Advances in Public Health最新文献

{"title":"The Psychological Benefits of COVID-19 Vaccination","authors":"My Nguyen","doi":"10.1155/2021/1718800","DOIUrl":"https://doi.org/10.1155/2021/1718800","url":null,"abstract":"This study evaluates the extent to which COVID-19 vaccination affects population mental health. Exploiting the within-state and within-survey week variation in the number fully vaccinated per 10 million people, I uncover the favorable effects of vaccination on individuals’ psychological well-being. Particularly, a 100% increase in the number fully vaccinated per 10 million people makes individuals 0.24, 0.23, 0.12, and 0.14 percentage points less likely to experience anxiety, worry, displeasure, and depression on a daily basis, respectively. The probability of having at least one of the four symptoms (anxiety, worry, displeasure, and depression) every day also reduces by 0.27 percentage points. The study calls for the expansion of vaccine coverage, especially for disproportionately affected communities.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"2 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2021-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78629540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intestinal Parasite Infection and Its Association with Undernutrition among Early Adolescents in Hawassa University Technology Village, Southern Ethiopia","authors":"Amelo Bolka Gujo, Assefa Philipos Kare, Shambel Gussa Shuramo","doi":"10.1155/2021/3937948","DOIUrl":"https://doi.org/10.1155/2021/3937948","url":null,"abstract":"Background. Different studies presented negating findings of the association between intestinal parasite infections (IPIs) and undernutrition among early adolescents in Ethiopia. This study was aimed at assessing intestinal parasite infection and its association with undernutrition among early adolescents in four selected districts of the Sidama region. Method. An institution-based cross-sectional study was conducted in October 2020 among 792 early adolescents. The multistage stage sampling was applied to select 16 primary schools. Simple random sampling was applied to select study participants. Trained data collectors administered questionnaires. Stool samples were collected and analyzed. Anthropometric measurements were taken and indices were calculated using AnthroPlus software. Data were entered into and analyzed by SPSS version 25 software. Association between IPI and undernutrition was measured using multivariable analysis. The outputs are presented using an adjusted odds ratio (AOR) with 95% confidence intervals (CIs). Result. The prevalence of IPI, thinness, and stunting was 32% (95% CI: 28.7%, 35.3%), 17.5% (95% CI: 14.8%, 20.2%), and 21.5% (95 CI: 18.6%, 24.4%), respectively. The higher odds of IPIs were observed among adolescents stunted (AOR = 3.61; 95% CI: 2.44–5.33), those who are thin (AOR = 3.07; 95% CI: 2.02–4.66), those who did not wash their hands after toilet (AOR = 1.89; 95% CI: 1.35–2.66), those who ate raw meat (AOR = 1.50; 95% CI: 1.03–2.14), and those whose family did not own toilet (AOR = 1.71; 95% CI: 1.18–2.46). Conclusion. The prevalence of IPI, thinness, and stunting was high and has public health significance in the study area. IPIs were associated with stunting, thinness, lack of toilets, not washing hands after a toilet visit, and eating raw meat. Strengthening nutrition interventions, deworming programs, and health education on personal and environmental hygiene and sanitation are recommended.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"41 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2021-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84889515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of RHIS Quality Assurance Practices in Tarkwa Submunicipal Health Directorate, Ghana","authors":"R. O. Boadu, Judith Obiri-Yeboah, Kwame Adu Okyere Boadu, Nathan Kumasenu Mensah, Grace Amoh-Agyei","doi":"10.1155/2021/5561943","DOIUrl":"https://doi.org/10.1155/2021/5561943","url":null,"abstract":"Background. Routine health information system (RHIS) quality assurance has become an important issue, not only because of its significance in promoting high standard of patient care, but also because of its impact on government budgets for the maintenance of health services. Routine health information system comprises healthcare data collection, compilation, storage, analysis, report generation, and dissemination on routine basis at the various healthcare settings. The data from RHIS give a representation of health status, health services, and health resources. The sources of RHIS data are normally individual health records, records of services delivered, and