Archives of public health = Archives belges de sante publique最新文献

{"title":"Has Latin America achieved universal health coverage yet? Lessons from four countries.","authors":"Ramiro E Gilardino,&nbsp;Pilar Valanzasca,&nbsp;Susan B Rifkin","doi":"10.1186/s13690-022-00793-7","DOIUrl":"https://doi.org/10.1186/s13690-022-00793-7","url":null,"abstract":"<p><strong>Background: </strong>Seven years after the commitment to United Nations' call for Universal Health Coverage, healthcare services in Argentina, Brazil, Colombia, Mexico are generally accessible and affordable; but they still struggle to meet population health demands and address the rising health care costs. We aim to describe measures taken by these four countries to commit by Universal Health Coverage, addressing their barriers and challenges.</p><p><strong>Methods: </strong>Scoping literature review, supplemented with targeted stakeholders survey.</p><p><strong>Results: </strong>The four countries analysed achieved an overall index of essential coverage of 76-77%, and households out of pocket health expenditures fall below 25%. Services coverage was improved by expanding access to primary healthcare systems and coverage for non-communicable diseases, while provided community outreach by the increase in the number of skilled healthcare workers. New pharmaceutical support programs provided access to treatments for chronic conditions at zero cost, while high-costs drugs and cancer treatments were partially guaranteed. However, the countries lack with effective financial protection mechanisms, that continue to increase out of pocket expenditure as noted by lowest financial protection scores, and lack of effective financial mechanisms besides cash transfers.</p><p><strong>Conclusions: </strong>Argentina, Brazil, Colombia, and Mexico have made progress towards UHC. Although, better financial protection is urgently required.</p>","PeriodicalId":365748,"journal":{"name":"Archives of public health = Archives belges de sante publique","volume":" ","pages":"38"},"PeriodicalIF":3.3,"publicationDate":"2022-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8777418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39847563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of perinatal depression on birth and infant health outcomes: a systematic review and meta-analysis of observational studies from Africa.","authors":"Abel Fekadu Dadi,&nbsp;Temesgen Yihunie Akalu,&nbsp;Haileab Fekadu Wolde,&nbsp;Adhanom Gebreegziabher Baraki","doi":"10.1186/s13690-022-00792-8","DOIUrl":"https://doi.org/10.1186/s13690-022-00792-8","url":null,"abstract":"<p><strong>Background: </strong>Antenatal depression is associated with intrauterine growth retardation, preterm birth, and low birth weight. Infants born to mothers with postnatal depression also may suffer from malnutrition and other health problems. Even though there are few single studies conducted so far, a systematic review of these studies is highly important to highlight the effect of antenatal and perinatal depression on adverse birth and infant health outcomes in Africa.</p><p><strong>Methods: </strong>We used the Preferred Report Items for Systematic Review and Meta-analysis (PRISMA) when conducting this study. Databases like CINAHL (EBSCO), MEDLINE (via Ovid and PubMed), PsycINFO, Emcare, Psychiatry Online, and Scopus were searched. In addition, Google Scholar and references from a list of eligible studies were explored. We included good quality observational studies based on Newcastle Ottawa Scale which are published in the English language between 2007 and 2018.  Heterogeneity and publication bias were assessed. Meta-analysis with a random effect model was employed to determine the pooled effect sizes with a 95% confidence interval. The review protocol is registered in PROSPERO (CRD42018106714).</p><p><strong>Result: </strong>We found three studies (1511 participants) and 11 studies (22,254 participants) conducted on the effect of antenatal depression on birth outcomes and perinatal depression on adverse infant health outcomes, respectively. The overall risk of having adverse birth outcomes was 2.26 (95% CI: 1.43, 3.58) times higher among pregnant mothers with depression. The risk of preterm birth and low birth weight was 1.77 (95% CI: 1.03, 3.04) and 2.98 (95% CI: 1.60, 5.55) respectively. Similarly, the risk of having adverse infant health outcomes namely malnutrition and febrile illness was 1.61 (95% CI: 1.34, 1.95) times higher among mothers who had perinatal depression.