Socioeconomic Determinants, Regional Differences, and Quality of Nephrology Research in Africa.
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ABSTRACT:
SUBMITTER: Noubiap JJ
PROVIDER: S-EPMC7569704 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
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Socioeconomic Determinants, Regional Differences, and Quality of Nephrology Research in Africa.
Noubiap Jean Jacques JJ Bigna Jean Joel JJ Ndoadoumgue Aude L AL Ekrikpo Udeme U Nkeck Jan J Udosen Aquaoqo A Tankeu Ronni R Kumar Komal K Bello Aminu A Okpechi Ikechi I
Kidney international reports 20200717 10
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Project description:BackgroundAccess to care for children with kidney disease is limited in less well-resourced regions of the world and paediatric nephrology (PN) workforce development with good practical skills is critical.MethodsRetrospective review of a PN training program and trainee feedback from 1999 to 2021, based at Red Cross War Memorial Children's Hospital (RCWMCH), University of Cape Town.ResultsA regionally appropriate 1-2-year training program enrolled 38 fellows with an initial 100% return rate to their country of origin. Program funding included fellowships from the International Pediatric Nephrology Association (IPNA), International Society of Nephrology (ISN), International Society of Peritoneal Dialysis (ISPD), and the African Paediatric Fellowship Program (APFP). Fellows were trained on both in- and out-patient management of infants and children with kidney disorders. "Hands-on skills" training included examination, diagnosis and management skills, practical insertion of peritoneal dialysis catheters for management of acute kidney injury and kidney biopsies. Of 16 trainees who completed > 1 year of training, 14 (88%) successfully completed subspecialty exams and 9 (56%) completed a master's degree with a research component. PN fellows reported that their training was appropriate and enabled them to make a difference in their respective communities.ConclusionsThis training program has successfully equipped African physicians with the requisite knowledge and skills to provide PN services in resource-constrained areas for children with kidney disease. The provision of funding from multiple organizations committed to paediatric kidney disease has contributed to the success of the program, along with the fellows' commitment to build PN healthcare capacity in Africa. A higher resolution version of the Graphical abstract is available as Supplementary information.
| S-EPMC10243235 | biostudies-literature
Project description:For Germany, regional differences for various health indicators, which are also associated with socioeconomic factors, have been documented. This article aims to develop a regional socioeconomic deprivation index for Germany that (1) can be used to analyse regional socioeconomic inequalities in health and (2) provides a basis for explaining regional health differences in Germany. The core data stem from the INKAR (indicators and maps on spatial and urban development in Germany and Europe) database compiled by Germany’s Federal Institute for Research on Building, Urban Affairs and Spatial Development. Factor analysis is used for indexing and the weighting of indicators for the three dimensions of education, occupation and income. The German Index of Socioeconomic Deprivation (GISD) is generated at the levels of associations of municipalities, administrative districts and administrative regions for the years 1998, 2003, 2008 and 2012. Aggregate data and individual data from the German Health Update 2014/2015-EHIS (GEDA 2014/2015-EHIS) study are used to analyse associations between the index and selected health indicators. For around two thirds of the causes of death, the German Index of Socioeconomic Deprivation reveals significant socioeconomic inequalities at the level of Germany’s administrative regions. At district level, life expectancy in the bottom fifth of districts presenting the highest levels of deprivation is, depending on the observation period, 1.3 years lower for women and 2.6 years lower for men in comparison to the upper fifth of districts presenting the lowest levels of deprivation. The index can explain 45.5% and 62.2% of regional differences in life expectancy for women and men, respectively. Moreover, the population in regions characterised by high levels of deprivation has significantly higher rates of smokers, engages less frequently in leisure-time physical activities and is more often obese. The German Index of Socioeconomic Deprivation illustrates regional socioeconomic differences at different spatial levels and contributes to explaining regional health differences. This index is intended for use in research as well as by federal and federal state health reporting systems and should enable access to new sources of data for investigating the links between social inequalities and health in Germany.
