District division administrative disaggregation data framework for monitoring leaving no one behind in the National Health Insurance Fund of Sudan: achieving sustainable development goals in 2030.

BACKGROUND: The aim of this study is to monitor the concept of 'leaving no one behind' in the Sustainable Development Goals (SDGs) to track the implications of the mobilization of health care resources by the National Health Insurance Fund (NHIF) of Sudan. METHODS: A cross-sectional study was used to monitor 'leaving no one behind' in NHIF by analyzing the secondary data of the information system for the year 2016. The study categorized the catchment areas of health care centers (HCCS) according to district administrative divisions, which are neighborhood, subdistrict, district, and zero. The District Division Administrative Disaggregation Data (DDADD) framework was developed and investigated with the use of descriptive statistics, maps of Sudan, the Mann-Whitney test, the Kruskal-Wallis test and health equity catchment indicators. SPSS ver. 18 and EndNote X8 were also used. RESULTS: The findings show that the NHIF has mobilized HCCs according to coverage of the insured population. This mobilization protected the insured poor in high-coverage insured population districts and left those living in very low-coverage districts behind. The Mann-Whitney test presented a significant median difference in the utilization rate between catchment areas (P value < 0.001). The results showed that the utilization rate of the insured poor who accessed health care centers by neighborhood was higher than that of the insured poor who accessed by more than neighborhood in each state. The Kruskal-Wallis test of the cost of health care services per capita in each catchment area showed a difference (P value < 0.001) in the median between neighborhoods. The cost of health care services in low-coverage insured population districts was higher than that in high-coverage insured population districts. CONCLUSION: The DDADD framework identified the inequitable distribution of health care services in low-density population districts leaves insured poor behind. Policymakers should restructure the equation of health insurance schemes based on equity and probability of illness, to distribute health care services according to needs and equity, and to remobilize resources towards districts left behind.

The Impact of Cigarette Plain Packaging on Health Warning Salience and Perceptions: Implications for Public Health Policy.

The study employed a mixed methods design using focus group interviews with 6 student groups and self-administered questionnaires with 1239 students. The participants were nonsmoking, current smokers, and quit-smoking teenagers from secondary schools and colleges. Focus group revealed that although nonsmoking teenagers perceived fear appeals to warning messages, current smokers did not perceive fear appeals to health. Black and white backgrounds of the cigarette package were chosen as the best color for plain packaging. However, most participants suggested various pictorials and a bigger size of pictorial warnings for greater and more effective fear appeal. Odds ratio showed that males had 2.43 times the odds to perceive intention not to smoke. Teenagers who had never smoked and those who had quit smoking had 13.27 and 3.61 times the odds, respectively, to perceive intention not to smoke.

Perception of tourists regarding the smoke-free policy at Suvarnabhumi International Airport, Bangkok, Thailand.

This study was conducted during February-March 2012 to determine the perception and support regarding smoke-free policy among tourists at Suvarnabhumi International Airport, Bangkok, Thailand. In this cross-sectional study, 200 tourists (n = 200) were enrolled by convenience sampling and interviewed by structured questionnaire. Descriptive statistics, chi-square, and multinomial logistic regression were adopted in the study. Results revealed that half (50%) of the tourists were current smokers and 55% had visited Thailand twice or more. Three quarter (76%) of tourists indicated that they would visit Thailand again even if it had a 100% smoke-free regulation. Almost all (99%) of the tourists had supported for the smoke-free policy (partial ban and total ban), and current smokers had higher percentage of support than non-smokers. Two factors, current smoking status and knowledge level, were significantly associated with perception level. After analysis with Multinomial Logistic Regression, it was found that perception, country group, and presence of designated smoking room (DSR) were associated with smoke-free policy. Recommendation is that, at institution level effective monitoring system is needed at the airport. At policy level, the recommendation is that effective comprehensive policy needed to be emphasized to ensure smoke-free airport environment.

Perception and knowledge on health risks by waterpipe tobacco-smoking tourists in a night spot of Bangkok, Thailand.

