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Non-financial access to healthcare services in rural areas: A case study of people with disabilities living in Northern Iran

by Lida Shams, Tahere Darvish, Mohamad Meskarpour Amiri, Sayyed-Morteza Hosseini-Shokouh, Taha Nasiri

Introduction

Access to healthcare for persons with disabilities (PWDs) is an important but often ignored issue for achieving universal health coverage. The current study aimed to investigate PWDs’ access to healthcare in the rural areas in north of Iran.

Methods

Following a descriptive-analytical design, 471 persons with disabilities (PWDs) living in the Nor city, Mazandaran province, were selected using quota sampling. Data were collected by a valid and reliable questionnaire that contained dimensions of time, geography, physical, and acceptability using face-to-face interviews. The findings are provided by central and dispersion indicators and analyses are performed with linear Regression using SPSS version 17.

Results

PWDs had moderate access to healthcare services in all dimensions. The regression models for access to health services in all four dimensions were significant (p Conclusion

A small percentage of PWDs had high access to health services. Hence, improving their access to healthcare services, particularly in rural and less developed areas, and developing appropriate policies should be the focus of Iranian policy-makers.

PAKistan Study of prEmature coronary atHerosclerosis in young AdulTs (PAK-SEHAT): a prospective longitudinal study protocol investigating the prevalence, severity and determinants of atherosclerotic cardiovascular disease in the young adult Pakistani popu

Por: Hanif · B. · Sheikh · S. · Peerwani · G. · Cainzos-Achirica · M. · Javed · W. · Baqar · J. B. · Samad · Z. · Bashir · F. · S Virani · S. · Nasir · K. · Aijaz · S.
Introduction

Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity, mortality and health expenditures worldwide. Despite having higher ASCVD in the Pakistani population, data on subclinical coronary atherosclerosis in young Pakistanis remain scarce. The PAKistan Study of prEmature coronary atHerosclerosis in young AdulTs (PAK-SEHAT) aims to assess the prevalence, severity and determinants of subclinical coronary atherosclerosis among Pakistani men (35–60 years) and women (35–65 years) free of clinically symptomatic ASCVD and will assess 5-year rates of ASCVD events.

Methods and analysis

PAK-SEHAT is an ongoing prospective cohort study with 2000 participants from all provinces of Pakistan who will be interviewed at the baseline along with phlebotomy, measurement of carotid intima-media thickness (CIMT) and coronary CT angiography (CCTA). Phlebotomy will be repeated at 2.5 years, whereas CIMT and CCTA will be repeated at 5 years. We will report the frequency of maximal coronary stenosis ≥50% and ≥70%, number of coronary vessels with plaque and the number of coronary segments affected per participant on CCTA. We will use Cox proportional hazards regression models to evaluate the association between baseline characteristics and incident ASCVD events during follow-up. These associations will be presented as HRs with 95% CIs.

Ethics and dissemination

The study protocol was approved by the Tabba Heart Institute Institutional Review Board (THI/IRB/FQ/22-09-2021/016). All study procedures are consistent with the principles of the Declaration of Helsinki. Findings of the study will be disseminated via peer-reviewed publications and conference presentations.

Trial registration number

NCT05156736.

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