records of health resources. Using reliable information from routine health information systems is fundamental in the healthcare delivery system. Quality assurance practices are measures that are put in places to ensure the health data that are collected meet required quality standards. Routine health information system quality assurance practices ensure that data that are generated from the system are fit for use. This study considered quality assurance practices in the RHIS processes. Methods. A cross-sectional study was conducted in eight health facilities in Tarkwa Submunicipal health service in the western region of Ghana. The study involved routine quality assurance practices among the 90-health staff and management selected from facilities in Tarkwa Submunicipal who collect or use data routinely from 24th December, 2019, to 20th January, 2020. Results. Generally, Tarkwa Submunicipal health service appears to practice quality assurance during data collection, compilation, storage, analysis, and dissemination. The results show some achievement in quality control performance in report dissemination (77.6%), data analysis (68.0%), data compilation (67.4%), report compilation (66.3%), data storage (66.3%), and collection (61.1%). Conclusions. Even though Tarkwa Submunicipal health directorate engages some control measures to ensure data quality, there is the need to strengthen the process to achieve the targeted percentage of performance (90.0%). There was significant shortfall in quality assurance practices performance especially during data collection, with respect to the expected performance.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"32 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91078873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forecasting Confirmed Malaria Cases in Northwestern Province of Zambia: A Time Series Analysis Using 2014–2020 Routine Data","authors":"Dhally M. Menda, Mukumbuta Nawa, Rosemary K. Zimba, Catherine M. Mulikita, Jim Mwandia, Henry Mwaba, Karen Sichinga","doi":"10.1155/2021/6522352","DOIUrl":"https://doi.org/10.1155/2021/6522352","url":null,"abstract":"Background. Malaria remains a significant public health problem, especially in resource-poor settings. We aimed to forecast the year 2021 monthly confirmed malaria cases in the northwestern province of Zambia. Methods. The total number of confirmed monthly malaria cases recorded at health facilities over the past 7-years period (January 2014 to December 2020) was taken from the District Health Information System version 2 (DHIS.2) database. Box–Jenkins autoregressive integrated moving average (ARIMA) was used to forecast monthly confirmed malaria cases for 2021. STATA software version 16 was used for analyzing the time series data. Results. Between 2014 and 2020, there were 3,795,541 confirmed malaria cases in the northwestern province with a monthly mean of 45,185 cases. ARIMA (2, 1, 2) (0, 1, 1)12 was the best fit and the most parsimonious model. The forecasted mean monthly confirmed malaria cases were 60,284 (95%CI 30,969–121,944), and the total forecasted confirmed malaria cases were 723,413 (95%CI 371,626–1,463,322) for the year 2021. Conclusion. The forecasted confirmed malaria cases suggest that there will be an increase in the number of confirmed malaria cases for the year 2021 in the northwestern province. Therefore, there is a need for concerted efforts to prevent and eliminate the disease if the goal to eliminate malaria in Zambia by 2030 is to be realized.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"522 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86887015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Knowledge and Practices in Medicine Dispensing between Retail Medicine Shops and Model Pharmacies in Dhaka Metropolis","authors":"M. Begum, Sanzana Fareen Rivu, Md. Ziauddin Iqbal, Nuzhat Tabassum, Nurnahar, Md Elias Uddin, Md. Marufur Rahman Moni, Md. Mahmud Al Hasan, M. Rahman","doi":"10.1155/2021/6633178","DOIUrl":"https://doi.org/10.1155/2021/6633178","url":null,"abstract":"Model pharmacy has been adopted recently to upgrade the healthcare delivery system in Bangladesh. This study was aimed to analyze and compare the effectiveness of drug dispensing patterns, practices, and knowledge of both clients and dispensers of model pharmacies over traditional retail medicine shops. Two established methods, namely, client simulated method (CSM) and provider interview method (PIM), were employed to determine the practice differences in 90 retail medicine shops and 90 model pharmacies in and around Dhaka city. The results are represented primarily in comparison with corresponding percentages. The survey results