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8. Feasibility assessment of invigorating grassrooTs primary healthcare for prevention and management of cardiometabolic diseases in resource-limited settings in China, Kenya, Nepal, Vietnam (the FAITH study): rationale and design

Author

Gong, Enying, Lu, Hongsheng, Shao, Shuai, Tao, Xuanchen, Peoples, Nicholas, Kohrt, Brandon A., Xiong, Shangzhi, Kyobutungi, Catherine, Haregu, Tilahun Nigatu, Khayeka-Wandabwa, Christopher, Van Minh, Hoang, Hanh, Tran Thi Duc, Koirala, Suraj, Gautam, Kamal, and Yan, Lijing L.

Published
2019
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10. Low physical activity is associated with adverse health outcome and higher costs in Indonesia: A national panel study

Author

Anindya, Kanya, primary, Marthias, Tiara, additional, Zulfikar Biruni, Muhammad, additional, Hage, Sophia, additional, Ng, Nawi, additional, Laverty, Anthony A., additional, McPake, Barbara, additional, Millett, Christopher, additional, Haregu, Tilahun Nigatu, additional, Hulse, Emily S. G., additional, Cao, Yingting, additional, and Lee, John Tayu, additional

Published
2022
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11. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Author

Forouzanfar, Mohammad H, Alexander, Lily, Anderson, H Ross, Bachman, Victoria F, Biryukov, Stan, Brauer, Michael, Burnett, Richard, Casey, Daniel, Coates, Matthew M, Cohen, Aaron, Delwiche, Kristen, Estep, Kara, Frostad, Joseph J, KC, Astha, Kyu, Hmwe H, Moradi-Lakeh, Maziar, Ng, Marie, Slepak, Erica Leigh, Thomas, Bernadette A, Wagner, Joseph, Aasvang, Gunn Marit, Abbafati, Cristiana, Ozgoren, Ayse Abbasoglu, Abd-Allah, Foad, Abera, Semaw F, Aboyans, Victor, Abraham, Biju, Abraham, Jerry Puthenpurakal, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M E, Aburto, Tania C, Achoki, Tom, Adelekan, Ademola, Adofo, Koranteng, Adou, Arsène K, Adsuar, José C, Afshin, Ashkan, Agardh, Emilie E, Al Khabouri, Mazin J, Al Lami, Faris H, Alam, Sayed Saidul, Alasfoor, Deena, Albittar, Mohammed I, Alegretti, Miguel A, Aleman, Alicia V, Alemu, Zewdie A, Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Ali, Mohammed K, Alla, François, Allebeck, Peter, Allen, Peter J, Alsharif, Ubai, Alvarez, Elena, Alvis-Guzman, Nelson, Amankwaa, Adansi A, Amare, Azmeraw T, Ameh, Emmanuel A, Ameli, Omid, Amini, Heresh, Ammar, Walid, Anderson, Benjamin O, Antonio, Carl Abelardo T, Anwari, Palwasha, Cunningham, Solveig Argeseanu, Arnlöv, Johan, Arsenijevic, Valentina S Arsic, Artaman, Al, Asghar, Rana J, Assadi, Reza, Atkins, Lydia S, Atkinson, Charles, Avila, Marco A, Awuah, Baffour, Badawi, Alaa, Bahit, Maria C, Bakfalouni, Talal, Balakrishnan, Kalpana, Balalla, Shivanthi, Balu, Ravi Kumar, Banerjee, Amitava, Barber, Ryan M, Barker-Collo, Suzanne L, Barquera, Simon, Barregard, Lars, Barrero, Lope H, Barrientos-Gutierrez, Tonatiuh, Basto-Abreu, Ana C, Basu, Arindam, Basu, Sanjay, Basulaiman, Mohammed O, Ruvalcaba, Carolina Batis, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L, Benjet, Corina, Bennett, Derrick A, Benzian, Habib, Bernabé, Eduardo, Beyene, Tariku J, Bhala, Neeraj, Bhalla, Ashish, Bhutta, Zulfiqar A, Bikbov, Boris, Abdulhak, Aref A Bin, Blore, Jed D, Blyth, Fiona M, Bohensky, Megan A, Başara, Berrak Bora, Borges, Guilherme, Bornstein, Natan M, Bose, Dipan, Boufous, Soufiane, Bourne, Rupert R, Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J, Brenner, Hermann, Briggs, Adam D M, Broday, David M, Brooks, Peter M, Bruce, Nigel G, Brugha, Traolach S, Brunekreef, Bert, Buchbinder, Rachelle, Bui, Linh