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1. Issues related to pregnancy, pregnancy prevention and abortion in the context of the COVID-19 pandemic: a WHO qualitative study protocol

Author

Cecatti, Jose Guilherme, primary, Bahamondes, Luis, additional, Ali, Moazzam, additional, Alangea, Deda Ogum, additional, Brizuela, Vanessa, additional, Nahyuha Chomi, Eunice, additional, Kouanda, Seni, additional, Karmaliani, Rozina, additional, Ladak, Laila, additional, Lumbiganon, Pisake, additional, Emefa, Modey, additional, Jen, Sothornwit, additional, Kuganantham, Hamsadvani, additional, and Kim, Caron, additional

Published
2022
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2. Health systems analysis and evaluation of the barriers to availability, utilisation and readiness of sexual and reproductive health services in COVID-19-affected areas: a WHO mixed-methods study protocol

Author

Kouanda, Seni, Nahyuha Chomi, Eunice, Kim, Caron, Jen, Sothornwit, Bahamondes, Luis, Cecatti, Jose Guilherme, Lumbiganon, Pisake, Emefa, Modey, Brizuela, Vanessa, Kuganantham, Hamsadvani, Seuc, Armando Humberto, Ali, Moazzam, Luis, Bahamondes, Jose Guilherme Cecatti, Eunice, Chomi, Seni, Kouanda, Kun, Tang, Hanxiyue, Zhang, Yifan, Zhu, Yueping, Guo, Yang, Ge, Chunxiao, Peng, Deda Ogum Alangea, Kwasi, Tropsey, Emefa Judith Modey, Rozina, Karmaliani, Laila, Ladak, Pisake, Lumbiganon, Marleen, Temmerman, Abdu, Mohiddin, Ferdinand, Okwaro, Mirandola, Massimo, Cordioli, Maddalena, Savoldi, Alessia, Garzon, Simone, Uccella, Stefano, Poli, Ranieri, Nigel, Sherriff, Alexandra, Sawyer, Jorg, Huber, Jaime, Vera, Debbie, Williams, Moazzam, Ali, Caron, Kim, Hamsadvani, Kuganantham, Igor, Toskin, Vanessa, Brizuela, Anna, Thorson, Joy Jerop Chebet, Hugo Gamerro Abrego, Soe Soe Thwin, and Armando, Seuc

Subjects
Systems Analysis, COVID19, public health, Social Sciences, COVID-19, General Medicine, World Health Organization, Cross-Sectional Studies, Pregnancy, Medicine and Health Sciences, Humans, Female, Reproductive Health Services, Pandemics, reproductive medicine
Abstract

IntroductionCOVID-19 has led to an unprecedented increase in demand on health systems to care for people infected, necessitating the allocation of significant resources, especially medical resources, towards the response. This, compounded by the restrictions on movement instituted may have led to disruptions in the provision of essential services, including sexual and reproductive health (SRH) services. This study aims to assess the availability of contraception, comprehensive abortion care, sexually transmitted infection prevention and treatment and sexual and gender-based violence care and support services in local health facilities during COVID-19 pandemic. This is a standardised generic protocol designed for use across different global settings.Methods and analysisThis study adopts both quantitative and qualitative methods to assess health facilities’ SRH service availability and readiness, and clients’ and providers’ perceptions of the availability and readiness of these services in COVID-19-affected areas. The study has two levels: (1) perceptions of clients (and the partners) and healthcare providers, using qualitative methods, and (2) assessment of infrastructure availability and readiness to provide SRH services through reviews, facility service statistics for clients and a qualitative survey for healthcare provider perspectives. The health system assessment will use a cross-sectional panel survey design with two data collection points to capture changes in SRH services availability as a result of the COVID-19 epidemic. Data will be collected using focus group discussions, in-depth interviews and a health facility assessment survey.Ethics and disseminationEthical approval for this study was obtained from the WHO Scientific and Ethics Review Committee (protocol ID CERC.0103). Each study site is required to obtain the necessary ethical and regulatory approvals that are required in each specific country.

Published
2022

3. Health care seeking behaviour and utilisation in a multiple health insurance system: does insurance affiliation matter?

Author

Nahyuha Chomi, Eunice, Mujinja, Phares G. M., Enemark, Ulrika, Hansen, Kristian, and Kiwara, Angwara Dennis

Subjects
*MEDICAL care, *ANALYSIS of variance, *COMPARATIVE studies, *DECISION making, *HELP-seeking behavior, *INSURANCE, *MEDICAL care use, *MULTIVARIATE analysis, *RESEARCH funding, *STATISTICS, *TIME, *MULTIPLE regression analysis, *SECONDARY analysis, *PREDICTIVE validity, *CROSS-sectional method, *DESCRIPTIVE statistics
Abstract

Background Many countries striving to achieve universal health insurance coverage have done so by means of multiple health insurance funds covering different population groups. However, existence of multiple health insurance funds may also cause variation in access to health care, due to the differential revenue raising capacities and benefit packages offered by the various funds resulting in inequity and inefficiency within the health system. This paper examines how the existence of multiple health insurance funds affects health care seeking behaviour and utilisation among members of the Community Health Fund, the National Health Insurance Fund and non-members in two districts in Tanzania. Methods Using household survey data collected in 2011 with a sample of 3290 individuals, the study uses a multinomial logit model to examine the influence of predisposing, enabling and need characteristics on the probability of seeking care and choice of provider. Results Generally, health insurance is found to increase the probability of seeking care and reduce delays. However, the probability, timing of seeking care and choice of provider varies across the CHF and NHIF members. Conclusions Reducing fragmentation is necessary to provide opportunities for redistribution and to promote equity in utilisation of health services. Improvement in the delivery of services is crucial for achievement of improved access and financial protection and for increased enrolment into the CHF, which is essential for broadening redistribution and cross-subsidisation to promote equity. [ABSTRACT FROM AUTHOR]

Published
2014
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