did not fully support the findings obtained from the observations of the CSM as PIM contrasted these to some extent, and the differences are statistically significant (\u0000 \u0000 p\u0000 <\u0000 0.0001\u0000 \u0000 ). According to CSM, the presence of A-grade pharmacists during working hours in retail medicine shops was 0%, and 63% in model pharmacies. As reported by PIM, in the retail medicine shops, 36% of clients were ignorant of visiting doctors before purchasing medicine. On the other hand, only 18% of clients could visit doctors. As per CSM, 40% of clients did not follow doctors' recommendations for completion of the full dose of antibiotics bought from retail medicine shops and 51% did not finish full antibiotic courses collected from model pharmacies. Additionally, CSM revealed that 28% of the clients administered leftover drugs following old and obsolete prescriptions of retail medicine shops and 21% of clients followed the same practices in terms of model pharmacies. The report of CSM revealed that 95% of dispensers of retail medicine shops sold medicine without prescription except over-the-counter (OTC), and in the model pharmacies, the percentage was 77%. The qualitative findings revealed substandard practices and dispensing pattern too. Model pharmacies were established to prevent aberrant medicine dispensing patterns and ensure proper medication dispensing practices and medicine intake. This research could not verify the situation that pharmacists or owners of model pharmacies were fully abiding by the guidelines set for them by the Directorate General of Drug Administration (DGDA).","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"30 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2021-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85287898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Knowledge, Attitude, and Practices of Cigarette Smokers and Use of Alternative Nicotine Delivery Systems in Pakistan: A Cross-Sectional Study","authors":"A. Hameed, Daud Malik","doi":"10.1155/2021/5555190","DOIUrl":"https://doi.org/10.1155/2021/5555190","url":null,"abstract":"Background. This research has been conducted to assess smokers’ knowledge and behavior vis-à-vis combustible smoking cessation, prevalence, and risk, and the use of alternative nicotine delivery systems to quit smoking. Methods. A mixed-method approach utilizing cross section primary survey data and comprising descriptive and s-KAP index analysis has been adopted to ascertain the relationship between dependent and independent s-KAP variables; the principal component analysis methodology has been used to determine the use of alternative nicotine delivery systems. Results. Most of the smokers were aged between 15 and 35 years. A predominant 69.8% of the smokers came from middle-class background. Moreover, 71.3% were unaware of any alternative Tobacco Harm Reduction product. A majority of the respondents (68.2%) were keen to quit smoking. However, when asked why they had not succeeded, 52.9% reported addiction to nicotine as the main impediment. In Pakistan, lack of smoking cessation services is the weak link in the fight against the tobacco epidemic. Smokers are generally unaware of the Tobacco Harm Reduction products available in Pakistan; moreover, only 10.9% of the respondents were willing to spend more than Rs. 4000 per month on Tobacco Harm Reduction products. The average s-KAP score for young adults below the age of 20 was much lower than the national average but improved with the level of education. Interestingly, the score of smokers who had ever tried to quit smoking was slightly higher than that of those who had never tried to quit. Conclusion. There is intent to quit combustible smoking but the policy and infrastructure necessary for successful quitting are missing. Pakistan needs to concentrate on two fronts: a large scale awareness campaign against the use and harms of combustible smoking and simultaneously providing affordable and accessible smoking services across the country. Pakistan should look at the use and regulation of safer nicotine products in the UK. The country should carefully weigh the options of ensuring how to incorporate the use of safer nicotine delivery systems in its tobacco control efforts.