N, Bukhman, Gene, Bulloch, Andrew G, Burch, Michael, Burney, Peter G J, Campos-Nonato, Ismael R, Campuzano, Julio C, Cantoral, Alejandra J, Caravanos, Jack, Cárdenas, Rosario, Cardis, Elisabeth, Carpenter, David O, Caso, Valeria, Castañeda-Orjuela, Carlos A, Castro, Ruben E, Catalá-López, Ferrán, Cavalleri, Fiorella, Çavlin, Alanur, Chadha, Vineet K, Chang, Jung-chen, Charlson, Fiona J, Chen, Honglei, Chen, Wanqing, Chen, Zhengming, Chiang, Peggy P, Chimed-Ochir, Odgerel, Chowdhury, Rajiv, Christophi, Costas A, Chuang, Ting-Wu, Chugh, Sumeet S, Cirillo, Massimo, Claßen, Thomas KD, Colistro, Valentina, Colomar, Mercedes, Colquhoun, Samantha M, Contreras, Alejandra G, Cooper, Cyrus, Cooperrider, Kimberly, Cooper, Leslie T, Coresh, Josef, Courville, Karen J, Criqui, Michael H, Cuevas-Nasu, Lucia, Damsere-Derry, James, Danawi, Hadi, Dandona, Lalit, Dandona, Rakhi, Dargan, Paul I, Davis, Adrian, Davitoiu, Dragos V, Dayama, Anand, de Castro, E Filipa, De la Cruz-Góngora, Vanessa, De Leo, Diego, de Lima, Graça, Degenhardt, Louisa, del Pozo-Cruz, Borja, Dellavalle, Robert P, Deribe, Kebede, Derrett, Sarah, Jarlais, Don C Des, Dessalegn, Muluken, deVeber, Gabrielle A, Devries, Karen M, Dharmaratne, Samath D, Dherani, Mukesh K, Dicker, Daniel, Ding, Eric L, Dokova, Klara, Dorsey, E Ray, Driscoll, Tim R, Duan, Leilei, Durrani, Adnan M, Ebel, Beth E, Ellenbogen, Richard G, Elshrek, Yousef M, Endres, Matthias, Ermakov, Sergey P, Erskine, Holly E, Eshrati, Babak, Esteghamati, Alireza, Fahimi, Saman, Faraon, Emerito Jose A, Farzadfar, Farshad, Fay, Derek F J, Feigin, Valery L, Feigl, Andrea B, Fereshtehnejad, Seyed-Mohammad, Ferrari, Alize J, Ferri, Cleusa P, Flaxman, Abraham D, Fleming, Thomas D, Foigt, Nataliya, Foreman, Kyle J, Paleo, Urbano Fra, Franklin, Richard C, Gabbe, Belinda, Gaffikin, Lynne, Gakidou, Emmanuela, Gamkrelidze, Amiran, Gankpé, Fortuné G, Gansevoort, Ron T, García-Guerra, Francisco A, Gasana, Evariste, Geleijnse, Johanna M, Gessner, Bradford D, Gething, Pete, Gibney, Katherine B, Gillum, Richard F, Ginawi, Ibrahim A M, Giroud, Maurice, Giussani, Giorgia, Goenka, Shifalika, Goginashvili, Ketevan, Dantes, Hector Gomez, Gona, Philimon, de Cosio, Teresita Gonzalez, González-Castell, Dinorah, Gotay, Carolyn C, Goto, Atsushi, Gouda, Hebe N, Guerrant, Richard L, Gugnani, Harish C, Guillemin, Francis, Gunnell, David, Gupta, Rahul, Gupta, Rajeev, Gutiérrez, Reyna A, Hafezi-Nejad, Nima, Hagan, Holly, Hagstromer, Maria, Halasa, Yara A, Hamadeh, Randah R, Hammami, Mouhanad, Hankey, Graeme J, Hao, Yuantao, Harb, Hilda L, Haregu, Tilahun Nigatu, Haro, Josep Maria, Havmoeller, Rasmus, Hay, Simon I, Hedayati, Mohammad T, Heredia-Pi, Ileana B, Hernandez, Lucia, Heuton, Kyle R, Heydarpour, Pouria, Hijar, Martha, Hoek, Hans W, Hoffman, Howard J, Hornberger, John C, Hosgood, H Dean, Hoy, Damian G, Hsairi, Mohamed, Hu, Guoqing, Hu, Howard, Huang, Cheng, Huang, John J, Hubbell, Bryan J, Huiart, Laetitia, Husseini, Abdullatif, Iannarone, Marissa L, Iburg, Kim M, Idrisov, Bulat T, Ikeda, Nayu, Innos, Kaire, Inoue, Manami, Islami, Farhad, Ismayilova, Samaya, Jacobsen, Kathryn H, Jansen, Henrica A, Jarvis, Deborah L, Jassal, Simerjot K, Jauregui, Alejandra, Jayaraman, Sudha, Jeemon, Panniyammakal, Jensen, Paul N, Jha, Vivekanand, Jiang, Fan, Jiang, Guohong, Jiang, Ying, Jonas, Jost B, Juel, Knud, Kan, Haidong, Roseline, Sidibe S Kany, Karam, Nadim E, Karch, André, Karema, Corine K, Karthikeyan, Ganesan, Kaul, Anil, Kawakami, Norito, Kazi, Dhruv S, Kemp, Andrew H, Kengne, Andre P, Keren, Andre, Khader, Yousef S, Khalifa, Shams Eldin Ali Hassan, Khan, Ejaz