</p><p><strong>Conclusions: </strong>We have found a significant association between antenatal depression and adverse birth outcomes, low birth weight and preterm birth. Similarly, a significant effect of perinatal depression on adverse infant health outcomes namely, malnutrition, and febrile illnesses was observed. The findings highlight that it is time to integrate mental health services with routine maternal health care services to improve birth outcomes and reduce infant morbidity.</p>","PeriodicalId":365748,"journal":{"name":"Archives of public health = Archives belges de sante publique","volume":" ","pages":"34"},"PeriodicalIF":3.3,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8772173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39956922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial epidemiology of skin cancer in Iran: separating sun-exposed and non-sun-exposed parts of the body.","authors":"Behzad Kiani,&nbsp;Parinaz Tabari,&nbsp;Alireza Mohammadi,&nbsp;Sayyed Mostafa Mostafavi,&nbsp;Mohsen Moghadami,&nbsp;Mitra Amini,&nbsp;Abbas Rezaianzadeh","doi":"10.1186/s13690-022-00798-2","DOIUrl":"https://doi.org/10.1186/s13690-022-00798-2","url":null,"abstract":"<p><strong>Background: </strong>Skin cancer is among the most common cancer types with an increasing global trend of incidence rate. This study explores the spatial distribution of skin cancer, considering body sites exposed and not exposed to sunshine separately.</p><p><strong>Methods: </strong>We used 4302 skin cancer cases recorded by Fars Cancer Registry in south-western Iran for over 6 years (2011-2017). The variables included in the study were patients' residence address, gender, age, report date, and final topographical code. The patients' addresses were geocoded to the counties of the study area. Skin cancer sites were categorized based on sun exposure in male and female cases. We used the empirical Bayesian smoothing approach to smooth the skin cancer incidence rate at the county level to remove any potential population size bias. Finally, Anselin's Local Moran's Index and Getis Ord G* were used to identify the clustered and high-risk skin cancer geographical areas.</p><p><strong>Results: </strong>The incidence rates had an increasing trend from 14.28 per 100,000 people in 2011 to 17.87 per 100,000 people in 2016, however, it was decreased to 13.05 per 100,000 people in 2017. Out of 4302 patients with skin cancer, 2602 cases (60%) were male. The cancer cumulative incidence rate in males and females who were not exposed to sunshine was 7.80 and 14.18 per 100,000, respectively. The rates increased to 86.22 and 48.20 in males and females who were exposed to the sun. There were some high-risk spatial clusters of skin cancer in the study area. Further investigations are required to identify the underlying cause of the formation of these clusters.</p><p><strong>Conclusions: </strong>Patients exposed to sunshine, especially among the male group, experienced much higher rates of cancer occurrence as compared to unexposed individuals. With a heterogeneous spatial pattern, hotspots were identified in non-sun-exposed and sun-exposed categories in the study area. Researchers and policymakers can significantly benefit from the spatial analyses of skin cancer incidence. These analyses can provide useful and timely prevention policies as well as tailored monitoring techniques in high-risk regions.</p>","PeriodicalId":365748,"journal":{"name":"Archives of public health = Archives belges de sante publique","volume":" ","pages":"35"},"PeriodicalIF":3.3,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8772111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39719886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous reporting of adverse drug reaction among health professionals in Ghana.","authors":"Morrison Asiamah,&nbsp;Kwadwo Owusu Akuffo,&nbsp;Pricillia Nortey,&nbsp;Nina Donkor,&nbsp;Anthony Danso-Appiah","doi":"10.1186/s13690-021-00783-1","DOIUrl":"https://doi.org/10.1186/s13690-021-00783-1","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous reporting of adverse drug reactions (ADR) is an effective means of ensuring postmarketing surveillance of drugs, and health professionals play a cardinal role through voluntary reporting of ADR. However, the pharmacovigilance system in Ghana is plagued with under-reporting issues, which is of public health concern.