Despite of the potential role of service quality analysis from the beneficiaries’ perspectives in health system strengthening, its use has been limited in the developing world. More so, the analysis of socio-economic and demographic correlates of the perception differentials has been least addressed by the researchers. This study is an attempt to explore the perception of the urbanites regarding quality of health centres in Bhubaneswar, India and its socio-economic correlates. A cross-sectional study was carried out in which, data were collected from a sample of 180 respondents residing in six different types of residential localities of the city and an un-weighted hospital quality index was computed for analyzing the satisfaction level and its differentials, after carrying out the validity and reliability analyses of the index. Urbanites in this study were dissatisfied with many aspects of health care delivery in government health centres, like supply of medicines and availability of appropriate medical equipments. Although most of the respondents (78%) were quite satisfied with the private hospitals, there existed few lacunas to be bridged too. Overall satisfaction level was found to be associated with age (p=.134), migration status (p=.005), education (p=.000), residence type (p=.000), household size (p=.001) and income of the respondents (p=.000). A strong need of strengthening the government health centres was felt and so also taking measures to further improve private hospital quality in the city. There was also a need to address the disparity in health care service provision between slum and non-slum households, at an urgent basis.
Urban Health ; Urban Health Services ; India

Results of retrospective survey of some water-born diseases in people at 3 urban districts, Hai Phong city showed that: the prevalence of low infected diseases were typhoid, hepatitis, malaria, haemorrhagic fever, eye disease; diarrhea, intestinal amebiasis, helminth were high infection but tended to decrease from 1997 to 2002. The prevalence of haemorrhagic fever and malaria on 100,000 people in Hai Phong city decreased by the year, reduction 7-49 folds compared to the whole country and there were only sporadic cases. The prevalence of the highest diseases was in the age of 60 (7.5%)
Water ; Disease ; Urban Health ; Urban Population

Objective: To explore the attitudes, behaviors, and beliefs of urban adult Filipinos on sunlight exposure as an initial step in the development and validation of a culturally-appropriate questionnaire. Methodology: Focus groups were conducted among urban Filipinos 19 years old and above (n=38). The transcribedresults underwent qualitative content and thematic analyses and were used to develop a conceptual framework. Results: Qualitative analysis revealed four main themes of sunlight exposure: internal influences, external influences,perceived benefits, and perceived risks. Both internal and external influences lead to perceived risks and benefits.Consequently, the perceived benefits (or lack) of sunlight exposure influence an individual’s attitude towards vitamin D supplementation; whereas the perceived risks of sunlight exposure influence an individual’s attitude towards the needfor sun protection Conclusion The attitudes, behaviors and beliefs of urban adult Filipinos on sunlight exposure are influenced by bothinternal and external factors, that in turn lead to perceived risks and benefits. An increased awareness of these factorsis necessary to establish future recommendations on proper sunlight exposure in this population. The study results willbe used to develop and validate a culturally-appropriate sunlight exposure questionnaire.
Urban Health ; Public Health ; Qualitative Research

In order to reduce the health inequalities within a society changes need to be made in broad health determinants and their distribution in the population. It has been expected that the Health impact assessment(HIA) and Healthy Cities can provide opportunities and useful means for changing social policy and environment related with the broad health determinants in developed countries. HIA is any combination of procedures or methods by which a proposed 4P(policy, plan, program, project) may be judged as to the effects it may have on the health of a population. Healthy city is one that is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and in developing to their maximum potential. In Korea, social and academic interest regarding the HIA and Healthy Cities has been growing recently but the need of HIA and Healthy Cities in the perspective of reducing health inequality was not introduced adequately. So we reviewed the basic concepts and methods of the HIA and Healthy Cities, and its possible contribution to reducing health inequalities. We concluded that though the concepts and methods of the HIA and Healthy Cities are relatively new and still in need of improvement, they will be useful in approaching the issue of health inequality in Korea.
Health Planning/*methods ; Health Services Accessibility ; *Health Status Disparities ; Humans ; Korea ; *Urban Health ; Urban Population

OBJECTIVETo investigate the sanitary status of urban secondary water supply facilities in Haidian district of Beijing.