A, Khang, Young-Ho, Khatibzadeh, Shahab, Khonelidze, Irma, Kieling, Christian, Kim, Daniel, Kim, Sungroul, Kim, Yunjin, Kimokoti, Ruth W, Kinfu, Yohannes, Kinge, Jonas M, Kissela, Brett M, Kivipelto, Miia, Knibbs, Luke D, Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kose, M Rifat, Kosen, Soewarta, Kraemer, Alexander, Kravchenko, Michael, Krishnaswami, Sanjay, Kromhout, Hans, Ku, Tiffany, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kuipers, Ernst J, Kulkarni, Chanda, Kulkarni, Veena S, Kumar, G Anil, Kwan, Gene F, Lai, Taavi, Balaji, Arjun Lakshmana, Lalloo, Ratilal, Lallukka, Tea, Lam, Hilton, Lan, Qing, Lansingh, Van C, Larson, Heidi J, Larsson, Anders, Laryea, Dennis O, Lavados, Pablo M, Lawrynowicz, Alicia E, Leasher, Janet L, Lee, Jong-Tae, Leigh, James, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Liang, Juan, Liang, Xiaofeng, Lim, Stephen S, Lindsay, M Patrice, Lipshultz, Steven E, Liu, Shiwei, Liu, Yang, Lloyd, Belinda K, Logroscino, Giancarlo, London, Stephanie J, Lopez, Nancy, Lortet-Tieulent, Joannie, Lotufo, Paulo A, Lozano, Rafael, Lunevicius, Raimundas, Ma, Jixiang, Ma, Stefan, Machado, Vasco M P, MacIntyre, Michael F, Magis-Rodriguez, Carlos, Mahdi, Abbas A, Majdan, Marek, Malekzadeh, Reza, Mangalam, Srikanth, Mapoma, Christopher C, Marape, Marape, Marcenes, Wagner, Margolis, David J, Margono, Christopher, Marks, Guy B, Martin, Randall V, Marzan, Melvin B, Mashal, Mohammad T, Masiye, Felix, Mason-Jones, Amanda J, Matsushita, Kunihiro, Matzopoulos, Richard, Mayosi, Bongani M, Mazorodze, Tasara T, McKay, Abigail C, McKee, Martin, McLain, Abigail, Meaney, Peter A, Medina, Catalina, Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Mekonnen, Wubegzier, Melaku, Yohannes A, Meltzer, Michele, Memish, Ziad A, Mendoza, Walter, Mensah, George A, Meretoja, Atte, Mhimbira, Francis Apolinary, Micha, Renata, Miller, Ted R, Mills, Edward J, Misganaw, Awoke, Mishra, Santosh, Ibrahim, Norlinah Mohamed, Mohammad, Karzan A, Mokdad, Ali H, Mola, Glen L, Monasta, Lorenzo, Hernandez, Julio C Montañez, Montico, Marcella, Moore, Ami R, Morawska, Lidia, Mori, Rintaro, Moschandreas, Joanna, Moturi, Wilkister N, Mozaffarian, Dariush, Mueller, Ulrich O, Mukaigawara, Mitsuru, Mullany, Erin C, Murthy, Kinnari S, Naghavi, Mohsen, Nahas, Ziad, Naheed, Aliya, Naidoo, Kovin S, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Narayan, KM Venkat, Nash, Denis, Neal, Bruce, Nejjari, Chakib, Neupane, Sudan P, Newton, Charles R, Ngalesoni, Frida N, de Dieu Ngirabega, Jean, Nguyen, Grant, Nguyen, Nhung T, Nieuwenhuijsen, Mark J, Nisar, Muhammad I, Nogueira, José R, Nolla, Joan M, Nolte, Sandra, Norheim, Ole F, Norman, Rosana E, Norrving, Bo, Nyakarahuka, Luke, Oh, In-Hwan, Ohkubo, Takayoshi, Olusanya, Bolajoko O, Omer, Saad B, Opio, John Nelson, Orozco, Ricardo, Pagcatipunan, Rodolfo S, Jr., Pain, Amanda W, Pandian, Jeyaraj D, Panelo, Carlo Irwin A, Papachristou, Christina, Park, Eun-Kee, Parry, Charles D, Caicedo, Angel J Paternina, Patten, Scott B, Paul, Vinod K, Pavlin, Boris I, Pearce, Neil, Pedraza, Lilia S, Pedroza, Andrea, Stokic, Ljiljana Pejin, Pekericli, Ayfer, Pereira, David M, Perez-Padilla, Rogelio, Perez-Ruiz, Fernando, Perico, Norberto, Perry, Samuel A L, Pervaiz, Aslam, Pesudovs, Konrad, Peterson, Carrie B, Petzold, Max, Phillips, Michael R, Phua, Hwee Pin, Plass, Dietrich, Poenaru, Dan, Polanczyk, Guilherme V, Polinder, Suzanne, Pond, Constance D, Pope, C Arden, Pope, Daniel, Popova, Svetlana, Pourmalek, Farshad, Powles, John, Prabhakaran, Dorairaj, Prasad, Noela M, Qato, Dima M, Quezada, Amado D, Quistberg, D Alex