Goodman Michael L, Seidel Sarah E, Kaberia Reegan, Keiser Philip H
Sodzo International, Houston, USA,
Int J Public Health. 2015 Jul;60(5):589-97. doi: 10.1007/s00038-015-0681-z. Epub 2015 May 1.
This study analyzes healthcare access and general self-rated health (GSRH) among orphan and vulnerable child (OVC) households enrolled in an empowerment program in Eastern Province, Kenya. Analyses investigate whether reported monthly income mediates the association between program participation and medical security. Predictors of GSRH are also investigated.
Cross-sectional survey data on families (n = 707) participating in a multisectoral empowerment program were collected in June 2012. Regression methods were used to investigate study aims.
Monthly income mediated 14.3 % of the total effect of program participation on healthcare accessibility. Program participation was not significantly associated with higher GSRH.
Increased reported monthly income predicted improved healthcare access, but only explained a portion of improved healthcare access in the study population. Partnerships between community-based empowerment programs and clinical providers might successfully target multiple outcomes among OVC, including improved healthcare access, though further research on potential synergies is required. GSRH was associated with increased access to food, medical care, literacy, safe drinking water and household income. Further research on GSRH among OVC should target measurement validity, potential sources of disparity in GSRH between OVC and non-OVC, and targets for improving GSRH among OVC.
本研究分析了肯尼亚东部省份参加赋权项目的孤儿及弱势儿童（OVC）家庭的医疗服务可及性和总体自评健康状况（GSRH）。分析调查报告的月收入是否在项目参与和医疗保障之间的关联中起中介作用。还对GSRH的预测因素进行了调查。
2012年6月收集了参与多部门赋权项目的家庭（n = 707）的横断面调查数据。采用回归方法来研究本研究的目标。
月收入在项目参与对医疗服务可及性的总效应中起14.3%的中介作用。项目参与与更高的GSRH没有显著关联。
报告的月收入增加预示着医疗服务可及性的改善，但在研究人群中仅解释了部分医疗服务可及性的改善。基于社区的赋权项目与临床服务提供者之间的合作可能成功地针对OVC实现多个成果，包括改善医疗服务可及性，不过需要对潜在协同效应进行进一步研究。GSRH与食物获取、医疗保健、识字能力、安全饮用水和家庭收入的增加有关。对OVC中GSRH的进一步研究应针对测量效度、OVC与非OVC之间GSRH差异的潜在来源以及改善OVC中GSRH的目标。
