Browsing by Author "Francisco, Diogo"
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- Examining the relation between the subjective and objective social status with health reported needs and health-seeking behaviour in Dande, AngolaPublication . Rosário, Edite Vila Nova; Severo, Milton; Francisco, Diogo; Brito, Miguel; Costa, DiogoBackground: Assessing subjective social status (SSS) may be easily accommodated in the context of a Health and Demographic Surveillance System (HDSS). To our knowledge, no prior studies have examined the association of SSS and health in Angola. Subjective socioeconomic measures may provide a rapid assessment of a relevant social status construct, important for studying health inequalities. In this study, we addressed social determinants of health by examining the relationship between the subjective and objective social status, reported health and healthcare-seeking behavior. Methods: This research results from a cross-sectional study performed during 2015 in the Dande HDSS, in Angola. We tested the application of the MacArthur scale as a measure of SSS in a developing setting, in a sample of 12,246 households. First, we investigated its relation to objective socioeconomic indicators, and then we explored how subjective and objective social status associates with health-reported needs and health-seeking behavior of the surveyed population. Chi-square, ANOVA tests, and Receiver Operating Characteristics (ROC) Curves analysis were computed for testing relationships between subjective status ladder quartiles, sociodemographic, and household characteristics. Logistic regression was used to examine the influence of subjective perception of status in self-reported health and health-seeking behavior. Results: Our findings suggest that the SSS follows a gradient distribution obtained with more objective socioeconomic indicators. Additionally, we found that subjective perception of status influences health needs reporting and health-seeking behavior, and its significant effect remained after controlling for the objective socioeconomic markers. Individuals standing in the second quartile of the social ladder have more odds of reporting illness and those in the highest quartiles of the ladder were twice more likely (OR = 2.23, 95% CI = 1.52–3.26) to seek help from formal health services than those at the bottom of the ladder. Conclusions: The MacArthur Scale is a valuable tool to measure SSS in the Dande HDSS, relevant for studying socioeconomic disparities and health inequalities. It is also an easier alternative to traditional measures such as income, usually difficult to measure in developing settings. The social perception of status should be considered as a complement with objective indicators when exploring social determinants of health.
- HDSS profile: the Dande health and demographic surveillance system (Dande HDSS, Angola)Publication . Rosário, Edite Vila Nova; Costa, Diogo; Francisco, Diogo; Brito, MiguelAn HDSS aims to systematically and continuously monitor the dynamics of a specified population in a geographically defined area, which lacks an effective system for registering demographic information and vital events. An initial census defines the target population and later, through periodic updating rounds, births, deaths and migrations are monitored. The first HDSS was implemented in 1940 in South Africa. There are now around 50 known HDSS worldwide, with surveyed population ranging between 13 350 and 260 000 individuals; 39 sites are spread in Africa, none of them in Central Africa or closest to Angola. Angola faced a long period of civil war between 1975 and 2002, and most of the previous existing civil registration and other social infrastructures have been severely debilitated. With the massive displacement of people moving to escape the war, the conditions became adverse to keeping effective records of structures and population dynamics. In 2014, the country carried out the first national population census since the country’s independence (1975), and a large investment has been placed in civil registration infrastructures (particularly birth registration). However, the resources needed to implement an accurate and complete vital statistics system are not yet available.