinking water source was detected in the Central part of Amhara, Somalia regions. Almost all regions except Addis Ababa and Diredewa predicted the highest prevalence of unimproved toilet facilities.ConclusionAccess to improved drinking water is relatively poor throughout Ethiopia, with some regions experiencing more limited access than others. From individual level variables age, educational level, and sex household head, whereas from community level variables residences, and region were factors significantly associated with access to limited drinking water services. The spatial analysis confirmed that there are inequalities in unimproved drinking water sources, and toilet facilities between regions in Ethiopia. The government of Ethiopia should work to increase the accessibility of improved drinking water at the national level and to narrow the gap in its accessibility between urban and rural residences and between regions. Accessibility to drinking water programs should focus on the disadvantaged group such as non-educated, male head households and living rural residences. All stalk holders should work to improve the quality of drinking water and sanitation facilities.

Children’s Health and Asset Endowments in Cameroon

This study attempts to carry out a comprehensive analysis on “children’s health and asset endowments (AE) in Cameroon”. The objective is to examine the effects of child health on household asset endowments. From the Control Function Model, we compute the result using the combined 2004/2011 demographic and health survey. The result of the Control function shows that child health is positively and significantly associated with the production of HAE. In addition, the relationship between child health and asset indicator is a matter of the male gender while decomposing child health effect on AE for household residence, we realized that it is more an issue of rural household residence due to inadequate provision of public goods. In terms of policy, child health should be included in the new vision of successful asset building so that, families raising children with good health, asset accumulation should start early and last long.

Understanding community awareness, knowledge and perceived importance of Land-Use Plans and Village Land Forest Reserves in the context of REDD+ in Tanzania

Knowing the community level of awareness and knowledge of village participatory land use plans (VPLUPs) and village land forest reserves (VLFRs) and their perceived importance thereof, can form a way of improving the plans and forests governance in the context of Reduced Emissions from Deforestation and Forest Degradation (REDD+), a global initiative to climate change measure. Thus, this study assessed community awareness, knowledge and perceived importance of VPLUPs and VLFRs in a REDD+ initiative in Tanzania. A mixed-method research design was adopted to collect data through participatory-community mapping (4 cases), focus group discussions (12 cases), key informant interviews (12 cases), direct observation and household interviews (328 cases). Results revealed that respondents were significantly aware of VPLUPs and VLFRs and were well-informed about VLFRs. However, they were ill-informed about the specified procedures of conducting VPLUPs. The community attached high value to VPLUPs and VLFRs. The residence period and household size of respondents emerged as the most important factors that significantly drive community awareness of VPLUPs and VLFRs respectively. The study recommends the use of the strategy (participatory approach) employed by the project proponents to implement VPLUPs and VLFRs.

Recognition of diabetes and sociodemographic predictors: results of a cross-sectional nationwide population-based survey in Singapore

ObjectiveTo assess recognition of diabetes among a nationally representative multiethnic sample of Singapore’s general public. Also, to explore the sociodemographic predictors associated with the ability to correctly recognise diabetes.Design and...

Findings from a natural experiment on the impact of covid-19 residential quarantines on domestic violence patterns in New Orleans.

PurposeFollowing the rise of the novel coronavirus, de facto residential quarantines resulted either from executive stay-at-home orders, unemployment or through remote work requirements. One question that has arisen is whether the COVID-19 quarantines led to increases in domestic violence (DV), with research findings thus far being mixed. To further this understanding, this study examined whether the frequency and geographic dispersion of DV increased during stay-at-home and phased reopening periods of the pandemic in New Orleans, Louisiana while accounting for socio-economic determinants.MethodsThe study built on a natural experiment of home quarantine and examined its effects on DV using a mixed-methods approach of quantitative and geospatial analyses. Data for the analyses came from a sample of 11,502 police reported DV incidents and ArcGIS portal data of sociodemographic information across neighborhood statistical areas (NSAs).ResultsWhile results revealed no significant increase of DV during early phases of the quarantine, a significant increase in frequency was observed in the second reopening phase compared to the same time-period in the previous year. However, the dispersion of DV incidents appeared stable with continued concentrations in pre-existing geographic ‘hot spots.’ Conversely, households which were greater in size exhibited significantly fewer DV incidents.ConclusionFindings suggest that prevention programs might target residences already inflicted with domestic violence histories in advance of future pandemic or natural disaster related residential quarantines. Findings also reveal that situational factors, such as number of household residents, might be used to triage the delivery of services.

