Centre for Development and the Environment, University of Oslo, Oslo, Norway.
Glob Health Promot. 2013 Mar;20(1 Suppl):33-8. doi: 10.1177/1757975912462420.
This paper examines the concept of vulnerability in the context of maternal morbidity and mortality in Burkina Faso, an impoverished country in West Africa. Drawing on a longitudinal cohort study into the consequences of life-threatening or 'near miss' obstetric complications, we provide an in-depth case study of one woman's experience of such morbidity and its aftermath. We follow Kalizeta's trajectory from her near miss and the stillbirth of her child to her death from pregnancy-related hypertension after a subsequent delivery less than two years later, in order to examine the impact of severe and persistent illness and catastrophic health expenditure on her health and on her family's everyday life. Kalizeta's case illustrates how vulnerability in health emerges and is maintained or exacerbated over time. Even where social arrangements are supportive, structural impediments, including unaffordable and inadequate healthcare, can severely limit individual resilience to mitigate the negative social and economic consequences of ill health.
本文探讨了布基纳法索孕产妇发病率和死亡率背景下的脆弱性概念,布基纳法索是西非一个贫穷国家。本文借鉴了一项关于危及生命或“接近失败”产科并发症后果的纵向队列研究,深入研究了一名妇女经历此类发病率及其后果的案例。我们按照 Kalizeta 的轨迹,从她的接近失败和她孩子的死产,到她在随后不到两年的一次分娩后因妊娠相关高血压而死亡,以研究严重和持续疾病以及灾难性医疗支出对她的健康和她家庭日常生活的影响。Kalizeta 的案例说明了健康脆弱性是如何随着时间的推移而出现并得以维持或加剧的。即使社会安排具有支持性,结构性障碍,包括无法负担和不足的医疗保健,也会严重限制个人的适应能力,从而减轻健康不良的负面社会和经济后果。