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孟加拉国的性别、社会经济发展与就医行为

Gender, socioeconomic development and health-seeking behaviour in Bangladesh.

作者信息

Ahmed S M, Adams A M, Chowdhury M, Bhuiya A

机构信息

BRAC Research anid Evaluation Division, BRAC Centre, Dhaka, Bangladesh.

出版信息

Soc Sci Med. 2000 Aug;51(3):361-71. doi: 10.1016/s0277-9536(99)00461-x.

Abstract

In efforts to reduce gender and socioeconomic disparities in the health of populations, the provision of medical services alone is clearly inadequate. While socioeconomic development is assumed important in rectifying gender and socioeconomic inequities in health care access, service use and ultimately, outcomes, empirical evidence of its impact is limited. Using cross-sectional data from the BRAC-ICDDR,B Joint Research Project in Matlab, Bangladesh, this paper examines the impact of membership in BRAC's integrated Rural Development Programme (RDP) on gender equity and health-seeking behaviour. Differences in health care seeking are explored by comparing a sample of households who are BRAC members with a sample of BRAC-eligible non-members. Individuals from the BRAC member group report significantly less morbidity (15-day recall) than those from the non-member group, although no gender differences in the prevalence of self-reported morbidity are apparent in either group. Sick individuals from BRAC member households tend to seek care less frequently than non-members. When treatment is sought, BRAC members rely to a greater extent on home remedies, traditional care, and unqualified allopaths than non-member households. While reported treatment seeking from qualified allopaths is more prevalent in the BRAC group, non-members use the para-professional services of community health care workers almost twice as frequently. In both BRAC member and non-member groups, women suffering illness report seeking care significantly less often than men. The policy and programmatic implications of between group and gender differences in care seeking are discussed with reference to the literature.

摘要

为减少人群健康方面的性别和社会经济差异,仅提供医疗服务显然是不够的。虽然社会经济发展被认为对纠正医疗保健获取、服务利用以及最终结果方面的性别和社会经济不平等很重要,但其影响的实证证据有限。本文利用孟加拉国Matlab地区BRAC-ICDDR,B联合研究项目的横断面数据,研究了参与BRAC综合农村发展项目(RDP)对性别平等和就医行为的影响。通过比较BRAC成员家庭样本和符合BRAC条件的非成员家庭样本,探讨了就医方面的差异。BRAC成员组的个体报告的发病率(15天回忆期)明显低于非成员组,尽管两组中自我报告发病率的患病率均未显示出性别差异。BRAC成员家庭的患病个体比非成员家庭的患病个体寻求治疗的频率更低。在寻求治疗时,与非成员家庭相比,BRAC成员在更大程度上依赖家庭疗法、传统护理和不合格的全科医生。虽然BRAC组中向合格全科医生寻求治疗的情况更为普遍,但非成员使用社区卫生工作者的准专业服务的频率几乎是非成员的两倍。在BRAC成员组和非成员组中,患病的女性报告寻求治疗的频率明显低于男性。本文结合文献讨论了组间差异和性别在就医方面差异的政策及方案影响。

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