A, Racapé, Lionel, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Sajjad Ur, Raju, Murugesan, Rakovac, Ivo, Rana, Saleem M, Rao, Mayuree, Razavi, Homie, Reddy, K Srinath, Refaat, Amany H, Rehm, Jürgen, Remuzzi, Giuseppe, Ribeiro, Antonio L, Riccio, Patricia M, Richardson, Lee, Riederer, Anne, Robinson, Margaret, Roca, Anna, Rodriguez, Alina, Rojas-Rueda, David, Romieu, Isabelle, Ronfani, Luca, Room, Robin, Roy, Nobhojit, Ruhago, George M, Rushton, Lesley, Sabin, Nsanzimana, Sacco, Ralph L, Saha, Sukanta, Sahathevan, Ramesh, Sahraian, Mohammad Ali, Salomon, Joshua A, Salvo, Deborah, Sampson, Uchechukwu K, Sanabria, Juan R, Sanchez, Luz Maria, Sánchez-Pimienta, Tania G, Sanchez-Riera, Lidia, Sandar, Logan, Santos, Itamar S, Sapkota, Amir, Satpathy, Maheswar, Saunders, James E, Sawhney, Monika, Saylan, Mete I, Scarborough, Peter, Schmidt, Jürgen C, Schneider, Ione J C, Schöttker, Ben, Schwebel, David C, Scott, James G, Seedat, Soraya, Sepanlou, Sadaf G, Serdar, Berrin, Servan-Mori, Edson E, Shaddick, Gavin, Shahraz, Saeid, Levy, Teresa Shamah, Shangguan, Siyi, She, Jun, Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin H, Shinohara, Yukito, Shiri, Rahman, Shishani, Kawkab, Shiue, Ivy, Sigfusdottir, Inga D, Silberberg, Donald H, Simard, Edgar P, Sindi, Shireen, Singh, Abhishek, Singh, Gitanjali M, Singh, Jasvinder A, Skirbekk, Vegard, Sliwa, Karen, Soljak, Michael, Soneji, Samir, Søreide, Kjetil, Soshnikov, Sergey, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stapelberg, Nicolas J C, Stathopoulou, Vasiliki, Steckling, Nadine, Stein, Dan J, Stein, Murray B, Stephens, Natalie, Stöckl, Heidi, Straif, Kurt, Stroumpoulis, Konstantinos, Sturua, Lela, Sunguya, Bruno F, Swaminathan, Soumya, Swaroop, Mamta, Sykes, Bryan L, Tabb, Karen M, Takahashi, Ken, Talongwa, Roberto T, Tandon, Nikhil, Tanne, David, Tanner, Marcel, Tavakkoli, Mohammad, Te Ao, Braden J, Teixeira, Carolina M, Téllez Rojo, Martha M, Terkawi, Abdullah S, Texcalac-Sangrador, José Luis, Thackway, Sarah V, Thomson, Blake, Thorne-Lyman, Andrew L, Thrift, Amanda G, Thurston, George D, Tillmann, Taavi, Tobollik, Myriam, Tonelli, Marcello, Topouzis, Fotis, Towbin, Jeffrey A, Toyoshima, Hideaki, Traebert, Jefferson, Tran, Bach X, Trasande, Leonardo, Trillini, Matias, Trujillo, Ulises, Dimbuene, Zacharie Tsala, Tsilimbaris, Miltiadis, Tuzcu, Emin Murat, Uchendu, Uche S, Ukwaja, Kingsley N, Uzun, Selen B, van de Vijver, Steven, Van Dingenen, Rita, van Gool, Coen H, van Os, Jim, Varakin, Yuri Y, Vasankari, Tommi J, Vasconcelos, Ana Maria N, Vavilala, Monica S, Veerman, Lennert J, Velasquez-Melendez, Gustavo, Venketasubramanian, N, Vijayakumar, Lakshmi, Villalpando, Salvador, Violante, Francesco S, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Wagner, Gregory R, Waller, Stephen G, Wallin, Mitchell T, Wan, Xia, Wang, Haidong, Wang, JianLi, Wang, Linhong, Wang, Wenzhi, Wang, Yanping, Warouw, Tati S, Watts, Charlotte H, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Werdecker, Andrea, Wessells, K Ryan, Westerman, Ronny, Whiteford, Harvey A, Wilkinson, James D, Williams, Hywel C, Williams, Thomas N, Woldeyohannes, Solomon M, Wolfe, Charles D A, Wong, John Q, Woolf, Anthony D, Wright, Jonathan L, Wurtz, Brittany, Xu, Gelin, Yan, Lijing L, Yang, Gonghuan, Yano, Yuichiro, Ye, Pengpeng, Yenesew, Muluken, Yentür, Gökalp K, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z, Younoussi, Zourkaleini, Yu, Chuanhua, Zaki, Maysaa E, Zhao, Yong, Zheng, Yingfeng, Zhou, Maigeng, Zhu, Jun, Zhu, Shankuan, Zou, Xiaonong, Zunt, Joseph R, Lopez, Alan D, Vos, Theo, and Murray, Christopher J

