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Health Care Access and Utilization after the 2010 Pakistan Floods

Published online by Cambridge University Press:  30 August 2016

Gabrielle A. Jacquet Open the ORCID record for Gabrielle A. Jacquet [Opens in a new window] ,
Thomas Kirsch ,
Aqsa Durrani ,
Lauren Sauer  and
Shannon Doocy
Gabrielle A. Jacquet
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, MarylandUSA Johns Hopkins Bloomberg School of Public Health, Baltimore, MarylandUSA Boston University School of Medicine, Boston, MassachusettsUSA Center for Global Health and Development, Boston University School of Public Health, Boston, Massachusetts, USA
Thomas Kirsch*
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, MarylandUSA Johns Hopkins Bloomberg School of Public Health, Baltimore, MarylandUSA
Aqsa Durrani
Affiliation:
University of Pennsylvania School of Medicine, Philadelphia, PennsylvaniaUSA
Lauren Sauer
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, MarylandUSA Johns Hopkins Bloomberg School of Public Health, Baltimore, MarylandUSA
Shannon Doocy
Affiliation:
Johns Hopkins Bloomberg School of Public Health, Baltimore, MarylandUSA
*
Correspondence: Thomas Kirsch, MD, MPH Johns Hopkins University School of Medicine Baltimore, Maryland 21205 USA E-mail: [email protected]
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Abstract

Introduction

The 2010 floods submerged more than one-fifth of Pakistan’s land area and affected more than 20 million people. Over 1.6 million homes were damaged or destroyed and 2,946 direct injuries and 1,985 deaths were reported. Infrastructure damage was widespread, including critical disruptions to the power and transportation networks.

Hypothesis

Damage and loss of critical infrastructure will affect the population’s ability to seek and access adequate health care for years to come. This study sought to evaluate factors associated with access to health care in the aftermath of the 2010 Pakistan floods.

Methods

A population-proportional, randomized cluster-sampling survey method with 80 clusters of 20 (1,600) households of the flood-affected population was used. Heads of households were surveyed approximately six months after flood onset. Multivariate analysis was used to determine significance.

Results

A total of 77.8% of households reported needing health services within the first month after the floods. Household characteristics, including rural residence location, large household size, and lower pre- and post-flood income, were significantly associated (P<.05) with inadequate access to health care after the disaster. Households with inadequate access to health care were more likely to have a death or injury in the household. Significantly higher odds of inadequate access to health care were observed in rural populations (adjusted OR 4.26; 95% CI, 1.89-9.61).

Conclusion

Adequate health care access after the 2010 Pakistani floods was associated with urban residence location, suggesting that locating health care providers in rural areas may be difficult. Access to health services also was associated with post-flood income level, suggesting health resources are not readily available to households suffering great income losses.

JacquetGA, KirschT, DurraniA, SauerL, DoocyS. Health Care Access and Utilization after the 2010 Pakistan Floods. Prehosp Disaster Med. 2016;31(5):485–491.

Keywords

catastrophic floodinghealth services accessibilitynatural disasterPakistan
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 5 , October 2016 , pp. 485 - 491
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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References

1. National Disaster Management Authority. http://www.ndma.gov.pk/new/. Accessed January 12, 2016.Google Scholar
2. OCHA Pakistan. http://www.unocha.org/pakistan/. Accessed February 14, 2014.Google Scholar
3. Solberg, K. Worst floods in living memory leave Pakistan in paralysis. Lancet. 2010;376(9746):1039-1040.Google Scholar
4. Ball State University Center for Business and Economic Research. Preliminary Damage Estimates for Pakistani Flood Events, 2010. http://cber.iweb.bsu.edu/research/PakistanFlood.pdf. Accessed January 12, 2016.Google Scholar
5. World Bank. Pakistan Foods 2010: Preliminary Damage and Needs Assessment. http://www.worldbank.org.pk/WBSITE/EXTERNAL/. Accessed January 12, 2016.Google Scholar
6. Greenough, GP, Lappi, MD, Hsu, E, et al. Burden of disease and health status among Hurricane Katrina-displaced persons in shelters: a population-based cluster sample. Ann Emerg Med. 2008;51(4):426-432.Google Scholar
7. Woersching, JC, Snyder, AE. Earthquakes in El Salvador: a descriptive study of health concerns in a rural community and the clinical implications, part I. Dis Management & Response. 2003;1(4):105-109.Google Scholar
8. Daniels, A, Aspilcueta, D, Doocy, S. Access to care after the 2007 Peruvian earthquake. Dis Med and Public Health Prep. 2009;3(2):97-103.CrossRefGoogle Scholar
9. Jacobsen, K, Marshack, A, Griffith, M. USAID: Increasing the Financial Resilience of Disaster-affected Populations. http://fic.tufts.edu/assets/Increasing-Financial-Resilience-2009.pdf. Accessed January 12, 2016.Google Scholar
10. Chan, EYY, Griffiths, S. Comparison of health needs of older people between affected rural and urban areas after the 2005 Kashmir, Pakistan earthquake. Prehosp Disaster Med. 2009;24(5):365-371.Google Scholar
11. Milch, K, Gorokhovich, Y, Doocy, S. Effects of seismic intensity and socioeconomic status on injury and displacement after the 2007 Peru earthquake. Disasters. 2010;34(4):1171-1182.CrossRefGoogle ScholarPubMed
12. O’Donnell, I, Smart, K, Ramalingam, B. Responding to urban disasters- learning from previous relief and recovery operations. http://www.alnap.org/pool/files/alnap-provention-lessons-urban.pdf. Accessed January 12, 2016.Google Scholar
13. del Ninno, C, Dorosh, PA, Smith, LC, Roy, DK. The 1998 Floods in Bangladesh Disaster Impacts, Household Coping Strategies, and Response. Washington, DC USA: International Food Policy Research Institute; 2001. http://www.ifpri.org/pubs/abstract/abstr122.htm. Accessed January 12, 2016.Google Scholar
14. Rodriguez, H, Aguirre, BE. Hurricane Katrina and the health care infrastructure: a focus on disaster preparedness, response, and resiliency. Front Health Serv Manage. 2006;23(1):31-38.Google ScholarPubMed
15. Adams, ML, Ford, JD, Dailey, WF. Predictors of help seeking among Connecticut adults after September 11, 2001. Am J Public Health. 2004;94(9):1596-1602.Google Scholar
16. Livanou, M, Basoglu, M, Salcioglu, E. Traumatic stress responses in treatment-seeking earthquake survivors in Turkey. J Nerv Ment Dis. 2002;190(12):816-823.CrossRefGoogle ScholarPubMed
17. Stuber, J, Fairbrother, G, Galea, S, Pfefferbaum, B, Wilson-Genderson, M, Vlahov, D. Determinants of counseling for children in Manhattan after the September 11 attacks. Psychiatr Serv. 2002;53(7):815-822.CrossRefGoogle ScholarPubMed
18. Davis, JR, Wilson, S, Brock-Martin, A, Glover, S, Svendsen, ER. The impact of disasters on populations with health and health care disparities. Dis Med and Public Health Prep. 2010;4(1):30-38.CrossRefGoogle ScholarPubMed
19. Nigg, J. Disaster recovery as a social process – University of Delaware Disaster Research Center. http://dspace.udel.edu:8080/dspace/bitstream/handle/19716/625/PP219.pdf?sequence=1. Accessed January 12, 2016.Google Scholar
20. Stimpson, JP, Wilson, FA, Jeffries, SK. Seeking help for disaster services after a flood. Dis Med and Public Health Prep. 2008;2(3):139-141.Google Scholar