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This study contributes to the literature on fear of missing out (FOMO) and poverty alleviation that tourists can be simultaneously affected by both personal FOMO (P‐FOMO) and social FOMO (S‐FOMO). The former is an individual‐based feeling, while the latter is how the individual would like to be perceived by others. An online survey was conducted using a quasi‐experimental approach with a sample of 493 Mainland China respondents. We analyzed the impact of FOMO‐laden online information on Chinese tourists subject to poverty alleviation travel. Anticipated elation, anticipated envy by other people, and moral obligation associated with P‐FOMO, while anticipated envy by other people, moral obligation, and social influence associated with S‐FOMO. The P‐FOMO affects tourists' intention to visit, rather than S‐FOMO. We fill the theoretical gap by examining FOMO in the context of poverty alleviation travel and subsequently contribute to sustainable tourism through poverty alleviation in this specific industry. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Tikrit University for Humanities is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Background: A national healthcare insurance has been implemented in Indonesia since 2014. Although cancer care currently represents a smaller part of the healthcare support, the demographic development will lead to a rapid growth of the population within age groups at cancer risk. This requires strategic and developmental planning of cancer care resources. Based on data of the national healthcare insurance, current cancer care processes and their determinants were evaluated. Methods: Nationwide reimbursement data as well as demographic, economic and healthcare infrastructure data were used for the study. Poor and underserved population was stratified according to the national classification system. Availability of healthcare resources was evaluated at provincial level. Cancer care usage was analysed applying descriptive and multivariate statistical approaches (regression, cluster analysis, tree classification). Findings: Cancer care was provided in primary care (PHC) for 2.6/1000 and advanced care (AHC) for 4.8/1000 participants within the family-based membership structure. Regression analysis revealed human resource availability in rural/remote areas a determinant for cancer PHC. Cancer care in AHC was determined by PHC provided by general practitioners (GP), availability of AHC infrastructure (Class A & B hospital beds) and treatment migration between provinces. Tree classification confirmed predominant roles of GP, AHC infrastructure and referral between cancer care provider levels. Interpretation: Cancer care will gain much higher importance for the Indonesian healthcare system within the next decade. Infrastructure, human resources, and process development should avoid rising overload of cancer care delivery by targeting reduction of treatment migration (availability of GPs in rural/remote provinces), improvement of referral systems (effective clinical selection processes and back-referral) and AHC cancer care structures (regional distribution of Class A & B hospitals). Funding: This project was supported by grants from Centre for Research, Publication, and Community Development Muhammadiyah University of Yogyakarta (SW, ID), and data provision by BPJS Indonesia.

[Objectives] The paper was to understand the health of rural poor population in Chongqing, and to put forward countermeasures for health poverty alleviation. [Methods] The 439 people living in poverty in Qianjiang District and Pengshui County, Chongqing, were investigated on the spot to deeply understand and analyze the health status, current medical insurance status and accuracy of medical system of rural poor population in Chongqing. [Results] The vast majority of poor households had been lifted out of poverty after targeted poverty alleviation. Poverty due to illness was the main cause of family poverty. The prevalence of chronic diseases in poor households was high, and the overall health level showed a downward trend. The countermeasures and suggestions for strengthening the construction of medical insurance system, exploring and perfecting rural medical assistance system, enhancing the service capacity of primary medical and health institutions, and strengthening health education and health management were put forward. [Conclusions] The study provides an empirical evidence for improving the health level of poor rural residents and promoting targeted health poverty alleviation policies. [ABSTRACT FROM AUTHOR]

Abstract Marking the end of the five-year programme initiated by the Chinese Government to lift more than 70 million people out of poverty, the year 2020 is a milestone. Poverty alleviation has moved strongly forward in China and the major health indicators are now better than the average of all middle- and high-income countries. However, the dual burden of infectious and chronic diseases remains a challenge with respect to achieving the health target in the United Nations 2030 Agenda for sustainable development goals (SDGs). In 2015, about 44% of the poor population in China were impoverished by illness but already in 2018, multi-sectoral actions delivered by the Health-related Poverty Alleviation programme had reduced the number almost by half. In the past three years 15 million poor people (98% of the poor population) with infectious and chronic diseases had been treated and taken care of thanks to financial support through multiple health insurance schemes and other governmental subsidies. This article discusses the lessons learnt with regard to health-related poverty alleviation in China with special reference to those still remaining impoverished by illness. Consolidation of the achievements reached and provision of basic needs to those still disadvantaged and in poor health will require a major improvement of accessibility to, and affordability of, health services. The next step towards enhanced productivity and better living conditions will involve upgrading of the capacity of health professionals in the poor regions, promotion of coherent efforts in health-related poverty alleviation and rural revitalization measures. As an additional measure, data monitoring and research on health poverty alleviation should be strengthened as they are essential to generate the evidence and knowledge needed to support the move in the direction envisioned by the SDGs, and the new Healthy China 2030 programme.