Published
2015
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27. Analysis of Patterns of Physical Activity and Sedentary Behavior in an Urban Slum Setting in Nairobi, Kenya.

Author

Haregu, Tilahun Nigatu, Khayeka-Wandabwa, Christopher, Ngomi, Nicholas, Oti, Samuel, Egondi, Thaddaeus, and Kyobutungi, Catherine

Subjects
PHYSICAL activity measurement, SEDENTARY behavior, GENDER differences (Psychology), HEALTH risk assessment, CARDIOVASCULAR diseases risk factors
Abstract

Background: Insufficient physical activity and sedentary behavior are key risk factors for the emergence of noncommunicable diseases in the sub-Saharan African setting. Given the limited evidence base, research is required to understand the trends. Objectives: This study describes the patterns of physical activity and sedentary behavior in a large sample of urban slum residents in Nairobi, Kenya. Methods: We used data collected from 5190 study participants as part of cardiovascular disease risk assessment. Data were collected about work-, transport-, and recreation-related physical activity as well as sitting and sleeping time. Using time spent on each type of physical activity and respective metabolic equivalents (METs), patterns of physical activity and associated factors were evaluated using descriptive statistics, Pearson correlations, and logistic regression. Results: Nearly 50% of the study population was involved in work-related physical activities, whereas only 6.3% was involved in recreation-related physical activities. Involvement in physical activities decreased with age, and 17.4% had <600 MET-minutes per week. Higher sitting time was associated with insufficient physical activity. There were substantial gender differences in the time spent for physical activity. Conclusions: Given the positive relationship between insufficient physical activity and sedentary behavior, complementary interventions that improve physical activity and at the same time reduce sitting time are needed. [ABSTRACT FROM AUTHOR]

Published
2016
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28. Impacts of multimorbidity on medication treatment, primary healthcare and hospitalization among middle-aged and older adults in China: evidence from a nationwide longitudinal study.

Author

Yang Zhao, Siqi Zhao, Lin Zhang, Haregu, Tilahun Nigatu, Haipeng Wang, Zhao, Yang, Zhao, Siqi, Zhang, Lin, and Wang, Haipeng

Abstract

Background: Multimorbidity is a significant contributor to inequalities in healthcare and has become a major unaddressed challenge for the health system in China. The aim of this study is to assess the socio-demographic distribution of multimorbidity and the relationships between multimorbidity, primary healthcare, hospitalization and healthcare spending.Methods: We conducted this nationwide population-based panel data study in China. Study participants included 12,306 residents aged ≥45 years from the China Health and Retirement Longitudinal Study in 2011, 2013 and 2015. Random-effects logistic regression models were applied to estimate the association between multimorbidity and primary healthcare as well as admission to the hospital. We used log-linear regression models to investigate the association between multimorbidity and health spending.Results: Overall, 46.2% of total interviewees reported multimorbidity. Random-effects logistic regression analyses showed that multimorbidity was associated with a higher likelihood of medication use (Adjusted odds ratio (AOR) =19.19, 95% CI = 17.60, 20.93), health check (AOR = 1.51, 95% CI = 1.43, 1.59), outpatient care (AOR = 2.39, 95% CI = 2.23, 2.56) and admission to hospital (AOR = 2.94, 95% CI = 2.68, 3.21). Log-linear regression models showed that multimorbidity was also positively associated with spending for outpatient care (coefficient = 0.64, 95% CI = 0.59, 0.68) and hospitalization (coefficient = 0.65, 95% CI = 0.60, 0.71).Conclusions: Multimorbidity is associated with higher levels of primary care, hospitalization and greater financial burden to individuals in China. Health systems need to shift from single-disease models to new financing and service delivery models to more effectively manage multimorbidity. [ABSTRACT FROM AUTHOR]

Published
2021
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29. The impact of mental and physical multimorbidity on healthcare utilization and health spending in China: A nationwide longitudinal population‐based study.