METHODSAdopting the quantitative classification table drafted by the Bureau for Sanitation Inspection and Supervision of Haidian district, we carried quantitative classification (A, B, C grade) on all 1725 secondary water supply facilities in Haidian district for two times. At the same time, we collected 20 residential areas with stratified random sampling method. As the public points in the first quantitative classification, the effect of level publicity on changing the sanitary grade of the secondary water supply facilities were observed.

RESULTSIn the first two times of quantitative classification, A-level and B-level secondary water supply facilities took up 81.04% (1398/1725) and 89.04% (1536/1725) of all secondary water supply facilities respectively; the ratio of effective sanitary permits achieved 86.14% (1486/1725) and 92.35% (1593/1725) respectively; and the ratio of effective water quality test reports achieved 86.60% (1494/1725) and 97.10% (1675/1725) respectively. There were 52 secondary water supply facilities in 20 collected areas, including 8 A-level, 27 B-level and 17 C-level secondary water supply facilities before level publicity, and 19, 29 and 4 after level publicity. The impact of level publicity on changing the sanitary grade of the secondary water supply facilities was statistically significant (χ(2) = 12.60, P = 0.002).

CONCLUSIONThe city secondary water supply facilities in Haidian district are overall in good sanitary conditions. Quantitative classification and level publicity can effectively improve the sanitary status of secondary water supply facilities.

OBJECTIVE: To establish the norms of Sub-Health Measurement Scale (SHMS V1.0) for Chinese urban residents. METHODS: Using a multistage stratified sampling method, we conducted a large-scale epidemiological investigation among 15 066 urban residents sampled from 6 regions in China, including Tianjin City (north China), Guangdong Province (south China), Anhui Province (central south China), Sichuan Province (southwest China), Lanzhou City (northwest China) and Harbin City (northeast China). The mean, percentile and threshold norms were established based on the characteristics of SHMS V1.0 scores for Chinese urban residents. RESULTS: The mean and percentile norms of total, physical, mental and social sub-health of Chinese urban residents were established according to gender and different age groups (14-19, 20-29, 30-49, 50-64 and ≥65 years). The threshold norms of SHMS V1.0 divided 5 health states, namely disease, severe sub-health, moderate subhealth, mild sub-health and healthy states according to the ± and ±0.5 of the converted scores. CONCLUSIONS The norms of Sub-Health Measurement Scale (SHMS V1.0) for Chinese urban residents were established, which provides a reference for rapid screening and diagnosis of sub-health status in Chinese urban residents and facilitates further study of the prevalence and contributing factors of sub-health.
Asian Continental Ancestry Group ; China ; Health Status ; Humans ; Prevalence ; Surveys and Questionnaires ; Urban Health ; Urban Population

The purpose of this study is to estimate the minimum optimal scale(MOS) of the self-employed health insurance associations. Considering the high proportion of operating expenses, the author have selected 254 regional health insurance associations from the 1990 Finance Report of the self-employed health insurance programs. both a quadratic function and a hyperbolic function were chosen for the analysis. The dependent variables are the average maintenance cost per insured person and per household, and the independent variables are the number of insured members and of household. The minimum optimal scale was obtained from the differentiation of the quadratic function. Major findings are summarized as follows: 1. The M.O.S. was calculated as 166,174 members (27,442 households) for the rural self-employed health insurance associations and 258,462 members (75,446 households) for the urban. Providing that both the rural and urban health insurance associations would e integrated, the M.O.S. be found to become 231,687 members (68,101 households) 2. Compared with the optimal minimum scale, the magnitude of the current health insurance association found to be much smaller, less than half of the optimal scale. 3. In order to reduce the operating cost, it is necessary to enlarge the operational scale of self-employed health insurance associations.
Family Characteristics ; Humans ; Insurance ; Insurance, Health* ; Korea* ; Urban Health