Background: Adopting Universal Health Coverage for implementation of a national health insurance system [Jaminan Kesehatan Nasional (JKN)/Badan Penyelenggara Jaminan Sosial or the Indonesian National Social Health Insurance Scheme (BPJS)] targets the 255 million population of Indonesia. The availability, accessibility, and acceptance of healthcare services are the most important challenges during implementation. Referral behavior and the utilization of primary care structures for underserved (rural/remote regions) populations are key guiding elements. In this study, we provided the first assessment of BPJS implementation and its resulting implications for healthcare delivery based on the entire insurance dataset for the initial period of implementation, specifically focusing on poor and remote populations.Methods: Demographic, economic, and healthcare infrastructure information was obtained from public resources. Data about the JKN membership structure, performance information, and reimbursement were provided by the BPJS national head office. For analysis, an ANOVA was used to compare reimbursement indexes for primary healthcare (PHC) and advanced healthcare (AHC). The usage of primary care resources was analyzed by comparing clustered provinces and utilization indices differentiating poor [Penerima Bantuan Iur (PBI) membership] and non-poor populations (non-PBI). Factorial and canonical discrimination analyses were applied to identify the determinants of PHC structures.Results: Remote regions cover 27.8% of districts/municipalities. The distribution of the poor population and PBI members were highly correlated (r2 > 0.8; p < 0.001). Three clusters of provinces [remote high-poor (N = 13), remote low-poor (N = 15), non-remote (N = 5)] were identified. A discrimination analysis enabled the >82% correct cluster classification of infrastructure and human resources of health (HRH)-related factors. Standardized HRH (nurses and general practitioners [GP]) availability showed significant differences between clusters (p < 0.01), whereas the availability of hospital beds was weakly correlated. The usage of PHC was ~2-fold of AHC, while non-PBI members utilized AHC 4- to 5-fold more frequently than PBI members. Referral indices (r2 = 0.94; p < 0.001) for PBI, non-PBI, and AHC utilization rates (r2 = 0.53; p < 0.001) were highly correlated.Conclusion: Human resources of health availability were intensively related to the extent of the remote population but not the numbers of the poor population. The access points of PHC were mainly used by the poor population and in remote regions, whereas other population groups (non-PBI and non-Remote) preferred direct access to AHC. Guiding referral and the utilization of primary care will be key success factors for the effective and efficient usage of available healthcare infrastructures and the achievement of universal health coverage in Indonesia. The short-term development of JKN was recommended, with a focus on guiding referral behavior, especially in remote regions and for non-PBI members.

Background Evidence points to diverse risk factors associated with small- (SGA) and large-for-gestational-age (LGA) births. A more comprehensive understanding of these factors is imperative, especially in vulnerable populations. Objectives To estimate the occurrence of and sociodemographic factors associated with SGA and LGA births in poor and extremely poor populations of Brazil. Methods The study population consisted of women of reproductive age (14–49 y), whose last child was born between 2012 and 2015. INTERGROWTH 21st consortium criteria were used to classify weight for gestational age according to sex. Multinomial logistic regression modeling was performed to investigate associations of interest. Results Of 5,521,517 live births analyzed, SGA and LGA corresponded to 7.8% and 17.1%, respectively. Multivariate analysis revealed greater odds of SGA in children born to women who self-reported as black (OR: 1.21; 95% CI: 1.19, 1.22), mixed-race (parda) (OR: 1.08; 95% CI: 1.07, 1.09), or indigenous (OR: 1.11; 95% CI: 1.06, 1.15), were unmarried (OR: 1.08; 95% CI: 1.07, 1.08), illiterate (OR: 1.47; 95% CI: 1.42, 1.52), did not receive prenatal care (OR: 1.57; 95% CI: 1.53, 1.60), or were aged 14–20 y (OR: 1.21; 95% CI: 1.20, 1.22) or 35–49 y (OR: 1.12; 95% CI: 1.10, 1.13). Considering LGA children, higher odds were found in infants born to women living in households with ≥3 inadequate housing conditions (OR: 1.11; 95% CI: 1.10, 1.12), in indigenous women (OR: 1.22; 95% CI: 1.19, 1.25), those who had 1–3 y of schooling (OR: 1.18; 95% CI: 1.17, 1.19), 1–3 prenatal visits (OR: 1.16; CI 95%: 1.14, 1.17), or were older (OR: 1.26; 95% CI: 1.25, 1.27). Conclusions In poorer Brazilian populations, socioeconomic, racial, and maternal characteristics are consistently associated with the occurrence of SGA births, but remain less clearly linked to the occurrence of LGA births. [ABSTRACT FROM AUTHOR]