Author

Zhao, Yang, Zhang, Puhong, Oldenburg, Brian, Hall, Teresa, Lu, Shurong, Haregu, Tilahun Nigatu, and He, Li

Subjects
COMORBIDITY, MEDICAL care use, INPATIENT care, LONGITUDINAL method, OUTPATIENT medical care, SINGLE-payer health care
Abstract

Background: In China, little evidence exists on the effect of mental and physical multimorbidity on individuals and the health system. This study aims to examine the prevalence of mental–physical multimorbidity and its impact on health service utilization and health expenditures. Methods: We conducted a panel study using two waves of data (in 2011 and 2015) from the China Health and Retirement Longitudinal Study, including 10,181 participants aged 45 years and older. Generalized linear regression models were used to assess the association of multimorbidity with total health expenditure and out‐of‐pocket expenditure (OOPE) on outpatient and inpatient care. Random‐effects logistic regression models were used to examine the impact of multimorbidity on outpatient visits, admission to hospital and incidence of catastrophic health expenditure (CHE). Results: Overall, 3210 participants (31.53% of 10,181) had mental–physical multimorbidity in 2015 in China. Compared to patients with a single physical disease, individuals with physical‐mental multimorbidity had over 150% of the increase in the number of outpatient visits and days of hospitalization. The percentage change of OOPE for outpatient and inpatient care was 156.8% and 163.6%, respectively. Mental–physical multimorbidity was associated with an increased likelihood of experiencing CHE (OR = 2.205, 95% CI = 2.048, 2.051). Conclusion: Multimorbidity, particularly mental–physical multimorbidity, is associated with higher levels of health service use and a greater financial burden to individuals in China. Healthcare system needs to shift from single‐disease models to new financing and service delivery models to more effectively manage mental–physical multimorbidity. [ABSTRACT FROM AUTHOR]

Published
2021
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33. The effect of multimorbidity on functional limitations and depression amongst middle-aged and older population in China: a nationwide longitudinal study.

Author

Zhao, Yang William, Haregu, Tilahun Nigatu, He, Li, Lu, Shurong, Katar, Ameera, Wang, Haipeng, Yao, Zhibin, and Zhang, Luwen

Subjects
*AGE distribution, *CONFIDENCE intervals, *STATISTICAL correlation, *MENTAL depression, *HEALTH care reform, *INTEGRATED health care delivery, *LIFE skills, *LONGITUDINAL method, *MEDICALLY underserved areas, *POLICY sciences, *POPULATION geography, *RURAL population, *SEX distribution, *COMORBIDITY, *LOGISTIC regression analysis, *ACTIVITIES of daily living, *SOCIOECONOMIC factors, *HEALTH equity, *DISEASE prevalence, *PATIENT-centered care, *DESCRIPTIVE statistics, *ODDS ratio
Abstract

Background multimorbidity contributes to a large portion of the disease burden in low- and middle-income countries. However, limited research has been undertaken in China. This study has investigated the prevalence of multimorbidity and the associations of multimorbidity with activities of daily living (ADL), instrumental activities of daily living (IADL) and depression in China. Methods the study participants included 10,055 adults aged 45 years and older from three rounds of the China Health and Retirement Longitudinal Study 2011–2015. Random-effects logistic regression models were used to examine the association of multimorbidity with ADL limitation, IADL limitation and mental disease. Results the prevalence of multimorbidity amongst adults in China aged 45 years and older was 62.1% in 2015. The prevalence of multimorbidity was increased with older age, among women, in a higher socio-economic group and in the most deprived regions. Multimorbidity is associated with an increased likelihood of experiencing ADL limitation (adjusted odds ratio [AOR] = 5.738, 95% confidence intervals (CI) = 5.733, 5.744) and IADL limitation (AOR = 2.590, 95% CI = 2.588, 2.592) and depression (AOR = 3.352, 95% CI = 3.350, 3.354). Rural–urban disparities in functional difficulties and depression were also found amongst patients with multimorbidity. Conclusions the burden of multimorbidity is high in China, particularly amongst the older population. Multimorbidity is associated with higher levels of functional limitations and depression. China healthcare reforms should introduce integrated care models and patient-centred healthcare delivery. The increasing need for reorientation of healthcare resources considering the distribution of multimorbidity and its adverse effect requires more attention from health policymakers in China and other developing countries. [ABSTRACT FROM AUTHOR]

Published
2021
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34. Integration of health system responses to HIV/AIDS and noncommunicable diseases in developing countries