Socio-economic inequality in reported dental self-care behaviour among Iranian households: A national pooled study.

Setting out effective prevention strategies in dental diseases needs recognition related factors of the prevention behaviours and targeting the most disadvantaged groups in the term of dental hygiene. This study aimed to investigate socio-economic inequality in the dental self-care status (DSS) of Iranian households and decompose the measured inequality into its contributors. In this cross-sectional study, pooled data were extracted from Households Income and Expenditure Surveys (HIESs) conducted in Iran from 2012 to 2017. The index of socio-economic status (SES) for each household was constructed using principal components analysis (PCA). We used Wagstaff normalized concentration index as a measure of socio-economic inequality in dental self-care. Decomposition analysis was applied to determine the main factors contributed to the measured inequality. The prevalence of dental self-care in the whole population was 40.56%. The total concentration index was 0.271 (CI: 0.266, 0.275). The results of decomposition analysis for the measured inequality showed that SES, was the highest positive contributors (90.19%) followed by sex of household's head (12.15%), place of residence (11.79%) and education level of household's head (11.71%). Furthermore, the province of residence had the highest negative contribution (-11.37) to the inequality. The findings of this study showed that a huge portion of the observed inequality was explained by SES that might give us a policy recommendation: There is room for improving dental health and reducing inequality in dental self-care by paying more attention to SES-disadvantaged households.

Psychosocial and clinical predictors of patient satisfaction with cancer care

PurposePatient satisfaction with healthcare was recognized as an indispensable component of healthcare quality assurance programs for decades. Limited research has explored psychosocial variables impacting patient satisfaction with cancer care. The objective of our study was to identify the level of patient satisfaction with cancer care in Riyadh, Saudi Arabia and determine the psychosocial and clinical predictors of patient satisfaction. MethodsA cross-sectional observational study was carried out in 2018–2019 with patients with cancer at the Outpatient Oncology Clinic at King Saud University Medical City in Riyadh, Saudi Arabia. The questionnaire contained a visual analog scale (VAS) of satisfaction with cancer care, a VAS of satisfaction with social support, the Patient Health Questionnaire-9 Depression scale, and the Generalized Anxiety Disorder 7-item scale. ResultsOut of the 400 patients approached, 280 agreed to participate in the study. Of the 280 patients participating in the study, 65% were satisfied with cancer care. Higher satisfaction was associated with being non-Saudi, being employed, having fewer household residents (≤4), being satisfied with social support, not receiving radiotherapy, and receiving hormonal or biological therapy. Having anxiety or depression was also associated with lower satisfaction. After adjustment for sociodemographic and clinical characteristics, being satisfied with social support, having ≤ 4 household residents, receiving hormonal therapy, and receiving biological therapy rather than radiotherapy were all independent predictors of higher satisfaction with cancer care. ConclusionThis study found an inadequate level of patient satisfaction with cancer care. Higher levels of satisfaction were associated with being satisfied with social support, using biological and hormonal therapy, while lower satisfaction was associated with a larger number of household residents (>4), depression, anxiety and using radiotherapy.

Selected Non-Price Factors and its Effects to Children’s Immunization Coverage in Pandacan, Philippines

Since 2008, the Philippines has been facing a continuous decline in its immunization rate for vaccine-preventable diseases leading to the re-emergence of polio cases and a nationwide measles outbreak. In 2017, more than half of the entire child population did not receive the complete set of vaccines. This study addressed this issue by discussing selected non-price factors that may affect immunization coverage of children, specifically, parental/caregiver vaccine literacy, the distance of the household's residence to a health facility, and the household size. This research used data from the survey questionnaires that were answered by parents or caregivers with children aged above one to five residing in Barangay 845, Pandacan, Manila. Multiple logistic regression was applied to analyze the data, and it was determined that parental/caregiver vaccine literacy and household size are significant factors that affect immunization coverage of children. However, the distance of the household's residence to a health facility was found to be insignificant to a child's immunization coverage.