Abstract Background According to several studies in population of high-income countries (HIC), patients with Type 2 diabetes mellitus (DM) have a considerably higher risk of cardiovascular morbidity and mortality. However, it is not clear if the magnitude of this association can be widespread in other populations. The objective of this study was to determine the independent association between Type 2 DM and first cardiovascular event in Colombian Caribbean poor population with no records of previous cardiovascular events reported. Methods We retrospectively reviewed the individual records from the hospitalizations database of 64,668 patients of cardiovascular risk management program from July 2014 to December 2015. We used a propensity score matching cohort analysis for this study. The Kaplan–Meier curves were constructed for the cardiovascular events related endpoints and matched Cox-regression analysis to estimate associations of a history of Type 2 DM with cardiovascular outcomes during 1.5 years of follow-up. A formal sensitivity analysis using The Breslow-Day and Tarone Homogeneity tests was conducted. Results Out of 56,351 patients with no previous cardiovascular events records, 19,368 (34.4%) patients were found to suffer Type 2 DM. Using propensity scores for Type 2 DM, we gathered a cohort of 18,449 pairs of patients with and without Type 2 DM who were balanced on 22 baseline characteristics. A first cardiovascular event occurred in 650 (3.5%) and 403 (2.1%) matched patients with and without Type 2 DM, respectively, during 1.5 years of follow-up. Type 2 DM was associated with first cardiovascular event (HR 1.69; 95% CI 1.43–2.00; p = 0.000), AMI (HR 1.79; 95% CI 1.45–2.20; p = 0.000) and stroke (HR 1.54; 95% CI 1.18–2.02; p = 0.001). Hazard ratios (95% CIs) for the association of Type 2 DM with all-cause mortality, cardiovascular mortality and all-cause hospitalization were 1.36 (1.21–1.53; p

Copyright of Mexican Journal of Economics & Finance / Revista Mexicana de Economia y Finanzas is the property of Instituto Mexicano de Ejecutivos de Finanzas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Marking the end of the five-year programme initiated by the Chinese Government to lift more than 70 million people out of poverty, the year 2020 is a milestone. Poverty alleviation has moved strongly forward in China and the major health indicators are now better than the average of all middle- and high-income countries. However, the dual burden of infectious and chronic diseases remains a challenge with respect to achieving the health target in the United Nations 2030 Agenda for sustainable development goals (SDGs). In 2015, about 44% of the poor population in China were impoverished by illness but already in 2018, multi-sectoral actions delivered by the Health-related Poverty Alleviation programme had reduced the number almost by half. In the past three years 15 million poor people (98% of the poor population) with infectious and chronic diseases had been treated and taken care of thanks to financial support through multiple health insurance schemes and other governmental subsidies. This article discusses the lessons learnt with regard to health-related poverty alleviation in China with special reference to those still remaining impoverished by illness. Consolidation of the achievements reached and provision of basic needs to those still disadvantaged and in poor health will require a major improvement of accessibility to, and affordability of, health services. The next step towards enhanced productivity and better living conditions will involve upgrading of the capacity of health professionals in the poor regions, promotion of coherent efforts in health-related poverty alleviation and rural revitalization measures. As an additional measure, data monitoring and research on health poverty alleviation should be strengthened as they are essential to generate the evidence and knowledge needed to support the move in the direction envisioned by the SDGs, and the new Healthy China 2030 programme. [ABSTRACT FROM AUTHOR]