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"22 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84676959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Intraocular Pressure (IOP) of Glaucoma Patients at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia","authors":"Mitiku Wale Muluneh, Shewayiref Geremew Gebremichael","doi":"10.1155/2021/5308376","DOIUrl":"https://doi.org/10.1155/2021/5308376","url":null,"abstract":"Background. Glaucoma is a leading cause of irreversible blindness in the world associated with characteristic damage to the optic nerve and patterns of visual field loss due to retinal ganglion cell degeneration. The main objective of this study was to investigate determinants for the variation of intraocular pressure of glaucoma patients under treatment at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia. Methods. A retrospective cohort study design was conducted on 328 randomly selected glaucoma patients in the ophthalmology clinic at the hospital under the follow-up period from January 2014 to December 2018. Glaucoma patients who have two and more than two visits in the study period were included in the study, but patients who are attending medications less than two visits were excluded from the study. A linear mixed-effects model for intraocular pressure change was used for data analysis. Result. The estimated coefficient of fixed effect intercept was 25.1829, which indicates that the average IOP of the patients was 25.1829 mmHg at baseline time by excluding all covariates in the model (\u0000 \u0000 p\u0000 \u0000 value <0.0001), age (\u0000 \u0000 β\u0000 \u0000 =0.07, 95%CI 0.03, 0.11), urban residence (\u0000 \u0000 β\u0000 \u0000  = −1.60, 95%CI −2.84, −0.36), family history of glaucoma (\u0000 \u0000 β\u0000 \u0000  = 4.90, 95%CI 3.38–6.43), timolol and pilocarpine medication (\u0000 \u0000 β\u0000 \u0000  = −2.02, 95%CI −4.01, −0.03), cup-disk ratio >0.7 (\u0000 \u0000 β\u0000 \u0000  = 2.60, 95% CI 1.24–3.96), and follow-up time (\u0000 \u0000 β\u0000 \u0000  = −0.34, 95%CI −0.47, −0.21) were significantly associated with intraocular pressure of glaucoma patients. Conclusion. The predictor age, residence, family history of glaucoma, type of medication, cup-disk ratio, and follow-up time were significantly associated with the intraocular pressure of glaucoma patients. Therefore, healthcare providers give more attention and prioritize those identified factors and give frequent counseling about reducing intraocular pressure of glaucoma patients.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"87 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2021-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85842284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and Attitudes Regarding Seasonal Influenza and Influenza Vaccination among Patients and Their Companions in North Palestine Hospitals","authors":"Issa Alawneh, Hamza Al-Sayeh, M. Zaid, Maysa Alawneh, H. Al-Tatari","doi":"10.1155/2021/3611846","DOIUrl":"https://doi.org/10.1155/2021/3611846","url":null,"abstract":"Background. Seasonal influenza is a common highly infectious disease that can affect the upper and lower airway in children and adults mainly in wintertime which is caused by many different influenza viruses and, in some cases, may cause serious complications such as pneumonia. We conducted this study to assess the knowledge and attitudes among patients and their companions in North Palestine hospitals regarding seasonal influenza and influenza vaccination and factors influencing the uptake of this vaccine so that we can identify gaps in their knowledge and give feedback to health authorities for future quality improvement projects by increasing awareness of its effectiveness and safety. Methods. A cross-sectional 17-item survey included randomly selected samples of 327 North Palestinian patients and their companions at North Palestine hospitals. Result. A total of 327 completed questionnaires were received with a response rate of 92%. Of these, 129 participants (39.4%) believed that influenza is the same as common cold. The majority of participants (85.3%) had heard of the influenza vaccine before. Although nearly half of them (53.6%) believed that the influenza vaccine is safe, only 112 (34.7%) of the participants considered vaccination an effective means in preventing serious influenza-related complications and only 89 (27.2%) participants were previously vaccinated. The main reasons for not being vaccinated included that vaccination is not necessary because flu is not a serious disease (67%), concerns about vaccine efficacy and its side effects (25.6%), fear of needles and injection (25.2%), and 17.8% of the participants believed that this vaccine is expensive. Conclusion. The uptake and knowledge of the influenza vaccine among Palestinians are low. Vaccinated participants in our survey showed a higher level of knowledge compared to nonvaccinated participants. Half of the participants believed in the safety of the vaccine and one-third of them believed in its efficacy in preventing flu illness and its complications. Extensive and sustained efforts are needed by public health programs to promote the flu vaccine among the public by increasing awareness of its effectiveness and safety.