Improving population health through targeted policies on water sanitation and hygiene: Case study of water, sanitation and hygiene related practices in the Hohoe Municipality, Ghana

Background: Policies that improve the availability of safe drinking water, good hygiene practices and adequate sanitation conditions are considered crucial ingredients to sustain and improve the health of all populations. To attain the United Nations Sustainable Development Goals require concerted efforts globally to improve or health related morbidity outcomes as a result of poor water sources, sanitation and unhygienic conditions.Aim: The study assessed water, sanitation and hygiene related practices among household residents in Hohoe Municipality, Ghana with the aim of mapping out targeted policies required to improve urban population health in Ghana.Setting: Hohoe Municipality, Ghana.Method: A descriptive cross-sectional design was used to collect data among 403 household residents in Hohoe Municipality, Ghana. Participants were selected using multistage sampling technique. Data was collected using self-administered questionnaire, entered, cleaned and analyzed in STATA version 13.1.Findings: About 16.4% of the participants practiced open defecation. Overall, 58% of the 403 household residents had adequate hygiene practice levels. Percentages of participants that had improved, unimproved and piped drinking water sources were 67%, 14% and 19% respectively.Conclusion: Participants generally had a fairly adequate hygiene practice level and access to improved drinking water source. While almost half of the participants did not own or shared a private toilet facility. Our findings underscore the need for WASH interventions including policies to improve upon WASH practices among the households in Hohoe Municipality.

Prevalence of obesity and elevated body mass index along a progression of rurality: A cross-sectional study - The Canadian Longitudinal Study on Aging.

Obesity is an important public health concern, and large studies of rural-urban differences in prevalence of obesity are lacking. Our purpose is to compare body mass index (BMI) and obesity in Canada using an expanded definition of rurality. A cross-sectional analysis of self-reported BMI across diverse communities of Canadians aged 45-85 years was conducted using data from the Canadian Longitudinal Study on Aging (CLSA), a national sample representative of community-dwelling residents. Rurality was identified in the CLSA based on residential postal codes, which were divided into 4 categories: urban, peri-urban, mixed and rural. Logistic regression models were constructed to calculate adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) between obesity (BMI ≥30 kg/m2 from self-reported weight and height) and rurality, adjusting for age, sex, province, marital status, number of residents in household and household income. Twenty-one thousand one hundred and twenty-six Canadian residents aged 45-85 years, surveyed during 2010-2015, were included. 26.8% were obese. Obesity was less prevalent amongst urban (25.2%) than rural (30.3%, P < 0.0001), mixed (28.7%, P < 0.0001) or peri-urban communities (28.1%, P < 0.0001). When compared to urban areas, the aOR (95% CI) for obesity was 1.09 (1.00-1.20) in rural regions and 1.20 (1.08-1.35) in peri-urban settings. In areas of mixed urban and rural residence, the aOR was 1.12 (0.99-1.27). One in four Canadian adults were obese. Living in a non-urban setting is an independent risk factor for obesity. Rural-urban health disparities could underlie rural-urban differences, but further research is needed.

Measuring contraceptive use in a displacement-affected population using the Multiple Indicator Cluster Survey: The case of Iraq

Access to safe, effective, affordable, and acceptable contraceptive methods of choice is a basic right for displaced people. Yet displaced people are typically invisible in national sample surveys on population health, and quantitative evidence on their reproductive health outcomes is limited. This study focuses on the case of Iraq, a country with widespread displacement and where contraceptive use is a government policy priority. Using displacement screening questions in the Iraq 2018 Multiple Indicator Cluster Survey questionnaires, I construct two displacement-related indicators based on reason for last move and previous household residence. Descriptive statistics and binary logistic regression are used to test associations between modern contraceptive use and displacement, demographic, and socioeconomic factors. Controlling for the variables in the models, factors significantly associated with modern contraceptive use among married women aged 15–49 in Iraq are Federal Iraq region (reference Kurdish Region of Iraq, OR 1.78), upper secondary and primary education (reference pre-primary or no education, OR 1.50 and 1.20, respectively), parity, age, and exposure to television. The association between displacement (reason for last move) and modern contraceptive use significantly depends on a woman's level of education and whether they live in an urban or rural area. Women who previously lived in a camp are almost half as likely to use modern contraception compared to other previous residence types. This paper highlights the methodological potential and substantive value of using national household surveys to analyse reproductive health outcomes through a displacement lens. It also critically examines the limitations of these data and measures, drawing on total survey error and feminist theory.