Browsing by Author "Völker M."

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    Determinants of healthcare access among older adults in Mandalay Region, Myanmar: A cross-sectional analysis
    (2026-05-01) Aung Y.; Chuanwan S.; Hunchangsith P.; Isarabhakdi P.; Sawangdee Y.; Völker M.; Aung Y.; Mahidol University
    Population ageing is accelerating globally, posing significant challenges to health systems, particularly in low-and middle-income countries. In Myanmar, access to healthcare services among older persons is under-researched, particularly in the Mandalay Region. This study examines healthcare utilization patterns and associated socio-demographic factors among older adults in three high-ageing index districts: Meikhtila, Nyaung U, and Myingyan. A cross-sectional analytical design was employed, with data collected from June to August 2021 based on a multi-stage stratified cluster sampling design. Results from a multivariate logistic regression analysis revealed that older adults living in rural areas (AOR=3.24), those with a moderate ability to perform daily activities (AOR=2.86), and those experiencing hearing difficulties (AOR=1.91) were more likely to use public hospitals. In contrast, residents of Myingyan district (AOR=0.48) were less likely to access public health facilities as compared to residents of Meikhtila district. The use of private hospitals was more common among older adults with moderate self-rated health (AOR=4.36) and those residing in Myingyan (AOR=2.07). However, individuals with moderate functional ability (AOR=0.28) and those with vision difficulties (AOR=0.41) were significantly less likely to use private hospitals. The utilization of charity clinics was higher among older adults who were employed (AOR=11.06), including unpaid family workers (AOR=6), and among those who required regular follow-up care (AOR=7.62) or had vision impairments (AOR=11.35). Conversely, individuals living in rural areas (AOR=0.07) and those from wealthier households (AOR=0.05) were less likely to use charity clinics. These findings highlight the complex and uneven patterns of healthcare access among older persons in Myanmar. They underscore the importance of addressing socio-demographic disparities—particularly in rural areas and among individuals with physical or sensory limitations—to promote equitable and effective healthcare delivery for an ageing population. For example, the provision of specialized care services should be strengthened across all areas to improve access to public ENT (Ear, Nose, and Throat) specialist hospitals in the Mandalay Region.
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    Risk perception of air pollution and behavioral responses: a mapping review of research studies during 2000–2021
    (2024-01-01) Völker M.; Sujaritpong S.; Völker M.; Mahidol University
    Air pollution is a key threat to human and ecosystem health. Successfully addressing this problem requires among other measures the active involvement of the population, depending on adequate public awareness and knowledge. This paper reviewed studies on perceptions of outdoor air pollution and behavioral responses in order to synthesize the state-of-the art in this research field and identify key research gaps. Three bibliographic databases were queried for studies published between 2000 and 2021 using standardized search terms. Of 2,616 titles and abstracts screened, 242 articles met the inclusion criteria. Our review revealed a growing interest in this domain of study, while we found a geographical mismatch between countries with poor air quality and those having been intensively researched. Moreover, we identified a lack of qualitative and mixed methods studies. Research also needs to focus more on vulnerable populations, influential subjects and data from online platforms. Among the outcomes investigated by the reviewed studies, there was a dearth of research on perceptions of ecosystem effects of air pollution, the use of air purifiers and relocating as self-protective means and people’s willingness-to-pay for self-protective measures.
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    Willingness-to-pay in physical activity: how much older adults value the community-wide initiatives programs?
    (2023-01-01) Somta S.; Völker M.; Widyastari D.A.; Mysook S.; Wongsingha N.; Potharin D.; Katewongsa P.; Mahidol University
    Background: Previous studies have shown insufficient physical activity (PA) as a significant global health concern and a major risk factor for non-communicable diseases (NCDs). Community-wide initiatives in physical activity (CWIPA) is considered as a best-buy for Community-wide initiatives in physical activity (CWIPA) is considered as a best-buy for NCDs prevention. However, assessment regarding resource allocation and cost-effectiveness of existing programs is lacking. This study investigated local residents’ willingness-to-pay (WTP) for community PA programs in Southern Thailand. Methods: The contingent valuation method (CVM) using the payment card approach was employed to elicit the WTP of 472 residents aged 45 years and over in selected provinces in which community PA programs had been implemented. Respondents were asked to indicate their WTP for the continuous offering of free CWIPA by choosing how much they were willing to pay from eight bid-value options, payable through their monthly electricity bill. Results: The mean WTP of Thai older adults was found to be 72 baht/month ($2/month) or 868 baht/year ($25/year). This indicated the maximum amount an older person was willing to pay for any community-based PA program. More than half the sample (54.2%) chose zero as their answer, while there was a fairly large variation in other levels of WTP. The WTP was lower among older respondents and those who resided in rural areas but was higher among those with a history of participation in an organized PA program. Conclusion: The level of WTP can be interpreted as an indicator of community satisfaction with CWIPA. That finding can be used as evidence for the government and policy makers in allocating resources and designing future CWIPA. A variety of organized PA programs should be offered to all community members to ensure inclusivity and also to provide equal access for senior citizens.