Author

Haregu, Tilahun Nigatu

Subjects
Uncategorized
Abstract

Introduction: HIV/AIDS and Noncommunicable diseases (NCDs) are major diseases of public health significance worldwide, especially in developing countries, and increasing research has reported important relationships between them. Recently, there is emerging evidence suggesting strategically important similarities between health system responses to these conditions and thus the need to consider more integrated approaches in the future. Such integrated approaches can maximize synergy and improve efficiency of response. However, the evidence base to inform this approach is limited. Therefore, there is an urgent need to conduct more research in relation to such an integrated approach in the context of health systems of low and middle income countries. Aims and objectives: The aims of this PhD research were to analyse the interrelationships (Convergence, Linkage, Co-occurrence and Parallels) between HIV/AIDS and NCDs; and to develop a model and a guiding tool to inform implementation of a more appropriate responses by health systems to HIV/AIDS and NCDs in the context of developing countries. Methods: The overall PhD research was a - Health policy and system research that employed a pragmatic mixed method and modelling techniques based on the constructivist approach. In this research, different methods were applied at different stages. To analyse connections between HIV/AIDS and NCDs, four methods were used: Correlational and cluster analysis (for convergence), framework development using thematic research synthesis (for linkage), systematic and critical reviews (for co-occurrence), and qualitative content analyses (for parallels). For the development of action model, multi-level (integrative, configurative and interpretive) evidence syntheses methods were applied. The integration tool was formulated based on the action model from best available evidence and was conceptually validated through further literature review and expert consultations. Results: With rapidly increasing NCD magnitude and stabilizing HIV epidemic, many low-and middle income countries are facing an overlapping double burden of HIV/AIDS and NCDs. The overlap, however, is different in the Sub-Saharan African and Asian Context. After identifying two forms, two types and six pathways of epidemiological linkages between HIV/AIDS and NCDs, a Public Health framework illustrating these linkages was developed. The magnitude of NCD comorbidities in HIV infection was high for cardiovascular abnormalities and precancerous lesions with the dynamics being highly reverted by the scale-up of anti-retroviral treatment coverage. The responses to HIV/AIDS and NCDs, both at Global and National levels, are similar in models and approaches. However, they are different in content. In this PhD research, an action model and a guiding tool for integration are also developed. Finally, evidence about the rationale, policies and models relevant to HIV-NCD integration is consolidated systematically. Conclusions: The strength of inter-relationships between HIV/AIDS and NCDs and the similarities between the responses to these conditions require improved and integrated responses as appropriate to specific local contexts. In addition to generating evidence relevant to HIV-NCD integration, this PhD research has yielded three important research outputs – a public Health Framework for linkage, a model of integration, and a guiding tool for integration. Further research is needed to refine these outputs and to test their applicability in specific contexts.

Published
2017
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35. Levels and determinants of perceived health risk from solid wastes among communities living near to dumpsites in Kenya.

Author

Amugsi, Dickson A., Haregu, Tilahun Nigatu, and Mberu, Blessing U.

Subjects
*ATTITUDE (Psychology), *FAMILIES, *HEALTH attitudes, *HEALTH promotion, *MULTIVARIATE analysis, *RISK perception, *SCALE analysis (Psychology), *WASTE products, *ENVIRONMENTAL exposure, *ECONOMIC status, *INDEPENDENT living, *HEALTH & social status, *DESCRIPTIVE statistics
Abstract

Many countries in sub-Saharan Africa have poor solid waste management systems, putting people living near dumpsites at higher risk of disease infections. Good risk perception could enhance individual- and community-level protection and prevention efforts. The objective of this study was to examine the levels and determinants of perceived health risk associated with exposure to solid waste dumpsites in Kenya. The level of risk was measured on a five-point Likert scale. The results showed that about 27% and 42% of the study population in Nairobi and Mombasa, respectively, perceive that they have little or no health risk from the nearby dumpsites. Study site, family size and wealth index were associated with risk perception in the multivariate analysis. A sizable proportion (42%) of the population living near dumpsites has lower risk perception. Health promotion interventions are needed to enhance risk awareness and perception in these communities. [ABSTRACT FROM AUTHOR]

Published
2020
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38. Effective coverage for hypertension treatment among middle-aged adults and the older population in China, 2011 to 2013: A nationwide longitudinal study.

Author

Yang Zhao, Mahal, Ajay Singh, Shenglan Tang, Tilahun Nigatu Haregu, Oldenburg, Brian, Zhao, Yang, Tang, Shenglan, and Haregu, Tilahun Nigatu

Subjects
ALCOHOLISM, BLOOD pressure measurement, CONFIDENCE intervals, HEALTH education, HEALTH services accessibility, HEALTH status indicators, HYPERTENSION, ANTIHYPERTENSIVE agents, INSURANCE, HEALTH insurance, INTERVIEWING, LONGITUDINAL method, QUESTIONNAIRES, STATISTICAL sampling, SEX distribution, SMOKING, MULTIPLE regression analysis, BODY mass index, DATA analysis software, STATISTICAL models, DESCRIPTIVE statistics, ODDS ratio, MIDDLE age, OLD age
Abstract