Access to water and sanitation services (WSSs) in low- or middle-income countries is constrained by the poverty and vulnerability conditions of the population. In this context, it is urgent to establish public policies for WSSs that will increase the economic access to these services so that they will be more comprehensive and comprise the entire population, ensuring a balance between social and financial objectives. This paper contributes to a better understanding of the provision of WSSs in vulnerable areas and of the difficulty in achieving universal access using Brazil as a case study. The role of regulation in the provision of WSSs in vulnerable areas and the impact of the recent institutional reform that took place last year in that country is discussed. The different experiences analyzed provide interesting lessons that contribute to the improvement of the Brazilian status quo and that, at the same time, can be good practices that can be applied in other countries. One of the main conclusions of this research is related to the contributions that regulation should provide in the universalization of WSSs, mainly when the provision of these services is ruled by a contract. Furthermore, we observed that public authorities have resigned their role in this scope and that they must be more effective and, particularly, more proactive so that universalization can be achieved.

The objectives to be achieved through this study are to 1) Analyze the limitations of land for the cultivation of regencies and cities in West Sumatra Province; 2) Model regional typologies based on indicators growth of population with limited district and city land in West Sumatra Province; and 3) Attract the implications of the typology of the region on population policies in West Sumatra. This study uses descriptive analytical methods and the nature of this research is explained which aims to test various indicators in the study. From the results of the study, it was explained that the high rate of growth population was caused by the high fertility rate in West Sumatra as a result of the pressure on the land or the reduced land index. The existence of pressure on the land and a low land index (insufficient) will have an impact on the ratio of the number of poor people in the regency/city in West Sumatra as happened in Solok city, Bukittinggi city, Padang Panjang city and Payakumbuh city. The implication of population policy for the city of Sawahlunto and Pariaman is how to maintain low population growth, while other cities how to reduce the rate of population growth. [ABSTRACT FROM AUTHOR]

Background: According to several studies in population of high-income countries (HIC), patients with Type 2 diabetes mellitus (DM) have a considerably higher risk of cardiovascular morbidity and mortality. However, it is not clear if the magnitude of this association can be widespread in other populations. The objective of this study was to determine the independent association between Type 2 DM and first cardiovascular event in Colombian Caribbean poor population with no records of previous cardiovascular events reported.Methods: We retrospectively reviewed the individual records from the hospitalizations database of 64,668 patients of cardiovascular risk management program from July 2014 to December 2015. We used a propensity score matching cohort analysis for this study. The Kaplan-Meier curves were constructed for the cardiovascular events related endpoints and matched Cox-regression analysis to estimate associations of a history of Type 2 DM with cardiovascular outcomes during 1.5 years of follow-up. A formal sensitivity analysis using The Breslow-Day and Tarone Homogeneity tests was conducted.Results: Out of 56,351 patients with no previous cardiovascular events records, 19,368 (34.4%) patients were found to suffer Type 2 DM. Using propensity scores for Type 2 DM, we gathered a cohort of 18,449 pairs of patients with and without Type 2 DM who were balanced on 22 baseline characteristics. A first cardiovascular event occurred in 650 (3.5%) and 403 (2.1%) matched patients with and without Type 2 DM, respectively, during 1.5 years of follow-up. Type 2 DM was associated with first cardiovascular event (HR 1.69; 95% CI 1.43-2.00; p = 0.000), AMI (HR 1.79; 95% CI 1.45-2.20; p = 0.000) and stroke (HR 1.54; 95% CI 1.18-2.02; p = 0.001). Hazard ratios (95% CIs) for the association of Type 2 DM with all-cause mortality, cardiovascular mortality and all-cause hospitalization were 1.36 (1.21-1.53; p < 0.001), 1.52 (1.12-2.08; p 0.004), and 1.20 (1.21-1.53; p < 0.001), respectively.Conclusion: Type 2 DM resulted to be a significant independent risk factor for first cardiovascular event in Colombian Caribbean poor population with no previous records of cardiovascular events. [ABSTRACT FROM AUTHOR]

The article analyses the modern state of development of medical insurance in Ukraine and also studies advantages and shortcomings of the use of micro-insurance for popularisation of programmes of voluntary medical insurance and satisfaction of needs in high quality medical services for all layers of the population. It identifies that as of today the Ukrainian healthcare system is at the stage of reformation, mandatory medical insurance is not yet introduced and main consumers of the programmes of voluntary medical insurance are corporate clients. The article considers main constraints of development of medical insurance in Ukraine, including: low level of income of the population; absence of high quality providers of medical services in regions; and insufficient degree of trust of the population to the insurance sphere. The article shows that introduction of micro-insurance would positively influence the development of insurance medicine in the country, would facilitate provision of medical services even for poor citizens and would allow reduction of state budget expenditures on healthcare. The conducted study of restrictions and shortcomings of introduction of micro-insurance allowed identification of the fact that main of them are information asymmetry (unfavourable selection of risks, moral risk and insurance fraud), significant limitation of insurance coverage and difficulties in identifying optimal insurance tariffs.

