Amegbor Prince M, Kuuire Vincent Z, Bisung Elijah, Braimah Joseph A
Department of Geography and Planning, Queen's University, Kingston, ON, Canada.
Department of Geography, University of Toronto Mississauga, Mississauga, ON, Canada.
Prim Health Care Res Dev. 2019 Aug 9;20:e71. doi: 10.1017/S1463423619000197.
This paper examined the association between wealth and health insurance status and the use of traditional medicine (TM) among older persons in Ghana.
There have been considerable efforts by sub-Saharan African countries to improve access to primary health care services, partly through the implementation of risk-pooling community or national health insurance schemes. The use of TM, which is often not covered under these insurance schemes, remains common in many countries, including Ghana. Understanding how health insurance and wealth influence the use of TM, or otherwise, is essential to the development of equitable health care policies.
The study used data from the first wave of the World Health Organisation's Study of Global Ageing and Adult Health conducted in Ghana in 2008. Descriptive statistics and negative loglog regression models were fitted to the data to examine the influence of insurance and wealth status on the use of TM, controlling for theoretically relevant factors.
Seniors who had health insurance coverage were also 17% less likely to frequently seek treatment from a TM healer relative to the uninsured. For older persons in the poorest income quintile, the odds of frequently seeking treatment from TM increased by 61% when compared to those in the richest quintile. This figure was 46%, 62% and 40% for older persons in poorer, middle and richer income quintiles, respectively, compared to their counterparts in the richest income quintile.
The findings indicate that TM was primarily used by the poor and persons who were not enrolled in the National Health Insurance Scheme. TM continues to be a vital health care resource for the poor and uninsured older adults in Ghana.
本文研究了加纳老年人的财富与健康保险状况以及传统医学(TM)使用之间的关联。
撒哈拉以南非洲国家付出了巨大努力来改善初级卫生保健服务的可及性,部分是通过实施风险共担的社区或国家健康保险计划。在包括加纳在内的许多国家,传统医学的使用在这些保险计划中通常未涵盖,却依然普遍。了解健康保险和财富如何影响传统医学的使用与否,对于制定公平的卫生保健政策至关重要。
该研究使用了2008年在加纳进行的世界卫生组织全球老龄化与成人健康研究第一波的数据。对数据进行描述性统计和负对数-对数回归模型拟合,以检验保险和财富状况对传统医学使用的影响,并控制理论上相关的因素。
相对于未参保者,拥有健康保险的老年人经常寻求传统医学治疗师治疗的可能性也要低17%。与最富裕五分位数组的老年人相比,最贫困收入五分位数组的老年人经常寻求传统医学治疗的几率增加了61%。与最富裕收入五分位数组的同龄人相比,贫困、中等和较富裕收入五分位数组的老年人这一数字分别为46%、62%和40%。
研究结果表明,传统医学主要由贫困人口和未参加国家健康保险计划的人使用。在加纳,传统医学仍然是贫困和未参保老年人的重要卫生保健资源。