| S-EPMC10161274 | biostudies-literature
Project description:ObjectiveTo examine perceived inpatient care quality according to regional socioeconomic status (SES), measured by regional household income, across the United States and Taiwan.Data sourcesPatient Experience in Hospital Care (PEHC) survey 2018-2019 data from National Taiwan University; US Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) 2018-2019 data from CMS.gov; and household income and facility data from publicly accessible databases.Study designThis retrospective study used multivariate logistic regression to estimate the effect of household income on the rate of positive inpatient experiences in Taiwan and the United States, adjusting for hospitals' teaching status and ownership, and physician density.Data collectionHospital administrators for HCAHPS and PEHC's research teams invited patients who received inpatient care during the data collection period in the United States and Taiwan, respectively. The analysis included 1024 facilities from nine US states and 350 facilities from twenty major cities/counties in Taiwan.Principal findingsPerceived inpatient care quality was higher in the United States than in Taiwan for the three experience measures. In Taiwan, hospitals with higher regional SES were less likely to receive a highly positive response for perceived respect, accommodation quality, and understanding upon discharge, with odds ratios (ORs) ranging from 0.83 to 0.88. In contrast, in the United States, higher regional SES was associated with a higher likelihood of a positive response for accommodation quality and understanding upon discharge (ORs = 2.51 and 1.48). Regional physician density and individual hospital characteristics show varying effects on perceived quality between Taiwan and the United States.ConclusionsHigher overall experience scores in the United States are consistent with higher spending on health care compared with Taiwan. Varying associations between regional SES and perceived inpatient care quality highlight how systemic and cultural differences between the two countries affect scoring patterns.
| S-EPMC8579198 | biostudies-literature
Project description: Not available
| S-EPMC7526633 | biostudies-literature
Project description: Not available
| S-EPMC7000839 | biostudies-literature
Project description:This study is part of the Mutant Mouse Regional Resource Center Research. The series subsets represent the strain and age group for easy comparisons. Each subseries has data for three different tissues (brain, liver and kidney) and 2 sexes. Keywords: other
2005-10-18 | E-GEOD-1920 | biostudies-arrayexpress
Project description:BackgroundThe landscape of available psychosocial services within pediatric nephrology care is poorly characterized. However, the effects of kidney disease on emotional health and health-related quality of life are well documented, as is the impact of social determinants of health on kidney disease outcomes. The objectives of this study were to assess pediatric nephrologists' perceptions of available psychosocial services and to elucidate inequities in access to psychosocial care.MethodsA web-based survey was distributed to members of the Pediatric Nephrology Research Consortium (PNRC). Quantitative analyses were performed.ResultsWe received responses from 49 of the 90 PNRC centers. With regards to dedicated services, social work was most commonly available (45.5-100%), followed by pediatric psychology (0-57.1%) and neuropsychology (0-14.3%), with no centers having embedded psychiatry. Availability of psychosocial providers was positively associated with nephrology division size, such that as center size increased, access to various psychosocial providers increased. Notably, the majority of respondents indicated that perceived need for psychosocial support exceeds that which is currently available, even at centers with higher levels of current support.ConclusionsWithin the US, there is wide variability in the availability of psychosocial services within pediatric nephrology centers despite a well-documented necessity for the provision of holistic care. Much work remains to better understand the variation in funding for psychosocial services and in utilization of psychosocial professionals in the pediatric nephrology clinic, and to inform key best practices for addressing the psychosocial needs of patients with kidney disease.
