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应用城市健康公平评估与应对工具评估埃及吉萨省一个城市贫民窟地区居民的健康不公平状况。

The application of Urban Health Equity Assessment and Response Tool to assess health inequity among dwellers of an urban slum area in Giza Governorate, Egypt.

作者信息

Gadallah Mohsen, Megid Soad, Refaey Samir, El-Hussinie Moustafa, Mohsen Amira, Ardakani Mohammad, El-Feky Samar

机构信息

Department of Community Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Ministry of Health and Population, Egypt.

出版信息

J Egypt Public Health Assoc. 2017 Jun 1;92(2):68-76. doi: 10.21608/epx.2018.8944.

Abstract

BACKGROUND

The WHO in 2008 developed the Urban Health Equity Assessment and Response Tool. It is a user-friendly guide for stakeholders and decision makers at national and local levels to identify health inequities. Moreover, using such tool will facilitate decisions on viable and effective strategies, interventions, and actions that should be used to reduce health inequities.

AIM

To assess the health equity in a disadvantaged district (Gezerit El Warak) located in Giza province, Egypt.

MATERIALS AND METHODS

A population-based survey was conducted in the study district. A total of 643 heads of households were interviewed using Urban Health Equity Assessment and Response developed by WHO. Indicators of key health outcomes and major social determinants were calculated and then compared with the corresponding national indicators.

RESULTS

The results of social determinants of health showed lower performance than national figures in the core indicators illiteracy (42.5%) and male tobacco smoking (56.0%), whereas good performance was reported for unemployment among adults (2.0%), fully immunized infants (95.1%), and females' overweight (34.5%)/obesity (38.0%). The main problem encountered was the inadequate physical infrastructure, mainly safe drinking water and sewage disposal system. The health outcome indicators revealed higher prevalence of hypertension among both males (20.7%) and females (19.2%). History of diabetes mellitus was markedly higher than the national figures among both males (11.5%) or females (9.6%).

CONCLUSION

Compared with the national indicators, the main health determinants with low performance encountered in the study area included the physical infrastructure and high prevalence of male tobacco smoking. Health outcome indicators with low performance were diabetes and hypertension. The response of stakeholders was positive and immediate actions were taken to tackle some of the low-performance indicators.

摘要

背景

世界卫生组织于2008年开发了城市卫生公平性评估与应对工具。它是一份便于使用的指南,供国家和地方层面的利益相关者及决策者识别卫生不公平现象。此外,使用该工具将有助于就可行且有效的战略、干预措施及行动做出决策,以减少卫生不公平现象。

目的

评估埃及吉萨省一个处境不利地区(盖泽里特·埃尔·瓦拉克)的卫生公平性。

材料与方法

在研究地区开展了一项基于人群的调查。使用世界卫生组织开发的城市卫生公平性评估与应对工具,共对643户家庭户主进行了访谈。计算关键卫生结果和主要社会决定因素的指标,然后与相应的国家指标进行比较。

结果

卫生社会决定因素的结果显示,在文盲率(42.5%)和男性吸烟率(56.0%)等核心指标方面,表现低于国家数据,而在成年人失业率(2.0%)、婴儿完全免疫率(95.1%)以及女性超重率(34.5%)/肥胖率(38.0%)方面表现良好。遇到的主要问题是物质基础设施不足,主要是安全饮用水和污水处理系统。卫生结果指标显示,男性(20.7%)和女性(19.2%)的高血压患病率较高。糖尿病病史在男性(11.5%)和女性(9.6%)中均明显高于国家数据。

结论

与国家指标相比,研究地区表现不佳的主要卫生决定因素包括物质基础设施和男性吸烟率高。表现不佳的卫生结果指标是糖尿病和高血压。利益相关者的反应积极,并立即采取行动应对一些表现不佳的指标。

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