Uddin Jalal, Mazur Robert E
Department of Sociology, Iowa State University, Ames, IA 50011, USA
Department of Sociology, Iowa State University, Ames, IA 50011, USA.
Health Policy Plan. 2015 Jul;30(6):782-90. doi: 10.1093/heapol/czu057. Epub 2014 Jul 3.
Although many studies have been carried out to examine healthcare utilizations in rural Bangladesh, yet little is known about the healthcare utilization among survivors of a natural disaster. This study addresses this gap by examining the socioeconomic factors associated with healthcare utilization among Cyclone Sidr survivors.
A systematic random sample of 384 heads of household was interviewed using a semi-structured questionnaire. This study used multivariate logistic analyses to examine post-cyclone healthcare utilizations. Healthcare utilization is defined as the process of seeking professional healthcare and submitting oneself to the application of available health services, with the purpose to prevent or treat health problems.
Over half (58%) of Cyclone Sidr survivors suffered from some type of illness occurring during the 15 days preceding the survey. The most common healthcare choices among survivors to address illnesses were seeking assistance from para-professionals (37%), qualified allopaths (26%) and drug store salespersons (17%). A principal finding was that a household's socioeconomic status, as reflected by wealth quintiles, was a major determinant in healthcare utilization. The household heads in the higher wealth quintile were significantly more likely to seek modern allopathic providers for healthcare than those in the poorest quintile (Odds ratio (OR) = 2.89, Confidence interval (CI): 1.92-5.87). The household heads who listened to health risk communications were 2.55 times more likely to seek any healthcare (CI: 1.35-5.11) and 1.77 times to seek modern allopathic care (CI: 1.62-5.09) than those who did not. Other significant predictors of healthcare utilization were education, listening to radio, distance to healthcare facility and perceived susceptibility to water-borne diseases.
Para-professionals, qualified allopath and drugstore salespeople are the primary vehicles for providing healthcare services to population at risk of cyclone. Therefore, there is a need for more medical training for these primary healthcare providers in rural Bangladesh.
尽管已经开展了许多研究来考察孟加拉国农村地区的医疗保健利用情况，但对于自然灾害幸存者的医疗保健利用情况却知之甚少。本研究通过考察与气旋希德（Cyclone Sidr）幸存者医疗保健利用相关的社会经济因素来填补这一空白。
使用半结构化问卷对384户家庭的户主进行了系统随机抽样访谈。本研究采用多变量逻辑分析来考察气旋过后的医疗保健利用情况。医疗保健利用被定义为寻求专业医疗保健并接受现有卫生服务应用的过程，目的是预防或治疗健康问题。
超过一半（58%）的气旋希德幸存者在调查前15天内患有某种疾病。幸存者应对疾病时最常见的医疗保健选择是向准专业人员（37%）、合格的全科医生（26%）和药店销售人员（17%）寻求帮助。一个主要发现是，家庭的社会经济地位，以财富五分位数来衡量，是医疗保健利用的一个主要决定因素。处于较高财富五分位数的户主比最贫困五分位数的户主更有可能寻求现代全科医疗服务提供者进行医疗保健（优势比（OR）=2.89，置信区间（CI）：1.92 - 5.87）。收听健康风险信息的户主寻求任何医疗保健的可能性是未收听者的2.55倍（CI：1.35 - 5.11），寻求现代全科医疗护理的可能性是未收听者的1.77倍（CI：1.62 - 5.09）。医疗保健利用的其他显著预测因素包括教育程度、收听广播、到医疗机构的距离以及对水传播疾病的易感性。
准专业人员、合格的全科医生和药店销售人员是为面临气旋风险的人群提供医疗保健服务的主要力量。因此，孟加拉国农村地区的这些基层医疗服务提供者需要更多的医学培训。