The objective of the study was to evaluate the effect of cardiovascular health education on change in blood pressure at 3, 6, 12, and 18 months follow-up. This was a prospective cohort study. Participants were from an urban poor community in Metro Manila. Included were the 98 adults at least 40 years of age with hypertension, without cardiovascular disease. Among those previously diagnosed with hypertension, 20.3% had controlled blood pressures at the time of screening. There were 29.6% newly diagnosed cases of hypertension in the study. During the 18-month intervention phase, cardiovascular disease health education and counseling on risk factor control were given along with medical check-ups. Systolic and diastolic blood pressures were measured at 3, 6, 12, and 18 months. The decreases in mean systolic blood pressures from the baseline at 3, 6, 12 and 18 months were 11.9, 15.2, 9.1, and 14.1-mm Hg, respectively. The diastolic blood pressures decreased by 6.9, 9.3,.4.6, and 4.4 mm Hg. These differences were statistically significant. For the urban poor, health education on risk factor modification and cardiovascular diseases can be an important tool in improving blood pressure.
Blood Pressure ; Life Style ; Urban Health ; Health Education

OBJECTIVES: This study examined the use of health impact assessment (HIA) as a tool for intersectoral collaboration using the case of an HIA project conducted in Gwang Myeong City, Korea. METHODS: A typical procedure for rapid HIA was used. In the screening step, the Aegi-Neung Waterside Park Plan was chosen as the target of the HIA. In the scoping step, the specific methods and tools to assess potential health impacts were chosen. A participatory workshop was held in the assessment step. Various interest groups, including the Department of Parks and Greenspace, the Department of Culture and Sports, the Department of Environment and Cleansing, civil societies, and residents, discussed previously reviewed literature on the potential health impacts of the Aegi-Neung Waterside Park Plan. RESULTS: Potential health impacts and inequality issues were elicited from the workshop, and measures to maximize positive health impacts and minimize negative health impacts were recommended. The priorities among the recommendations were decided by voting. A report on the HIA was submitted to the Department of Parks and Greenspace for their consideration. CONCLUSIONS: Although this study examined only one case, it shows the potential usefulness of HIA as a tool for enhancing intersectoral collaboration. Some strategies to formally implement HIA are discussed.
*Health Policy ; Humans ; Organizational Case Studies ; Politics ; *Public Health ; Public Policy ; Urban Health

OBJECTIVETo understand the current status and its changing patterns of perinatal health care in some southern and northern areas of China from 1994 to 2000.

METHODSData was collected in 13 counties/cities covered by Perinatal Health Care Surveillance System which was part of the Sino-American cooperative project on neural tube defects prevention, established in 1992. The study population consisted of 368 589 women who delivered single live births of at least 20 gestational weeks from 1994 through 2000. Chi-square test was employed to test the difference on the proportions of women with prenatal checkup, women with early prenatal care onset, women with at least five prenatal visits, hospital delivery versus home delivery as well as the proportion of women with at least three postpartum visits. Two-way ANOVA was used to test the differences of mean of gestational weeks at first prenatal visit and the mean of prenatal visits between different year and areas.

RESULTSThe proportion of women with prenatal checkup remained over 99.0% from 1994 through 2000. The mean of gestational weeks at first prenatal visit changed from 13.1 weeks in 1994 to 10.7 weeks in 2000. The proportions of women with early prenatal care onset increased from 65.5% in 1994 to 79.4% in 2000 while women with at least five prenatal visit increasing from 34.1% to 71.8%, hospital delivery increasing from 91.3% to 98.8%, home delivery decreasing from 5.6 % to 0. 6%, women with at least three postpartum visits increasing from 80.5 % to 95.1%. Except for the proportion of women with early prenatal care onset, other proportions in northern areas were lower than those in southern areas in the same year. Greater differences between urban and rural areas in northern areas were found than in southern areas.

CONCLUSIONThe utilization of perinatal health care services was greatly improved in both southern and northern areas from 1994 to 2000. However, there were still obvious differences in the perinatal health care services between northern and southern areas as well as between urban and rural areas in northern China.