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Level of confidence in and endorsement of the health system among internet users in 12 low-income and middle-income countries.
Roder-DeWan, Sanam; Gage, Anna; Hirschhorn, Lisa R; Twum-Danso, Nana A Y; Liljestrand, Jerker; Asante-Shongwe, Kwanele; Yahya, Talhiya; Kruk, Margaret.
Afiliação
  • Roder-DeWan S; Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA roderdewan@mail.harvard.edu.
  • Gage A; Health Systems, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania.
  • Hirschhorn LR; Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA.
  • Twum-Danso NAY; Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
  • Liljestrand J; Maternal and Child Health, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.
  • Asante-Shongwe K; Bill and Melinda Gates Foundation, Seattle, Washington, USA.
  • Yahya T; African Organisation for Research and Training in Cancer, Cape Town, South Africa.
  • Kruk M; Quality Management Unit, Health Quality Assurance Department, Ministry of Health, Community, Development, Gender, Elderly and Children, Dodoma, Tanzania.
BMJ Glob Health ; 5(8)2020 08.
Article em En | MEDLINE | ID: mdl-32859647
INTRODUCTION: People's confidence in and endorsement of the health system are key measures of system performance, yet are undermeasured in low-income and middle-income countries (LMICs). We explored the prevalence and predictors of these measures in 12 countries. METHODS: We conducted an internet survey in Argentina, China, Ghana, India, Indonesia, Kenya, Lebanon, Mexico, Morocco, Nigeria, Senegal and South Africa collecting demographics, ratings of quality, and confidence in and endorsement of the health system. We used multivariable logistic regression to assess the association between confidence/endorsement and self-reported quality of recent healthcare. RESULTS: Of 13 489 respondents, 62% reported a health visit in the past year. Applying population weights, 32% of these users were very confident that they could receive effective care if they were to 'become very sick tomorrow'; 30% endorsed the health system, that is, agreed that it 'works pretty well and only needs minor changes'. Reporting high quality in the last visit was associated with 4.48 and 2.69 greater odds of confidence (95% CI 3.64 to 5.52) and endorsement (95% CI 2.33 to 3.11). Having health insurance was positively associated with confidence and endorsement (adjusted odds ratio (AOR) 1.68, 95% CI 1.49 to 1.90 and AOR 1.34, 95% CI 1.22 to 1.48), while experiencing discrimination in healthcare was negatively associated (AOR 0.67, 95% CI 0.56 to 0.80 and AOR 0.63, 95% CI 0.53 to 0.76). CONCLUSION: Confidence and endorsement of the health system were low across 12 LMICs. This may hinder efforts to gain support for universal health coverage. Positive patient experience was strongly associated with confidence in and endorsement of the health system.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Internet / Países em Desenvolvimento Tipo de estudo: Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Humans País/Região como assunto: Africa / Asia / Mexico Idioma: En Revista: BMJ Glob Health Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Internet / Países em Desenvolvimento Tipo de estudo: Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Humans País/Região como assunto: Africa / Asia / Mexico Idioma: En Revista: BMJ Glob Health Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido