The Kazakh National Medical University, 88 Tole Bi Street, Almaty 480012, Kazakhstan.
J Public Health Policy. 2010 Apr;31(1):30-50. doi: 10.1057/jphp.2009.47.
The present study examines how growing socio-economic inequalities in transitional countries that have followed different health policy paths affect women's access to reproductive health care. I conducted surveys in Kazakhstan and Belarus and used logistic regression analyses to determine accessibility to and satisfaction with reproductive health services, reproductive status, and reproductive history based on country of residence. By all measures, access to reproductive health services was most problematic for the low-income women in Kazakhstan but to a significantly lesser extent for economically disadvantaged respondents in Belarus. Differences in education had a significant effect on women's access to reproductive health services in Kazakhstan but were not present in Belarus. Household income was the most powerful predictor of self-perceived health in Kazakhstan, but not in Belarus. The unreformed health-care system in Belarus appears to be more accessible for all women than Kazakhstan's health-care system that underwent significant market-oriented reform.
本研究考察了在采取不同卫生政策路径的转型国家中,日益增长的社会经济不平等如何影响妇女获得生殖保健的机会。我在哈萨克斯坦和白俄罗斯进行了调查,并使用逻辑回归分析,根据居住国确定获得和对生殖保健服务的满意度、生殖状况和生殖历史。从所有方面来看,哈萨克斯坦低收入妇女获得生殖保健服务的问题最为严重,但白俄罗斯经济处于不利地位的受访者的问题则要严重得多。教育方面的差异对哈萨克斯坦妇女获得生殖保健服务的机会有重大影响,但对白俄罗斯则没有影响。家庭收入是哈萨克斯坦自我评价健康状况的最有力预测因素,但白俄罗斯则不是。白俄罗斯的未改革医疗保健系统似乎比哈萨克斯坦进行了重大市场化改革的医疗保健系统对所有妇女都更具可及性。