Wealth stratified inequalities in service utilisation of breast cancer screening across the geographical regions: A pooled decomposition analysis
Article
Article Title | Wealth stratified inequalities in service utilisation of breast cancer screening across the geographical regions: A pooled decomposition analysis |
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ERA Journal ID | 40980 |
Article Category | Article |
Authors | Mahumud, Rashidul Alam (Author), Alam, Khorshed (Author), Keramat, Syed Afroz (Author), Renzaho, Andre M.N. (Author), Hossain, Md. Golam (Author), Haque, Rezwanul (Author), Ormsby, Gail M. (Author), Dunn, Jeff (Author) and Gow, Jeff (Author) |
Journal Title | Archives of Public Health |
Journal Citation | 78, pp. 1-12 |
Article Number | 32 |
Number of Pages | 12 |
Year | 2020 |
Publisher | BioMed Central Ltd. |
Place of Publication | United Kingdom |
ISSN | 2049-3258 |
Digital Object Identifier (DOI) | https://doi.org/10.1186/s13690-020-00410-5 |
Web Address (URL) | https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-020-00410-5 |
Abstract | Background: Breast cancer is the most commonly occurring cancer among women in low-resourced countries. Reduction of its impacts is achievable with regular screening and early detection. The main aim of the study was to examine the role of wealth stratified inequality in the utilisation breast cancer screening (BCS) services and identified potential factors contribute to the observed inequalities. Methods: A population-based cross-sectional multi-country analysis was used to study the utilisation of BCS services. Regression-based decomposition analyses were applied to examine the magnitude of the impact of inequalities on the utilisation of BCS services and to identify potential factors contributing to these outcomes. Observations from 140,974 women aged greater than or equal to 40 years were used in the analysis from 14 low-resource countries from the latest available national-level Demographic and Health Surveys (2008–09 to 2016). Results: The population-weighted mean utilisation of BCS services was low at 15.41% (95% CI: 15.22, 15.60), varying from 80.82% in European countries to 25.26% in South American countries, 16.95% in North American countries, 15.06% in Asia and 13.84% in African countries. Women with higher socioeconomic status (SES) had higher utilisation of BCS services (15%) than those with lower SES (9%). A high degree of inequality in accessing and the use of BCS services existed in all study countries across geographical areas. Older women, access to limited mass media communication, being insured, rurality and low wealth score were found to be significantly associated with lower utilisation of BCS services. Together they explained approximately 60% in the total inequality in utilisation of BCS services. Conclusions: The level of wealth relates to the inequality in accessing BCS amongst reproductive women in these 14 low-resource countries. The findings may assist policymakers to develop risk-pooling financial mechanisms and design strategies to increase community awareness of BCS services. These strategies may contribute to reducing inequalities associated with achieving higher rates of the utilisation of BCS services. |
Keywords | Breast cancer screening, Decomposition analysis, Low-resource countries, Inequality |
ANZSRC Field of Research 2020 | 429999. Other health sciences not elsewhere classified |
380108. Health economics | |
320213. Medical genetics (excl. cancer genetics) | |
Byline Affiliations | School of Commerce |
American International University, Bangladesh | |
University of Western Sydney | |
University of Rajshahi, Bangladesh | |
University of Southern Queensland | |
Centre for Health, Informatics and Economic Research | |
Open access url | https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-020-00410-5 |
Institution of Origin | University of Southern Queensland |
https://research.usq.edu.au/item/q5xxx/wealth-stratified-inequalities-in-service-utilisation-of-breast-cancer-screening-across-the-geographical-regions-a-pooled-decomposition-analysis
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