| S-EPMC10168552 | biostudies-literature
Project description:BackgroundEpidemiological research has long observed a varying prevalence of hypertension across socioeconomic strata. However, patterns of association and underlying causal mechanisms are poorly understood in sub-Saharan Africa. Using education and income as indicators, we investigated the extent to which socioeconomic status is linked to blood pressure in the first wave of the National Income Dynamics Study--a South African longitudinal study of more than 15,000 adults--and whether bio-behavioural risk factors mediate the association.MethodsIn a cross-sectional analysis, structural equation modelling was employed to estimate the effect of socioeconomic status on systolic and diastolic blood pressure and to assess the role of a set of bio-behavioural risk factors in explaining the observed relationships.ResultsAfter adjustment for age, race and antihypertensive treatment, higher education and income were independently associated with higher diastolic blood pressure in men. In women higher education predicted lower values of both diastolic and systolic blood pressure while higher income predicted lower systolic blood pressure. In both genders, body mass index was a strong mediator of an adverse indirect effect of socioeconomic status on blood pressure. Together with physical exercise, alcohol use, smoking and resting heart rate, body mass index therefore contributed substantially to mediation of the observed relationships in men. By contrast, in women unmeasured factors played a greater role.ConclusionIn countries undergoing epidemiological transition, effects of socioeconomic status on blood pressure may vary by gender. In women, factors other than those listed above may have substantial role in mediating the association and merit investigation.
| S-EPMC4021547 | biostudies-literature
Project description:BackgroundHigh rates of maternal mortality and morbidity remain significant health issues in low- and middle-income countries. Despite this, few researchers have investigated the underlying factors of severe maternal complications in sub-Saharan Africa. Therefore, the objective of this systematic review was to determine the socioeconomic, demographic, and obstetric predictors of severe maternal complications in this region.MethodFor this systematic review, we searched PubMed, Scopus and Science Direct between 2000 and 2022. Studies were eligible if they reported a relationship between impending maternal death and one or more socioeconomic, demographic or obstetric determinants. We did not contact the authors of the articles, as we had access to their full texts. The quality of qualitative and quantitative studies was assessed using the Critical Appraisal Skills quality assessment tool.ResultsAmong the 3001 identified studies, this systematic review selected 25 articles. Factors such as economic status, level of education, maternal age, marital status, rural residence, transfers to other facilities, and delays during childbirth were identified as the main determinants of severe complications occurrence in Africa. Disparities in access to maternal healthcare were observed among women from different socioeconomic groups, often due to power imbalances in decision-making processes.ConclusionSeveral factors, including education, prenatal care follow-up, pre-existing medical conditions, method of admission, and mode of delivery, have been identified as significant indicators of the likelihood of severe maternal morbidity. To reduce these cases, it is crucial to implement targeted socio-economic development programs, including improving access to education, strengthening prenatal health services, providing support to pregnant women with pre-existing medical conditions, and ensuring appropriate admission and delivery methods.
| S-EPMC11819575 | biostudies-literature
Project description:This study evaluates the nexus of regional integration, socioeconomic determinants and sustainable development (SD) by investigating the effect of health, humans and age structure on sustainable development, with the regional integration (RI) as the moderating variable. Socioeconomic determinants have an important role in sustainable development, while regional integration has fueled up the development process. The sample is based on 64 Belt and Road (BRI) countries from 2003-2018. Pair-wise correlation results indicate that human development, health expenditure and age structure showed a positive relationship with sustainable development. Two-step System-GMM direct effect outcomes are mixed and reveal that human development, health expenditure per capita, age structure, governance index and population size have a positive impact on sustainable development. On the other hand, e-government, government size, and globalization showed negative effects on SD. Apart from that, the moderating channel of regional integration (RI), interaction term with human development and health expenditure, showed a significant and positive impact on sustainable development. However, age structure interaction with regional integration showed a negative impact on SD. Other socio-economic factors, i.e., governance index and population contribute positively towards SD. It can be concluded that the dynamic nature of sustainable development is positive and the net present value is increasing. Therefore, BRI countries are on the sustainable path from 2003-2018, as suggested by economic and social welfare theory. The integration of BRI can be labeled as an entrance to successful sustainable development. However, weak e-government systems, globalization and government resources need to be utilized amicably in Belt and Road countries. Driscoll-Kraay standard-errors regression confirmed and validated the two-step System-GMM results. The findings of the current research have important policy implications for balanced and sustainable growth.
| S-EPMC8270197 | biostudies-literature