</p><p><strong>Method: </strong>A questionnaire-based cross-sectional study involving 268 health professionals at Kpone-Katamanso District was carried out. Data on spontaneous reporting of ADR, demographics of participants, knowledge, and attitudes of professionals towards reporting and factors that may influence ADR reporting were collected. Logistic regression models were used to examine the association of the independent variables with spontaneous reporting of ADR.</p><p><strong>Result: </strong>Overall, 77.6% (208) of the 268 respondents had observed ADR; however, only 17.3% of the respondents had ever reported an ADR to the Ghana FDA. Health professionals who had average knowledge on spontaneous reporting of ADR were 51.9%, while 30.3% had good knowledge of spontaneous reporting of ADR. After adjustment on potential confounding variables (Knowledge, Feedback from FDA, Uncertainty about cause of ADR, Severity of ADR), Age (AOR = 2.26, 95%CI = 1.25-4.10), Fear of Legal Consequences (AOR = 0.15, 95%CI = 0.41-0.51), Time Constraint (AOR = 0.3, 95%CI = 0.10-0.91), Pharmacovigilance training (AOR = 18.78, 95%CI = 5.46-64.59) and Unavailability of Reporting form (AOR = 0.28, 95%CI = 0.09-0.88) were found to be significantly associated spontaneous reporting of ADR.</p><p><strong>Conclusion: </strong>The proportion of health professionals in the Kpone- Katamanso District who spontaneously reported observed ADR was low though they had average knowledge about ADR reporting. This underscores the need for a policy to be implemented that makes spontaneous reporting of adverse drug reaction mandatory for health professionals.</p>","PeriodicalId":365748,"journal":{"name":"Archives of public health = Archives belges de sante publique","volume":" ","pages":"33"},"PeriodicalIF":3.3,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8772084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39720312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of disaggregate data in evaluations of public health interventions: cross-sectional dependence can bias inference.","authors":"Torleif Halkjelsvik, Antonio Gasparrini, Rannveig Kaldager Hart","doi":"10.1186/s13690-022-00795-5","DOIUrl":"10.1186/s13690-022-00795-5","url":null,"abstract":"<p><p>Higher availability of administrative data and better infrastructure for electronic surveys allow for large sample sizes in evaluations of national and other large scale policies. Although larger datasets have many advantages, the use of big disaggregate data (e.g., on individuals, households, stores, municipalities) can be challenging in terms of statistical inference. Measurements made at the same point in time may be jointly influenced by contemporaneous factors and produce more variation across time than suggested by the model. This excess variation, or co-movement over time, produce observations that are not truly independent (i.e., cross-sectional dependence). If this dependency is not accounted for, statistical uncertainty will be underestimated, and studies may indicate reform effects where there is none. In the context of interrupted time series (segmented regression), we illustrate the potential for bias in inference when using large disaggregate data, and we describe two simple solutions that are available in standard statistical software.</p>","PeriodicalId":365748,"journal":{"name":"Archives of public health = Archives belges de sante publique","volume":" ","pages":"36"},"PeriodicalIF":0.0,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8772208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39705082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and characterization of forgoing care: comparison of two prospective multicentre cohorts between pre-COVID-19 era and a lockdown period.","authors":"Delphine Douillet,&nbsp;Clémence Dupont,&nbsp;Noémie Leloup,&nbsp;Grégory Ménager,&nbsp;Maud Delori,&nbsp;Caroline Soulie,&nbsp;François Morin,&nbsp;Thomas Moumneh,&nbsp;Dominique Savary,&nbsp;Pierre-Marie Roy,&nbsp;Aurore Armand","doi":"10.1186/s13690-022-00797-3","DOIUrl":"https://doi.org/10.1186/s13690-022-00797-3","url":null,"abstract":"<p><strong>Background: </strong>Little is known about patients who forego healthcare, although it is an important provider of unfavorable health-related outcomes. Forgoing healthcare characterizes situations in which people do not initiate or interrupt a care process, even though they perceive the need for it, whether or not this need is medically proven. The aims of this study were to assess the prevalence and the determinants of patients who forego healthcare. The second aim was to compare the characteristics of patients who gave up healthcare during the French lockdown due to COVID-19.