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约旦部分贫民窟地区健康的社会决定因素:挑战与政策方向

Social determinants of health in selected slum areas in Jordan: challenges and policy directions.

作者信息

Ajlouni Musa T

机构信息

Department of Hospital Administration, Philadelphia University, Amman, Jordan.

出版信息

Int J Health Plann Manage. 2016 Jan-Mar;31(1):113-25. doi: 10.1002/hpm.2267. Epub 2014 Oct 3.

Abstract

BACKGROUND

The unplanned urbanization in Jordan has over time created many informal settlements "slums" around big cities as Amman, Zerka and Aqaba. The purpose of this study was to highlight the most common challenges related to social determinants of health in two selected slum areas in Amman and Aqaba and suggest policy directions and interventions to meet these challenges.

METHODS

In addition to a prestructured interview with all household heads living in the two slum sites, focus group meetings with a purposefully selected sample of 12 slum dwellers in each site were used to assess the structural and intermediary determinants of health as perceived by slum residents in the two study locations.

RESULTS

The study found that slum residents in the two locations suffer from many challenges as severe poverty; unemployment; illiteracy and low education attainments; gender discrimination; insufficient and poor diet; social and official exclusion; unhealthy environment; lack of water supply, electricity and basic sanitation facilities; high prevalence of diseases; and insufficient and inappropriate health services. Specific policy directions to meet these challenges were recommended and grouped into three main clusters: social protection, social inclusion and empowerment.

CONCLUSION

New plans and tools should be developed by local authorities in Jordan to understand, protect, include and empower those vulnerable people who are forced to live in these unhealthy and inhuman environments.

摘要

背景

随着时间的推移,约旦的无计划城市化在安曼、扎尔卡和亚喀巴等大城市周边形成了许多非正规住区(“贫民窟”)。本研究的目的是突出安曼和亚喀巴两个选定贫民窟地区与健康社会决定因素相关的最常见挑战,并提出应对这些挑战的政策方向和干预措施。

方法

除了对居住在两个贫民窟地点的所有户主进行结构化访谈外,还在每个地点与特意挑选的12名贫民窟居民样本进行焦点小组会议,以评估两个研究地点的贫民窟居民所感知的健康结构和中介决定因素。

结果

研究发现,这两个地点的贫民窟居民面临诸多挑战,如严重贫困、失业、文盲和低教育水平、性别歧视、饮食不足且质量差、社会和官方排斥、不健康的环境、缺乏供水、电力和基本卫生设施、疾病高发以及卫生服务不足和不适当。针对应对这些挑战提出了具体的政策方向,并分为三个主要类别:社会保护、社会包容和赋权。

结论

约旦地方当局应制定新的计划和工具,以了解、保护、包容和赋权那些被迫生活在这些不健康和不人道环境中的弱势群体。

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