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巴马科倡议计划中的不公平现象——对尼日利亚东南部疟疾治疗的影响。

Inequity in the Bamako Initiative programme--implications for the treatment of malaria in south-east Nigeria.

作者信息

Uzochukwu Benjamin, Onwujekwe Obinna, Eriksson Bo

机构信息

Department of Community Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria.

出版信息

Int J Health Plann Manage. 2004 Oct-Dec;19 Suppl 1:S107-16. doi: 10.1002/hpm.779.

Abstract

An exploratory study was carried out to examine the utilization of malaria treatment services in the Bamako Initiative (BI), the exemption practices and the cost recovery of user-fees for treatment of malaria in south-east Nigeria. Structured questionnaires were used from 1594 households to collect socio-economic and demographic information, the utilization of health care services and experience with user fee exemption. Historical data on malaria utilization rates from 1991 to 2000 were obtained from health centres. In addition, financial information was collected on the annual BI revenue. Health centres for malaria experienced a drop in outpatient attendance when the programme started which later rose again. The more affluent population, as assessed by household belongings and education, used the health centres more often than the poorer population, were more aware of exemptions and benefited from exemptions more than the poorer and lesser educated populations. The sale of anti-malaria drugs was a large proportion of the costs recovered. BI appears to have increased malaria care utilization but has also raised some equity issues. It seems that richer households benefited more than poorer households.

摘要

开展了一项探索性研究,以调查尼日利亚东南部巴科倡议(BI)中疟疾治疗服务的利用情况、豁免做法以及疟疾治疗使用者付费的成本回收情况。采用结构化问卷对1594户家庭进行调查,收集社会经济和人口信息、医疗服务利用情况以及使用者付费豁免经历。1991年至2000年疟疾利用率的历史数据来自各卫生中心。此外,还收集了关于BI年度收入的财务信息。该项目启动时,疟疾卫生中心的门诊就诊人数有所下降,之后又再次上升。根据家庭财产和教育程度评估,较富裕人群比贫困人群更频繁地使用卫生中心,对豁免情况更了解,并且比贫困和受教育程度较低的人群从豁免中受益更多。抗疟疾药物的销售占回收成本的很大比例。BI似乎提高了疟疾治疗的利用率,但也引发了一些公平性问题。似乎富裕家庭比贫困家庭受益更多。

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