Gyan Thomas, McAuley Kimberley, Strobel Natalie, Newton Sam, Owusu-Agyei Seth, Edmond Karen
Division of Paediatrics, Faculty of Health and Medical Sciences, University of Western Australia, Level 4, Administration Building, Princess Margaret Hospital for Children, Perth, WA, 6008, Australia.
Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana.
BMC Pediatr. 2017 Aug 29;17(1):185. doi: 10.1186/s12887-017-0937-2.
BACKGROUND: The influence of socio-economic determinants on choice of infant male circumcision provider is not known in areas with high population coverage such as rural Africa. The overall aim of this study was to determine the key socio-economic factors which influence the choice of infant male circumcision provider in rural Ghana. METHODS: The study investigated the effect of family income, distance to health facility, and cost of the circumcision on choice of infant male circumcision provider in rural Ghana. Data from 2847 circumcised infant males aged under 12 weeks and their families were analysed in a population-based cross-sectional study conducted from May to December 2012 in rural Ghana. Multivariable logistic regression models were adjusted for income status, distance to health facility, cost of circumcision, religion, maternal education, and maternal age. RESULTS: Infants from the lowest income households (325, 84.0%) were more likely to receive circumcision from an informal provider compared to infants from the highest income households (260, 42.4%) even after adjusting for religious affiliation (adjusted odds ratio [aOR] 4.42, 95% CI 3.12-6.27 p = <0.001). There appeared to be a dose response with increasing risk of receiving a circumcision from an informal provider as distance to a health facility increased (aOR 1.25, 95 CI 1.30-1.38 P = <0.001). Only 9.0% (34) of families in the lowest socio-economic quintile received free circumcision services compared to 27.9% (171) of the highest income families. CONCLUSIONS: The Government of Ghana and Non-Government Organisations should consider additional support to poor families so they can access high quality free infant male circumcision in rural Ghana.
背景:在非洲农村等人口覆盖率高的地区,社会经济决定因素对婴儿男性包皮环切术提供者选择的影响尚不清楚。本研究的总体目标是确定影响加纳农村地区婴儿男性包皮环切术提供者选择的关键社会经济因素。 方法:本研究调查了家庭收入、到医疗机构的距离以及包皮环切术费用对加纳农村地区婴儿男性包皮环切术提供者选择的影响。在2012年5月至12月于加纳农村进行的一项基于人群的横断面研究中,分析了2847名年龄在12周以下接受包皮环切术的男婴及其家庭的数据。多变量逻辑回归模型针对收入状况、到医疗机构的距离、包皮环切术费用、宗教、母亲教育程度和母亲年龄进行了调整。 结果:即使在调整宗教信仰后,来自最低收入家庭的婴儿(325名,84.0%)比来自最高收入家庭的婴儿(260名,42.4%)更有可能由非正规提供者进行包皮环切术(调整后的优势比[aOR]为4.42,95%置信区间为3.12 - 6.27,p = <0.001)。随着到医疗机构距离的增加,由非正规提供者进行包皮环切术的风险似乎呈剂量反应增加(aOR为1.25,95%置信区间为1.30 - 1.38,P = <0.001)。社会经济最底层五分之一的家庭中只有9.0%(34户)获得了免费包皮环切术服务,而最高收入家庭中这一比例为27.9%(171户)。 结论:加纳政府和非政府组织应考虑为贫困家庭提供更多支持,以便他们能够在加纳农村获得高质量的免费婴儿男性包皮环切术。
Trop Med Int Health. 2013-4-5
Int J Health Plann Manage. 2003
Int J Health Plann Manage. 1996
Ethiop J Health Sci. 2014-9
J Health Care Poor Underserved. 2013-8
Reprod Health. 2013-8-20
Kathmandu Univ Med J (KUMJ). 2010
Bull World Health Organ. 2010-10-29