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"3 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86537644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Armed Conflict and Child Weight in DR Congo","authors":"Kien Le","doi":"10.1155/2021/6931096","DOIUrl":"https://doi.org/10.1155/2021/6931096","url":null,"abstract":"This paper investigates the extent to which armed conflict influences the weight of young children in the Democratic Republic of the Congo. Exploiting the variation across districts in exposure to armed conflict and the within-district variation in the timing of whether the child was exposed to armed conflict due to birth timing within a difference-in-differences framework, we detect adverse impacts of conflict exposure to child weight. Specifically, experiencing armed conflict makes children weigh less for their age and weigh less for their height by 0.20 and 0.24 standard deviations, respectively. Armed conflict also increases the probability of children being underweight and wasted by 4.7 and 2.7 percentage points, respectively. Our heterogeneity analyses reveal that children of disadvantaged backgrounds, i.e., those born to low-educated mothers, poor mothers, and rural mothers, tend to be disproportionately affected. Our study calls for effective measures to mitigate the detrimental repercussions of armed conflict.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"31 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2021-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89657715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access Differentials in Primary Healthcare among Vulnerable Populations in a Health Insurance Setting in Kumasi Metropolis, Ghana: A Cross-Sectional Study","authors":"G. Acquah-Hagan, D. Boateng, E. Appiah-Brempong, Peter Twum, Joseph Amankwa Atta, P. Agyei-Baffour","doi":"10.1155/2021/9911436","DOIUrl":"https://doi.org/10.1155/2021/9911436","url":null,"abstract":"Background. Access to healthcare remains a challenge towards the achievement of the Sustainable Development Goals in Ghana. There still remain inequalities in the distribution of health services especially among vulnerable groups despite sustained efforts to strengthen the health system. This study was conducted to analyze access differentials among different vulnerable groups in the context of primary healthcare under a National Health Insurance Scheme (NHIS) in Ghana. Methods. This study was a descriptive cross-sectional study conducted among multilevel participants of vulnerable groups in Kumasi Metropolis: 710 vulnerable people constituting elderly/aged (n = 359), pregnant women (n = 117), head poters (teenage girls who migrated from the northern Ghana mainly to the capital cities of the Ashanti and Greater Accra region to help in carrying of goods for their livelihood) (n = 86), sex workers (n = 75), and other vulnerable groups (people with disabilities and street participants) (n = 73). Data were collected using a semistructured questionnaire. Poisson regression with robust variance was used to access the association between vulnerability and access to healthcare. Results. Close to a fifth, 18.5% of the study respondents were unable to access care at any point in time during the last 12 months. Reasons for the inability to access healthcare included limited funding (69.7%), poor attitude of service providers (7.6%), distance to health centers (8.3%), and religious reasons (6.2%). More than 95% of respondents were insured under the NHIS, but acceptability of service provision under the NHIS was low among the vulnerable groups. In the crude models, pregnant women had lower prevalence of access to medications as compared to the elderly (prevalence ratio (PR): 0.88; 95% CI: 0.80–0.98). Head poters and other vulnerable groups were also less likely to view healthcare as affordable as compared to the elderly. The differences in healthcare access observed were attenuated after adjustment for sociodemographic characteristics and healthcare-related factors. Conclusions. Despite the introduction of a NHIS in Ghana, this study highlights challenges in healthcare access among vulnerable populations independent of the type of vulnerability. This suggests the need for stakeholders to work to address access differentials in the NHIS and adopt other innovative care strategies that may have broader applicability for all populations.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"5 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83592272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}