OBJECTIVE: To identify the perception level, and knowledge level of health risks due to waterpipe tobacco smoking, and knowledge about prohibition of waterpipe tobacco smoking, of foreign tourists in Thailand. MATERIAL AND METHOD: This is a descriptive cross-sectional study, carried out among foreign tourists in nightspots on Khao San Road area of Bangkok. Structured interview questionnaire was the data collection instrument for 176 convenience-sampling. RESULTS: More than half (52.3%) of the foreign tourists had a poor level of perception about waterpipe smoking. Majority of foreign tourists (75.5%) had low level of knowledge on the health risks. More than 50% didn't know about the illegal status of waterpipe smoking in Thailand. Chi-square analysis showed that the region where tourists reside was statistically associated with the perception level regarding waterpipe smoking. Age of waterpipe smoking initiation was associated with the region and gender Age of tourists was associated with the knowledge on prohibition of waterpipe smoking. CONCLUSION: Raising awareness among foreign tourists through media advocacy about the rules and regulations regarding waterpipe smoking is necessary to support tobacco control policy. Strict enforcement of the existing law on prohibiting waterpipe smoking should be implemented, Authorities should inform owners/managers of waterpipe, tobacco-smoking prohibition, and require them to put up prohibition signs in their establishments, in both Thai and English languages.

Self-care behaviours of chemotherapy patients.

OBJECTIVE: To present study self-care behaviours and variables associated with self-care behaviors of cancer patients treated with chemotherapy. MATERIAL AND METHOD: This is a descriptive, cross-sectional study in cancer patients receiving chemotherapy in out-patient department of the National Regional Cancer Center in Chonburi City. Interview questionnaire was the data collection instrument for 133 purposive sampling. RESULTS: Survey result indicated that patients were highly aware of the support provided by staff on service supports, emotional supports and informational support. The present study results also found that the top 3 patient self-care knowledge are, avoiding those who have cold when the patients have low white blood cells, eating hot (cooked well with heat) food and knowing the effects of chemotherapy on causing low red blood cells, lowplatelets and low white blood cells. The top 3 self-care behaviours of the patients were, always eat cooked food, inquire and understand the instructions from health personnel for self-care and always check herself/himself to maintain good health. However patients did not usually exercise at least 15 minutes every day, select the recreational activities adequately, and not finding ways to improve their own health. Results from hypothesis testing, indicated that only knowledge variable was associated with self-care behaviours of patients treated with chemotherapy. The demographic variables such as age, marital status, education level, income were not associated with self-care behaviours of patients treated with chemotherapy CONCLUSION: Knowledge is associated with self-care behaviours of cancer patients who received chemotherapy. Providing health promotion for patients is necessary for them to have better self-care behaviours.

Drug policy and administration affecting quality of life of the poor in Thailand.

OBJECTIVE: This study aims to analyze drug policy and administration affecting quality of life of the poor in Thailand. METHOD: Review of official reports and related documents, for the past 10 years (from 2000-2010). RESULTS: By imposing compulsory licensing, the Thai government maintains negotiating power over the price of pharmaceutical products with the patent holders of the original drugs. This gives an opportunity for relevant government agencies to produce or import patented drugs. At present, there are many problems and obstacles. The findings show that developing countries need to strengthen their negotiating power so that the pharmaceutical manufacturers cannot take advantage through mechanisms provided for such as compulsory licensing and provisions for flexibility in Trade-Related Intellectual Property Rights (TRIPS) agreement. Furthermore, these countries must support and empower the local pharmaceutical manufacturers to produce generic drugs. CONCLUSION AND RECOMMENDATIONS: Developing countries should ensure that their populations have confidence in universal coverage service and medical systems regarding the quality of generic drugs.

Alcoholic beverages drinking among female students in a tourist province, Thailand.