</p><p><strong>Methods: </strong>We conducted two multicenter cross-sectional studies in 2017 and 2020 carried out in French patients presenting to the emergency departments. Patients who gave their consent to participate were interviewed with a standardized questionnaire. It consisted of two parts: epidemiological characteristics and health care refusal. A third part concerning the renunciation of care during the COVID-19 period was added to the second study period.</p><p><strong>Results: </strong>A total of 1878 patients had completed the questionnaire during the interview with the physicians, 900 during the first period in 2017 (47.9%) and 978 (52.1%) during the second period. A total of 401/1878 patients reported not seeking care in the last 12 months (21.4% [95%CI: 19.5-23.3%]). In 2020, patients forewent care more during the confinement period than outside with different characteristics of the foregoing care populations.</p><p><strong>Conclusion: </strong>Forgoing care is common in a universal health care system such as France's and increased during the pandemic. Key public health messages targeted at the reasons for not seeking care must now be disseminated in order to combat this.</p>","PeriodicalId":365748,"journal":{"name":"Archives of public health = Archives belges de sante publique","volume":" ","pages":"32"},"PeriodicalIF":3.3,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8766360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39944372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating technical and political views for a sustainable European Distributed Infrastructure on Population Health.","authors":"Alicia Padron-Monedero,&nbsp;Rodrigo Sarmiento Suárez,&nbsp;Petronille Bogaert,&nbsp;Linda Abboud,&nbsp;Herman Van Oyen,&nbsp;Hanna Tolonen,&nbsp;Mariken J Tijhuis,&nbsp;Luigi Palmieri,&nbsp;Romana Haneef,&nbsp;Anne Gallay,&nbsp;Luis Lapao,&nbsp;Paulo Jorge Nogueira,&nbsp;Thomas Ziese,&nbsp;Stefanie Seeling,&nbsp;Jakov Vukovic,&nbsp;Isabel Noguer-Zambrano","doi":"10.1186/s13690-022-00790-w","DOIUrl":"https://doi.org/10.1186/s13690-022-00790-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Non-Communicable diseases (NCD) are the main contributors to mortality and burden of disease. There is no infrastructure in Europe that could provide health information (HI) on Public Health monitoring and Health Systems Performance (HSP) for research and evidence-informed decision-making. Moreover, there was no EU and European Economic Area Member States (EU/EEA MSs) general consensus, on developing this initiative and guarantee its sustainability. The aim of this study is to analyze the integration of technical and political views made by the Joint Action on Health Information (InfAct; Information for Action) and the results obtained from those activities, in terms of advice and national and institutional support to develop an integrated and sustainable European Distributed Infrastructure on Population Health (DIPoH) for research and evidence-informed policy-making.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;InfAct established two main boards, the Technical Dialogues (TDs) and the Assembly of Members (AoM), to provide a platform for discussion with EU/EEA MSs to establish a sustainable infrastructure for HI: 1) The TDs were composed by national technical experts (NTE) with the aim to discuss and provide feedback about scientific aspects, feasibility and EU-added value of the infrastructure proposed by InfAct. 2) The AoM gathered country representatives from Ministries of Health and Research at the highest political level, with the aim of providing policy-oriented advice for the future political acceptance, support, implementation, and development of InfAct's outcomes including DIPoH. The documentation provided for the meetings consisted in Fact-Sheets, where the main results, new methods and proposals were clearly exposed for discussion and assessment; altogether with more extended information of the DIPoH. The documentation was provided to national representatives within one more before each TD and AoM meeting. The Agenda and methodological approaches for each TD and AoM meeting consisted in the presentations of the InfAct outcomes extending the information provided in the Fact-Sheets; followed by a non-structured interaction, exchange of information, discussion and suggestions by the MSs representatives. The outcomes of the non-structured discussions were collected in Minutes of the TD and AoM meetings, and the final version was obtained with the consensus of all participants. Additionally, structured letters of political support were provided to the AoM representatives, for them to consider providing their MS written support for DIPoH.