Eye Care Service Use and Associated Health-Seeking Behaviors Among Malawian Adults: Secondary Analysis of the Malawi Fifth Integrated Household Survey 2019-2020.

Background: The use of eye care services varies among different population groups. Objective: This study aimed to assess self-reported eye care use (ECU) and associated demographic factors among Malawian adults. Methods: This study used secondary data from the Malawi Fifth Integrated Household Survey 2019-2020, a nationally representative survey. The study included 12,288 households and 27,336 individuals 15 years and older. We entered age, sex, level of education, residency (urban/rural), and chronic disease into a logistic regression model, and used a confusion matrix to predict the model's accuracy. A P value <.05 was considered statistically significant. Results: About 60.6% (95% CI 60.0%-61.2%) of those with eye problems accessed formal care 2 weeks before the survey date. A logistic regression model showed that ECU was positively associated with education compared to none (odds ratio [OR] 6.6, 95% CI 5.927-7.366; P<.001), males compared to females (OR 1.2, 95% CI 1.104-1.290; P<.001), and urban residence compared to rural (OR 1.2, 95% CI 1.118-1.375; P<.001). ECU was negatively associated with age (OR 7, 95% CI 6.782-8.476; P<.001) and having chronic diseases (OR 0.6, 95% CI 0.547-0.708; P<.001). Conclusions: Social support, women empowerment, education, and mobile clinics are key strategic areas that would increase access to eye care in Malawi. Further studies can investigate ECU among the pediatric population.

Mitigating the regressivity of private mechanisms of financing healthcare: An Assessment of 29 countries.

Progressive financing of health care can help advance the equity and financial protection goals of health systems. All countries' health systems are financed in part through private mechanisms, including out-of-pocket payments and voluntary health insurance. Yet little is known about how these financing schemes are structured, and the extent to which policies in place mitigate regressivity. This study identifies the potential policies to mitigate regressivity in private financing, builds two qualitative tools to comparatively assess regressivity of these two sources of revenue, and applies this tool to a selection of 29 high-income countries. It provides new evidence on the variations in policy approaches taken, and resultant regressivity, of private mechanisms of financing health care. These results inform a comprehensive assessment of progressivity of health systems financing, considering all revenue streams, that appears in this special section of the journal.

Perception of COVID-19 and acceptance of vaccination in Delta State Nigeria

Background: With more than 80 million recorded cases and over 1.7 million deaths at the time of this research, providing safe effective vaccine to curb the ravaging COVID-19 has emerged a global priority. Public attitude towards COVID-19 and interventions like vaccination varies considerably as the access to knowledge. This study looked at knowledge of COVID-19 and its impact on acceptance of the upcoming vaccination in Delta State, Nigeria. Method: Cross-sectional survey of 401 participants from three Local Government Areas in Delta North, Central, and South Senatorial Districts carried out in December 2020. Data collected by Google forms was analyzed using Microsoft Excel and SPSS. Results: For COVID-19 knowledge, 75.6% of respondents were aware of the cause and 81.2% had knowledge of mode of transmission. For preventive measures, 77.6% practice social distancing, 65.6% hand washing, 61.6% use of hand sanitizers and 67.6% wearing of masks. Also, 76.6% knew about the vaccines in development, 53.9% were aware of Nigeria's interest in rolling out the vaccine and 48.6% were willing to accept the vaccine. A statistically significant relationship at p < 0.05 was observed between vaccine acceptance and gender, religious affiliation, education, employment status, income, knew a person with COVID-19, self-reported susceptibility to COVID-19, and individual agreement with effectiveness of government COVID-19 interventions. Conclusion: The population had a good knowledge of COVID-19 and the vaccine, although more than half were not willing to accept it. This calls for interventions to encourage trust and compliance as the government sets out to invest in vaccine rollout.