Copyright of Revista Trabajo Social is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Access to microcredit can have a beneficial effect on the well-being of low-income households excluded from the traditional banking system. It allows this population to receive affordable financial services to help them to meet their needs and to improve their living conditions. However to provide access to credit, microfinance institutions should ensure not only their social mission but also commercial and financial mission to enable the institution to perpetuate and become self-sufficient. To this end, MFIs (microfinance institutions) must apply an interest rate that covers their costs and risk, while generating profits, Also microentrepreneurs need, to this end, to ensure the profitability of their activities. This paper presents the microfinance sector in Morocco. It focuses then on the interest rate applied by the Moroccan microfinance institutions; it provides also a comparative study between Morocco and other comparable countries in terms of interest rates charged to borrowers. Finally, this article presents a stochastic model of the interest rate in microcredit built in random loan repayment periods and on a real example of the program of loans of microfinance institution in Morocco. [ABSTRACT FROM AUTHOR]

Elaborou-se um alimento natural, destinado à complementação alimentar de populações carentes, em programas de combate à fome e desnutrição humana. O experimento foi realizado no sentido de se analisar duas misturas obtidas de matérias-prima à base de cana-de-açúcar, soja, mandioca, banana e lêvedo de cerveja, na proporção em massa seca de 5,0 x 0,5 x 0,2 x 0,2 x 0,1, respectivamente, e uma testemunha obtida com apenas caldo-de-cana. A primeira mistura, cujo produto final foi identificado por PR1, foi composta por: caldo de cana, proteína integral de soja, farinha crua de mandioca, farinha de banana e levedo de cerveja. E a segunda mistura cujo produto final foi identificado por PR2, foi composta por: caldo de cana, leite de soja em pó, farinha crua de mandioca, banana seca, em pedaços e lêvedo de cerveja. Na terceira mistura ou testemunha, cujo produto final foi identificado por PR3, havia somente caldo de cana natural. Cada 100 g de PR1 apresentou média de 236,74 kcal, umidade 13,83%, 7,53% de proteínas, 0,7% de lipídeos, 0,8% de fibra bruta, 1% de cinzas e 76,14% de carboidratos; teores consideráveis de pectina (total - 6,80 g, 7,40 g e solúvel - 1,71 g, 2,13 g) e vitamina C (20,84 g, 19,22 g); presença de micronutrientes: ferro (49,83 g, 46,07 g), manganês (11,25 g, 11,25 g), cobre (12,20 g, 35,63 g) e zinco (8,03 g, 7,57 g); dos macronutrientes: potássio (0,33 g, 0,39 g), magnésio (0,04 g, 0,04 g), fósforo (0,12 g, 0,10 g) e fatores antinutricionais dentro dos níveis recomendados. Cada 100 g de PR2 apresentou média de 266,92 kcal, umidade 13,67 g, 4,62 g de proteínas, 1,0 g de lipídeos, 0,63 g de fibra bruta, 1 g de cinzas e 79,08 g de carboidratos; teores consideráveis de pectina (total e solúvel) e vitamina C; presença de micronutrientes: ferro, manganês, cobre e zinco; dos macronutrientes: potássio, magnésio, fósforo e fatores antinutricionaionais dentro dos níveis recomendados. Cada 100g de PR3 apresentou média de 279,35 kcal, umidade 5,3 g, 0,73 g de proteínas, 1,04 g de cinzas, 0,07 g de fibras bruta e 92,86 g de carboidratos. Os produtos foram também submetidos a análises microbiológicas, testes texturais e sensoriais, com resultados satisfatórios para consumo humano.ABSTRACT - A natural meal was developed intended aso food complementation to poor populations in programs of hunger combat and human malnutrition. The experimental design was defined as two mixtures obtained from raw materials based on sugar cane, soybean, cassava, banana, and beer yeast at the weight ratio of 5.0 × 0.5 × 0.2 × 0.2 × 0.1, respectively. The first mixture, whose final product was identified as PR1, was cane juice, whole soybean protein, raw cassava flour, banana flour, and beer yeast. The second mixture, whose final product was identified as PR2, was cane juice, soybean milk powder, raw cassava flour, sun-dried flour, and beer yeast. The third mixture or check, whose final product was identified as PR3, was cane juice natural only. Every 100 g of PR1 presented 237 kcal, moisture content of 14%, 7.5% proteins, 0.7% lipids, 1% ash, 0.8% raw fiber, and 76% carbohydrates. Contents of pectin (soluble and total), vitamin C, micronutrients (Fe, Mn, Cu, and Zn), macronutrients (K, Mg, and P), and antinutritional factors are within the recommended levels. Every 100 g of PR2 presented 267 kcal, moisture content of 14% 5% proteins, 1% lipids, 1% ash, 0.6% raw fiber, and 79% carbohydrates. Contents of pectin (soluble and total), vitamin C, micronutrients (Fe, Mn, Cu, and Zn), macronutrients (K, Mg, and P), and antinutritional factors are within the recommended levels. Every 100 g of PR3 presented 279 kcal, moisture content 5%, 0.7% proteins, 1.0% ash, 0.07% raw fiber, and 93% carbohydrates. The products were also submitted to microbiological analysis, textural and sensorial tests, with satisfactory results to the human consume.

