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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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