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;NTE, within the TDs, considered that DIPoH was useful for technical mutual learning and cooperation among and within countries; although they considered that the technical feasibility to uptake InfAct deliverables at the national and EU level was complex. The AoM focused on political support, resources, and expected MSs returns. The AoM representatives agree","PeriodicalId":365748,"journal":{"name":"Archives of public health = Archives belges de sante publique","volume":" ","pages":"29"},"PeriodicalIF":3.3,"publicationDate":"2022-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8761966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39827909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-emergent care visits in a turkish tertiary care emergency department after 2008 health policy changes: review and analysis.","authors":"Cihad Dundar,&nbsp;Seydanur Dal Yaylaoglu","doi":"10.1186/s13690-022-00787-5","DOIUrl":"https://doi.org/10.1186/s13690-022-00787-5","url":null,"abstract":"<p><strong>Background: </strong>The Turkish government liberalized national healthcare policies in 2008 enabling Turkish citizens to seek general care in hospital emergency departments (ED). The number of ED visits has exceeded the total population every year for the last ten years. To explain this phenomenon and to identify trends and risk factors for non-emergent visits, we retrospectively reviewed the ED records of a tertiary hospital and the Turkish Ministry of Health bulletin.</p><p><strong>Methods: </strong>This retrospective record-based study was conducted at a tertiary hospital in Samsun province of Turkey. A total of 87,528 records of adult patients who visited the ED between January 1 and December 31, 2017, were included in this study. We evaluated the pattern of ED use for non-emergent patients by age, gender, nationality, time of visit, means of arrival, ICD (International Classification of Diseases) diagnostic codes, triage codes, number of repeated and out-of-hours visits. We used the Turkish Ministry of Health statistics bulletins to compare the number of ED visits across the country by year.</p><p><strong>Results: </strong>The non-emergent visit rate in ED was found 9.9%. The rate of non-emergent ED visits was significantly higher in the 18-44 age group, in the female gender, and in those who arrived at the ED without an ambulance. The number of non-emergent visits was very similar between weekends and weekdays but was significantly higher in working hours on weekdays than out-of-hours (p<0.001). The most frequent diagnostic code was \"Pain, unspecified\" (R52) and the rate of repeat visits was 14.8% of non-emergent ED visits. According to binary logistic analysis, non-emergency visits were associated with 18-44 age group (OR = 2.75), female gender (OR = 1.11) and non-ambulance transportation (OR = 9.86).</p><p><strong>Conclusions: </strong>Our results showed that the 18-44 age group and female gender seek care in the ED for non-emergent problems more than the other parts of the population. The numbers of ED visits in the last decade continued to increase regardless of population growth. The health policy changes may have facilitated access to rapid physical and laboratory examination but also an exacerbation of the free-rider problem in ED services.</p>","PeriodicalId":365748,"journal":{"name":"Archives of public health = Archives belges de sante publique","volume":" ","pages":"31"},"PeriodicalIF":3.3,"publicationDate":"2022-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8762921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39827914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Locally structured correlation (LSC) plots describe inhomogeneity in normally distributed correlated bivariate variables.","authors":"Rebekka Mumm,&nbsp;Christiane Scheffler,&nbsp;Michael Hermanussen","doi":"10.1186/s13690-021-00748-4","DOIUrl":"https://doi.org/10.1186/s13690-021-00748-4","url":null,"abstract":"<p><strong>Background: </strong>The association between bivariate variables may not necessarily be homogeneous throughout the whole range of the variables. We present a new technique to describe inhomogeneity in the association of bivariate variables.