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消费者对改善疟疾治疗服务的偏好是否因其社会经济地位和地理位置而异?尼日利亚东南部的一项研究。

Do consumers' preferences for improved provision of malaria treatment services differ by their socio-economic status and geographic location? A study in southeast Nigeria.

机构信息

Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, Nigeria.

出版信息

BMC Public Health. 2010 Jan 5;10:7. doi: 10.1186/1471-2458-10-7.

Abstract

BACKGROUND

Improvement of utilization of malaria treatment services will depend on provision of treatment services that different population groups of consumers prefer and would want to use. Treatment of malaria in Nigeria is still problematic and this contributes to worsening burden of the disease in the country. Therefore this study explores the socio-economic and geographic differences in consumers' preferences for improved treatment of malaria in Southeast Nigeria and how the results can be used to improve the deployment of malaria treatment services.

METHODS

This study was undertaken in Anambra state, Southeast Nigeria in three rural and three urban areas. A total of 2,250 randomly selected householders were interviewed using a pre tested interviewer administered questionnaire. Preferences were elicited using both a rating scale and ranking of different treatment provision sources by the respondents. A socio-economic status (SES) index was used to examine for SES differences, whilst urban-rural comparison was used to examine for geographic differences, in preferences.

RESULTS

The most preferred source of provision of malaria treatment services was public hospitals (30.5%), training of mothers (19%) and treatment in Primary healthcare centres (18.1%). Traditional healers (4.8%) and patent medicine dealers (4.2%) were the least preferred strategies for improving malaria treatment. Some of the preferences differed by SES and by a lesser extent, the geographic location of the respondents.

CONCLUSION

Preferences for provision of improved malaria treatment services were influenced by SES and by geographic location. There should be re-invigoration of public facilities for appropriate diagnosis and treatment of malaria, in addition to improving the financial and geographic accessibility of such facilities. Training of mothers should be encouraged but home management will not work if the quality of services of patent medicine dealers and pharmacy shops where drugs for home management are purchased are not improved. Therefore, there is the need for a holistic improvement of malaria treatment services.

摘要

背景

改善疟疾治疗服务的利用情况将取决于提供不同消费群体更喜欢和愿意使用的治疗服务。尼日利亚的疟疾治疗仍然存在问题,这导致该国疾病负担恶化。因此,本研究探讨了东南尼日利亚消费者对改善疟疾治疗的社会经济和地理差异偏好,以及如何利用这些结果来改善疟疾治疗服务的部署。

方法

本研究在尼日利亚东南的阿南布拉州的三个农村和三个城市地区进行。共随机选择了 2250 户家庭进行访谈,使用了预先测试的访谈者管理问卷。通过受访者的评分量表和不同治疗提供来源的排名,得出了偏好。社会经济地位(SES)指数用于检查 SES 差异,而城乡比较用于检查偏好中的地理差异。

结果

提供疟疾治疗服务的最受欢迎的来源是公立医院(30.5%)、母亲培训(19%)和初级保健中心治疗(18.1%)。传统治疗师(4.8%)和专利药经销商(4.2%)是改善疟疾治疗的最不受欢迎的策略。一些偏好因 SES 以及受访者的地理位置而有所不同。

结论

提供改善疟疾治疗服务的偏好受到 SES 和地理位置的影响。除了改善这些设施的财务和地理可及性外,还应重振公共设施,以进行适当的疟疾诊断和治疗。应该鼓励母亲培训,但如果未经改善购买家庭管理药物的专利药经销商和药店的服务质量,则家庭管理将无法奏效。因此,需要全面改善疟疾治疗服务。

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本文引用的文献

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Determinants of provider choice for malaria treatment: experiences from The Gambia.
Soc Sci Med. 2008 Aug;67(4):487-96. doi: 10.1016/j.socscimed.2008.04.007. Epub 2008 Jun 5.
4
Interactions between patent medicine vendors and customers in urban and rural Nigeria.
Health Policy Plan. 2004 May;19(3):177-82. doi: 10.1093/heapol/czh021.
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Antimalarials dispensing pattern by patent medicine dealers in rural settlements in Nigeria.
Public Health. 2000 Jul;114(4):282-5. doi: 10.1016/s0033-3506(00)00346-2.

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