Background: A national healthcare insurance has been implemented in Indonesia since 2014. Although cancer care currently represents a smaller part of the healthcare support, the demographic development will lead to a rapid growth of the population within age groups at cancer risk. This requires strategic and developmental planning of cancer care resources. Based on data of the national healthcare insurance, current cancer care processes and their determinants were evaluated., Methods: Nationwide reimbursement data as well as demographic, economic and healthcare infrastructure data were used for the study. Poor and underserved population was stratified according to the national classification system. Availability of healthcare resources was evaluated at provincial level. Cancer care usage was analysed applying descriptive and multivariate statistical approaches (regression, cluster analysis, tree classification)., Findings: Cancer care was provided in primary care (PHC) for 2.6/1000 and advanced care (AHC) for 4.8/1000 participants within the family-based membership structure. Regression analysis revealed human resource availability in rural/remote areas a determinant for cancer PHC. Cancer care in AHC was determined by PHC provided by general practitioners (GP), availability of AHC infrastructure (Class A & B hospital beds) and treatment migration between provinces. Tree classification confirmed predominant roles of GP, AHC infrastructure and referral between cancer care provider levels., Interpretation: Cancer care will gain much higher importance for the Indonesian healthcare system within the next decade. Infrastructure, human resources, and process development should avoid rising overload of cancer care delivery by targeting reduction of treatment migration (availability of GPs in rural/remote provinces), improvement of referral systems (effective clinical selection processes and back-referral) and AHC cancer care structures (regional distribution of Class A & B hospitals)., Funding: This project was supported by grants from Centre for Research, Publication, and Community Development Muhammadiyah University of Yogyakarta (SW, ID), and data provision by BPJS Indonesia., Competing Interests: AA, AGM, and SS are employees of the BPJS health insurance; JH: projects from Ministry of Research and Education (Germany) and Ministry of International Collaboration (Germany), received funding for attending meeting from Indonesian Embassy (Germany), CEO at IGP-Institute for Public Health and Healthcare; JS: Chair Scientific Advisory Board at IGP-Institute for Public Health and Healthcare Science., (© 2022 The Authors.)

This research analyses the main social and economical characteristics of the poor population in the District of Barranquilla, with emphasis on these people's aspirations and perceptions of public social institutions dedicated to satisfying social demands. The study examines the relationship between less privileged citizens and social institutionality in their multiple expressions and dimensions, following the rules of institutional theory. In methodological terms this study follows a descriptive qualitative-quantitative model. The interpretation of recolected data was made through an analysis of multiple correspondences. [ABSTRACT FROM AUTHOR]

This research analyses the main social and economical characteristics of the poor population in the District of Barranquilla, with emphasis on these people's aspirations and perceptions of public social institutions dedicated to satisfying social demands. The study examines the relationship between less privileged citizens and social institutionality in their multiple expressions and dimensions, following the rules of institutional theory. In methodological terms this study follows a descriptive qualitative- quantitative model. The interpretation of recolected data was made through an analysis of multiple correspondences. [ABSTRACT FROM AUTHOR]