Methods: We used the baseline survey and first follow-up surveys of the China Health and Retirement Longitudinal Study of middle-aged and older populations conducted between 2011 and 2013. Correlates of effective coverage and treatment coverage for hypertension were analysed using multivariate logistic regression models, after controlling for demographic characteristics.Results: In 2011, 38.40% of 13 702 individuals surveyed were identified with hypertension. Overall, the effective treatment coverage among the middle-aged and older population in China from 2011 to 2013 was only 22.40% compared to the treatment coverage of 55.86%. Variations in effective coverage among patients enrolled in the three public health insurance schemes ranged from 22.60% to 29.31%.Conclusions: The level of effective coverage for hypertension treatment in China was still very low, and that health insurance schemes play a significant role in improving treatment coverage and effective coverage for hypertension treatment. In the implementation of China's health system reform, health equity and health care equality should be emphasised and enhanced by offering more equitable benefits packages across social health insurance schemes. [ABSTRACT FROM AUTHOR]

Published
2020
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48. Global Responses to HIV/AIDS and Noncommunicable Diseases: Analysis of Similarities and Differences

Author

Haregu, Tilahun Nigatu, Oldenburg, Brian, Elliott, Julian, and Setswe,Geoffrey

Subjects
Noncommunicable diseases, global response, HIV/AIDS
Abstract

Introduction: Recent evidence suggests that HIV/AIDS and Noncommunicable diseases (NCDs) share essential commonalities in their risk factors, progression and management. However, the interrelatedness between the global responses to HIV/AIDS and NCDs hasn’t been systematically analyzed. Objective: To examine the similarities and differences between global responses to HIV/AIDS and NCDs. Methods: Using preliminary review of literature, we identified four major themes of the global response: Strategies, Systems, Intervention and Monitoring and Evaluation. Detailed review of purposively selected documents was then conducted under these four themes. Similarities and differences between the global response to HIV/AIDS and NCDs were then examined for each major theme using qualitative content analysis and interpretive synthesis. The findings were presented using narrative summaries, tables and boxes. Findings: HIV/AIDS and NCD strategies are similar in their general approach. However, HIV strategies are geared towards improving effectiveness and efficiency of programs while NCD ones focus on increasing access to and coverage of services and enhancing the priority accorded to NCDs. The organizational systems involved in the global response to both HIV/AIDS and NCDs involve multi-sectoral, multi-stakeholder and multilevel approaches that require global coordination mechanisms. The presence of many diseases in the NCD group means more complex coordination of the NCD response. HIV/AIDS and NCD interventions use similar models and approaches despite their differences in the technical content of the interventions and the demographic characteristics of the target population groups. The indicators and the target populations for monitoring and evaluation of HIV/AIDS and NCD programs differ in their timeframe, level of specificity, and relative magnitude. Besides, the current NCD targets are voluntary. However, the Monitoring and Evaluation frameworks share important similarities in the methods used to generate and manage information. Conclusion: The similarities between the global responses to HIV and NCDs indicate that there are many processes that could be coordinated and/or integrated to improve synergy and efficiency. The differences, on the other hand, warrant the need for maintaining the integrity of the responses to each disease condition.

Published
2013
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49. Contribution of traditional birth attendants to the formal health system in Ethiopia: the case of Afar region

Author

Temesgen, Tedla Mulatu, Umer, Jemal Yousuf, Buda, Dawit Seyoum, and Haregu, Tilahun Nigatu

Subjects
Male, Rural Population, Research, Data Collection, Child Health Services, Infant, Newborn, maternal and child health, Focus Groups, Midwifery, Maternal Mortality, Pregnancy, Infant Mortality, Humans, Traditional birth attendants, Female, Ethiopia, pastoralist community, Delivery of Health Care
Abstract

Background Traditional birth attendants (TBAs) have been a subject of discussion in the provision of maternal and newborn health care. The objective of this study was to assess the role of trained traditional birth attendants in maternal and newborn health care in Afar Regional State of Ethiopia. Methods A qualitative study was used where 21 in-depth interviews and 6 focus group discussions were conducted with health service providers, trained traditional birth attendants, mothers, men, kebele leaders and district health personnel. Results The findings of this study indicate that trained traditional birth attendants are the backbone of the maternal and child health development in pastoralist communities. However, the current numbers are inadequate and cannot meet the needs of the pastoralist communities including antenatal care, delivery, postnatal care and family planning. In addition to service delivery, all respondents agreed on multiple contributions of trained TBAs, which include counselling, child care, immunisation, postnatal care, detection of complication and other social services. Conclusion Without deployment of adequate numbers of trained health workers for delivery services, trained traditional birth attendants remain vital for the rural community in need of maternal and child health care services. With close supportive supervision and evaluation of the trainings, the TBAs can greatly contribute to decreasing maternal and newborn mortality rates.

Published
2012

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