This study aimed to investigate alcoholic beverages drinking and predictive factors among female students. The participants were 377 subjects from 3 high schools in a tourist province, of Thailand. Data collection was done through self-administered questionnaire. Scales of the questionnaire had reliability coefficients ranging from 0.84 - 0.88. The data were analyzed by using descriptive and inferential statistics. The findings revealed as follows. About half (51%) of them have ever drunk and 10.5% of drinkers have drunk once a week. In addition, 15.6% of drinkers began their first drink when they were under 10 years old. Risk factors for alcohol consumption of female student were age, GPA, drinker in family, peer pressure, advertisement and accessibility to alcoholic beverages while protective factors were perception of drinking impacts on family and moral values. Students who have a drinking family member were 4.6 times more likely to drink than those who do not have.

Prevalence and psychosocial correlates of current smoking among adolescent students in Thailand, 2005.

This article examines the prevalence of current smoking and associated psychosocial correlates and whether these correlates differ by sex among adolescent students in Thailand. Data were analyzed from the Thailand Global Youth Tobacco Survey (GYTS), a school-based, cross-sectional survey conducted in 2005 and completed by Mathayom 1, 2, and 3 (U.S. seventh through ninth grades) students. Weighted prevalence estimates of the percentage of students who were current smokers (smoked on ≥ 1 day during the past 30 days) and noncurrent smokers were calculated for the sample and for each psychosocial variable. Separate logistic regression models were calculated for males and females to examine the independent association of the psychosocial correlates of current smoking. Significant correlates for both males and females included close peer smoking, secondhand smoke exposure, being offered a free cigarette by a tobacco industry representative, and belief that smoking is not harmful. These correlates are examined in the context of comprehensive tobacco control laws in Thailand.

Prevalence of smoking and other smoking-related behaviors reported by the Global Youth Tobacco Survey (GYTS) in Thailand.

INTRODUCTION: Thailand ratified the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) on November 8, 2004. The WHO FCTC requires all parties to inform all persons of the health consequences of tobacco consumption and exposure to tobacco smoke. Each party has agreed to develop, implement and evaluate effective tobacco control programs to measure progress in reaching the goals of the WHO FCTC. METHODS: The Global Youth Tobacco Survey (GYTS) was developed to provide data on youth tobacco use to countries for their development of youth-based tobacco control programs. Data in this report can be used as baseline measures for future evaluation of the tobacco control programs implemented by the Ministry of Public Health. RESULTS: Overall, about 1 in 10 Thai students are current smokers, this number including 4 times more boys than girls (17% versus 3.9%). Almost 2 in 10 Thai students start smoking before the age of 10, and almost 7 in 10 students are reported to have been exposed to smoke from others in public places. About 4 in 10 students are reported to have an object with a cigarette brand logo on it. CONCLUSION: The key for Thailand is to implement and enforce the provisions on indirect tobacco advertising, smoking in public places, selling tobacco to youths under 18 years of age, and to use the data from the GYTS to monitor progress toward achieving the goals of the WHO FCTC. When these goals are met, tobacco consumption and exposure in Thailand will have declined substantially.

Potential effectiveness of health warning labels among employees in Thailand.

OBJECTIVE: Explore and investigate the perceptions and responses of employees regarding the effects of a Health Warning Label (HWL) on their decision to encourage quitting and stages of change in smoking behavior. MATERIAL AND METHOD: One thousand six hundred thirty seven employees in workplaces from four regions, including Bangkok city, were studied during the year 2005-2006. Six hundred nine employees (both non- or cigarette smokers) were part of a cohort study using qualitative and quantitative approaches. Questionnaires were used to sample the cohort twice and two individuals per factory were interviewed in-depth. RESULTS: The New-HWL that made the best impression was the "cancer caused by cigarette smoking" and 3.8% stopped smoking after seeing the New-HWL. Moreover, New-HWL increased employees "pro" attitudes about smoking cessation. Decisional balance that reflected different "con" to quit, among non-quitting and quitting smokers. CONCLUSION: New-HWL significantly increased attitudes about smoking cessation.