Background: Adopting Universal Health Coverage for implementation of a national health insurance system [Jaminan Kesehatan Nasional (JKN)/Badan Penyelenggara Jaminan Sosial or the Indonesian National Social Health Insurance Scheme (BPJS)] targets the 255 million population of Indonesia. The availability, accessibility, and acceptance of healthcare services are the most important challenges during implementation. Referral behavior and the utilization of primary care structures for underserved (rural/remote regions) populations are key guiding elements. In this study, we provided the first assessment of BPJS implementation and its resulting implications for healthcare delivery based on the entire insurance dataset for the initial period of implementation, specifically focusing on poor and remote populations. Methods: Demographic, economic, and healthcare infrastructure information was obtained from public resources. Data about the JKN membership structure, performance information, and reimbursement were provided by the BPJS national head office. For analysis, an ANOVA was used to compare reimbursement indexes for primary healthcare (PHC) and advanced healthcare (AHC). The usage of primary care resources was analyzed by comparing clustered provinces and utilization indices differentiating poor [Penerima Bantuan Iur (PBI) membership] and non-poor populations (non-PBI). Factorial and canonical discrimination analyses were applied to identify the determinants of PHC structures. Results: Remote regions cover 27.8% of districts/municipalities. The distribution of the poor population and PBI members were highly correlated ( r 2 > 0.8; p < 0.001). Three clusters of provinces [remote high-poor ( N = 13), remote low-poor ( N = 15), non-remote ( N = 5)] were identified. A discrimination analysis enabled the >82% correct cluster classification of infrastructure and human resources of health (HRH)-related factors. Standardized HRH (nurses and general practitioners [GP]) availability showed significant differences between clusters ( p < 0.01), whereas the availability of hospital beds was weakly correlated. The usage of PHC was ~2-fold of AHC, while non-PBI members utilized AHC 4- to 5-fold more frequently than PBI members. Referral indices ( r 2 = 0.94; p < 0.001) for PBI, non-PBI, and AHC utilization rates ( r Human resources of health availability were intensively related to the extent of the remote population but not the numbers of the poor population. The access points of PHC were mainly used by the poor population and in remote regions, whereas other population groups (non-PBI and non-Remote) preferred direct access to AHC. Guiding referral and the utilization of primary care will be key success factors for the effective and efficient usage of available healthcare infrastructures and the achievement of universal health coverage in Indonesia. The short-term development of JKN was recommended, with a focus on guiding referral behavior, especially in remote regions and for non-PBI members.2 = 0.53; p < 0.001) were highly correlated. Conclusion: Human resources of health availability were intensively related to the extent of the remote population but not the numbers of the poor population. The access points of PHC were mainly used by the poor population and in remote regions, whereas other population groups (non-PBI and non-Remote) preferred direct access to AHC. Guiding referral and the utilization of primary care will be key success factors for the effective and efficient usage of available healthcare infrastructures and the achievement of universal health coverage in Indonesia. The short-term development of JKN was recommended, with a focus on guiding referral behavior, especially in remote regions and for non-PBI members., Competing Interests: AA and AG are employed by BPJS National Healthcare Insurance Indonesia. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Wenang, Schaefers, Afdal, Gufron, Geyer, Dewanto and Haier.)

Access to water and sanitation services (WSSs) in low- or middle-income countries is constrained by the poverty and vulnerability conditions of the population. In this context, it is urgent to establish public policies for WSSs that will increase the economic access to these services so that they will be more comprehensive and comprise the entire population, ensuring a balance between social and financial objectives. This paper contributes to a better understanding of the provision of WSSs in vulnerable areas and of the difficulty in achieving universal access using Brazil as a case study. The role of regulation in the provision of WSSs in vulnerable areas and the impact of the recent institutional reform that took place last year in that country is discussed. The different experiences analyzed provide interesting lessons that contribute to the improvement of the Brazilian status quo and that, at the same time, can be good practices that can be applied in other countries. One of the main conclusions of this research is related to the contributions that regulation should provide in the universalization of WSSs, mainly when the provision of these services is ruled by a contract. Furthermore, we observed that public authorities have resigned their role in this scope and that they must be more effective and, particularly, more proactive so that universalization can be achieved. [ABSTRACT FROM AUTHOR]