印度加尔各答一个城市贫民窟中与健康寻求行为相关的性别体验。
The gendered experience with respect to health-seeking behaviour in an urban slum of Kolkata, India.
机构信息
School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
Centre for Study of Social Change and Development, Institute for Social and Economic Change (ISEC), Bangalore, India.
出版信息
Int J Equity Health. 2018 Feb 14;17(1):24. doi: 10.1186/s12939-018-0738-8.
BACKGROUND
Empirical evidence shows that the relationship between health-seeking behaviour and diverse gender elements, such as gendered social status, social control, ideology, gender process, marital status and procreative status, changes across settings. Given the high relevance of social settings, this paper intends to explore how gender elements interact with health-seeking practices among men and women residing in an Indian urban slum, in consideration of the unique socio-cultural context that characterises India's slums.
METHODS
The study was conducted in Sahid Smriti Colony, a peri-urban slum of Kolkata, India. The referral technique was used for selecting participants, as people in the study area were not very comfortable in discussing their health issues and health-seeking behaviours. The final sample included 66 participants, 34 men and 32 women. Data was collected through individual face-to-face in-depth interviews with a semi-structured questionnaire.
RESULTS
The data analysis shows six categories of reasons underlying women's preferences for informal healers, which are presented in the form of the following themes: cultural competency of care, easy communication, gender-induced affordability, avoidance of social stigma and labelling, living with the burden of cultural expectations and geographical and cognitive distance of formal health care. In case of men ease of access, quality of treatment and expected outcome of therapies are the three themes that emerged as the reasons behind their preferences for formal care.
CONCLUSION
Our results suggest that both men and women utilise formal and informal care, but with different motives and expectations, leading to contrasting health-seeking outcomes. These gender-induced contrasts relate to a preference for socio-cultural (women) versus technological (men) therapies and long (women) versus fast (men) treatment, and are linked to their different societal and familial roles. The role of women in following and maintaining socio-cultural norms leads them to focus on care that involves long discussions mixed with socio-cultural traits that help avoid economic and social sanctions, while the role of men as bread earners requires them to look for care that ensures a fast and complete recovery so as to avoid financial pressures.
背景
实证证据表明，求医行为与性别等多种因素之间的关系因环境而异，这些因素包括性别社会地位、社会控制、意识形态、性别过程、婚姻状况和生育状况等。鉴于社会环境的高度相关性，本文旨在探讨在考虑到印度贫民窟独特的社会文化背景下，性别因素如何与居住在印度城市贫民窟的男性和女性的求医行为相互作用。
方法
该研究在印度加尔各答的一个城郊贫民窟 Sahid Smriti 殖民地进行。采用转诊技术选择参与者，因为研究区域的人们不太愿意讨论他们的健康问题和求医行为。最终样本包括 66 名参与者，其中男性 34 名，女性 32 名。通过使用半结构化问卷进行个人面对面深入访谈收集数据。
结果
数据分析显示，女性偏好选择非正规治疗师的原因有六个类别，以以下主题的形式呈现：护理的文化能力、易于沟通、性别导致的可负担性、避免社会耻辱和标签、承受文化期望的负担以及正规医疗保健的地理和认知距离。对于男性，易于获得、治疗质量和治疗预期结果是他们选择正规医疗的三个主题。
结论
我们的研究结果表明，男性和女性都利用正规和非正规医疗，但动机和期望不同，导致求医结果迥异。这些由性别引起的差异与对社会文化（女性）与技术（男性）疗法的偏好以及长（女性）与快（男性）治疗相关，并与他们不同的社会和家庭角色有关。女性在遵循和维持社会文化规范方面的角色使她们专注于涉及长时间讨论并结合社会文化特征的护理，这有助于避免经济和社会制裁，而男性作为养家糊口的角色则需要他们寻找能够确保快速和完全康复的护理，以避免经济压力。
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