</p><p><strong>Methods: </strong>We consider the correlation of two normally distributed random variables. The 45° diagonal through the origin of coordinates represents the line on which all points would lie if the two variables completely agreed. If the two variables do not completely agree, the points will scatter on both sides of the diagonal and form a cloud. In case of a high association between the variables, the band width of this cloud will be narrow, in case of a low association, the band width will be wide. The band width directly relates to the magnitude of the correlation coefficient. We then determine the Euclidean distances between the diagonal and each point of the bivariate correlation, and rotate the coordinate system clockwise by 45°. The standard deviation of all Euclidean distances, named \"global standard deviation\", reflects the band width of all points along the former diagonal. Calculating moving averages of the standard deviation along the former diagonal results in \"locally structured standard deviations\" and reflect patterns of \"locally structured correlations (LSC)\". LSC highlight inhomogeneity of bivariate correlations. We exemplify this technique by analyzing the association between body mass index (BMI) and hip circumference (HC) in 6313 healthy East German adults aged 18 to 70 years.</p><p><strong>Results: </strong>The correlation between BMI and HC in healthy adults is not homogeneous. LSC is able to identify regions where the predictive power of the bivariate correlation between BMI and HC increases or decreases, and highlights in our example that slim people have a higher association between BMI and HC than obese people.</p><p><strong>Conclusion: </strong>Locally structured correlations (LSC) identify regions of higher or lower than average correlation between two normally distributed variables.</p>","PeriodicalId":365748,"journal":{"name":"Archives of public health = Archives belges de sante publique","volume":" ","pages":"30"},"PeriodicalIF":3.3,"publicationDate":"2022-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8762973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39828529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and determinants of postpartum family planning uptake among postpartum women in Western Ethiopia: a facility-based cross-sectional study.","authors":"Temesgen Tilahun,&nbsp;Tariku Tesfaye Bekuma,&nbsp;Motuma Getachew,&nbsp;Rut Oljira,&nbsp;Assefa Seme","doi":"10.1186/s13690-022-00786-6","DOIUrl":"https://doi.org/10.1186/s13690-022-00786-6","url":null,"abstract":"<p><strong>Background: </strong>Despite Ethiopia's efforts to avail postpartum family planning (PPFP) services, the unmet need for family planning among postpartum women remains high. Therefore, this study is aimed to assess barriers and determinants of postpartum family-planning uptake among women visiting Maternal, Neonatal, and Child Health (MNCH) services in public health facilities of western Ethiopia.</p><p><strong>Methods: </strong>A facility-based cross-sectional study design with a quantitative method was conducted on 989 postpartum women in Western Ethiopia from September 1 to October 30, 2020. Data were collected through face-to-face interviews using pretested structured questionnaires, entered using EPI-INFO version 7.0, and analyzed by SPSS version 25. Descriptive analysis and logistic regressions were performed. The adjusted odds ratio with a 95% confidence interval was used and statistical significance was declared at P-value < 0.05.</p><p><strong>Result: </strong>In this study, 56.1% of participants had used PPFP in the last year. The most commonly used method was injectable (51.7%). Family planning use before the index pregnancy (AOR = 2.09;95%CI:1.29,3,41),counselling on PPFP during antenatal care and delivery (AOR = 4.89;95%CI:2.31,10.37),health facility delivery (AOR = 7.61;95%CI:4.36,13.28), skilled birth attendance (AOR = 4.99;95%CI:2.88,8.64),COVID-19 restrictions (AOR = 0.59;95%CI:0.39,0.90) were factors associated with PPFP utilization. Being breastfeeding and amenorrhea were major reasons for not using postpartum family planning.</p><p><strong>Conclusion: </strong>Post-partum family planning utilization among study participants was low. Given the associated factors, it is recommended that health facilities should make postpartum family planning one of their top priorities and focus on these factors to improve its utilization.</p>","PeriodicalId":365748,"journal":{"name":"Archives of public health = Archives belges de sante publique","volume":" ","pages":"27"},"PeriodicalIF":3.3,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8753320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39691773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}