Health-Seeking Behaviors and its Determinants: A Facility-Based Cross-Sectional Study in the Turkish Republic of Northern Cyprus

Background: Understanding health-seeking behaviors and determining factors help governments to adequately allocate and manage existing health resources. The aim of the study was to examine the health-seeking behaviors of people in using public and private health facilities and to assess the factors that influence healthcare utilization in Northern Cyprus.Methods: A cross-sectional study was conducted in 2 polyclinics among 507 people using a structured interviewer-administered questionnaire. Health-seeking behaviors were measured using four indicators including routine medical check-ups, preferences of healthcare facilities, admission while having health problems, and refusal of health services while ill. Descriptive statistics and multivariable logistic regression analyses were done to explore factors influencing the use of health services. Results: About 77.3% of the participants reported to have visited health centers while they had any health problems. More than half (51.7%) of them had a routine medical check-up during the previous year, while 12.2% of them had refused to seek healthcare when they felt ill during the last five years. Of all, 39.1% of them reported preferring private health services. Current smokers (adjusted odds ratio [AOR] = 1.92, 95% CI: 1.17-3.14), having chronic diseases (AOR = 2.05, 95% CI: 1.95-2.16), having poor perceptions on health (AOR = 2.33; 95% CI: 1.563.48), and spending less on health during the last three months (AOR = 2.08, 95% CI: 1.43- 3.01) had about twice the odds of having routine checkups. Higher education (AOR = 1.87, 95% CI: 1.38-2.55) was shown to be a positive predictor for the health-seeking behaviors, whereas having self-care problems (AOR = 0.18, 95% CI: 0.08-0.40) and having a moderate-income (AOR = 0.68, 95% CI: 0.57-0.81) were inversely associated with seeking healthcare. Conclusion: The utilization of public and private health sectors revealed evident disparities in the socio-economic characteristics of participants. The health-seeking behaviors were determined by need factors including chronic disease status and having poor health perception and also by enabling factors such as education, income, insurance status and ability to pay by oneself. These findings highlight the need for further nationwide studies and provide evidence for specific strategies to reduce the socioeconomic inequalities in the use of healthcare services

Industry associations, health innovation systems and politics of development: the cases of India and South Africa

Over the last 20 years, developing countries have witnessed the increased role of non-governmental actors such as health industry associations and umbrella organizations in the diffusion and governance of health innovation. Utilizing extensive interviews with actors in the Indian and South African health industries, this paper argues that, in a context of emerging pluralism – i.e., a dynamic context of bargaining between competing (public and private) interests and values – these associations constitute public actors that play dual roles in the politics of innovation and development. Specifically, not only do they engage downstream by diffusing knowledge to their respective health innovation systems in order to achieve common objectives, they also engage upstream with their governments to co-develop policies and regulations. This dual role of health industry associations and umbrella organizations makes them less neutral politically but more effective institutionally, and their innovative and political role should be seriously taken into account in the healthcare sector

Impact of routine PCV7 (Prevenar) vaccination of infants on the clinical and economic burden of pneumococcal disease in Malaysia

<p>Abstract</p> <p>Background</p> <p>Pneumococcal disease is the leading cause of vaccine-preventable death in children younger than 5 years of age worldwide. The World Health Organization recommends pneumococcal conjugate vaccine as a priority for inclusion into national childhood immunization programmes. Pneumococcal vaccine has yet to be included as part of the national vaccination programme in Malaysia although it has been available in the country since 2005. This study sought to estimate the disease burden of pneumococcal disease in Malaysia and to assess the cost effectiveness of routine infant vaccination with PCV7.</p> <p>Methods</p> <p>A decision model was adapted taking into consideration prevalence, disease burden, treatment costs and outcomes for pneumococcal disease severe enough to result in a hospital admission. Disease burden were estimated from the medical records of 6 hospitals. Where local data was unavailable, model inputs were obtained from international and regional studies and from focus group discussions. The model incorporated the effects of herd protection on the unvaccinated adult population.</p> <p>Results</p> <p>At current vaccine prices, PCV7 vaccination of 90% of a hypothetical 550,000 birth cohort would incur costs of RM 439.6 million (US$128 million). Over a 10 year time horizon, vaccination would reduce episodes of pneumococcal hospitalisation by 9,585 cases to 73,845 hospitalisations with cost savings of RM 37.5 million (US$10.9 million) to the health system with 11,422.5 life years saved at a cost effectiveness ratio of RM 35,196 (US$10,261) per life year gained.</p> <p>Conclusions</p> <p>PCV7 vaccination of infants is expected to be cost-effective for Malaysia with an incremental cost per life year gained of RM 35,196 (US$10,261). This is well below the WHO's threshold for cost effectiveness of public health interventions in Malaysia of RM 71,761 (US$20,922).</p

Health Biotechnology In Malaysia: Issues And Challenges Faced By The Innovative Biotechnology Firms

Since 2005, the Malaysian government has boosted its support towards the biotechnology sector in terms of a strong policy framework, financial mechanisms and by setting up several implementation agencies to drive this sector forward. This chapter evaluates the current development of the health biotech sector by identifying the main challenges faced by private health biotechnology firms in Malaysia. The case study analysis is based on comprehensive information obtained from semi-structured interviews, a survey and a focus group discussion with key informants from the private biotech sector combined with secondary data using the triangulation method. The chapter identifies several main challenges related to regulatory systems, niche areas, human capital and access to financing. These challenges stem from an underdeveloped health innovation system in Malaysia. Additionally, we propose several specific strategies and recommendations to build an effective national healthcare innovation system, which can strengthen private sector capabilities and increase interactivity and knowledge flows between various actors within the health biotech sector. The effective exploitation of the role of biotechnology firms and industry would be the key to sustaining successful development of this knowledge-intensive sector.Wo

Review of the potential health effects of light and environmental exposures in underground workplaces

Underground workplaces are an important element in modern urban planning. As a result, an increasing but unquantified proportion of the population is being regularly exposed to them. We narratively reviewed the literature on the range of possible environmental exposures, and the possible health effects, to identify future research directions. There is a large but mainly observational research literature on likely underground exposures, including effects of artificial lighting, shift working and light at night on circadian disruptions and associated health effects. There are five studies comparing underground and aboveground environments. Shift working, artificial lighting and poor sleep quality leading to circadian disruption is one physiologic pathway. Working underground may increase exposure to these risks, and may also be associated with vitamin D deficiency, sick building syndrome, excessive noise, radon exposure, and negative psychological effects. In order to plan appropriate interventions, we need to expand our knowledge of the health effects of underground environments. Larger and longer-term studies are required to measure a range of human factors, environmental exposures and confounders. Controlled trials with health economic analyses of new lighting technologies are also required.NRF (Natl Research Foundation, S’pore)Accepted versio