估计女性生殖器切割的效用值。
Estimating utility value for female genital mutilation.
机构信息
Department of Health Management and Economics, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran.
Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran.
出版信息
BMC Public Health. 2020 May 29;20(1):811. doi: 10.1186/s12889-020-08947-4.
BACKGROUND
Female genital mutilation/cutting (FGM/C) is a clear violation of women's rights and can have adverse and irreversible health effects as well. Worldwide, more than 200 million women and girls have undergone FGM/C. Utility value of FGM/C has not been estimated yet, so we designed this study to extract the health utility value of FGM/C for the first time in the world.
METHODS
In a cross-sectional study in Iran, 125 girls and women who underwent FGM/C procedure were examined by the trained midwives in order to determine its type. In addition, a questionnaire was completed for identifying the socio-demographic factors and extracting the health utility of these individuals. Health utility was measured using Time Trade-off method and also to determine the effects of the socio-demographic factors on the health utility a two-limit censored regression model was applied.
RESULTS
The mean and median of the health utility of women with FGM/C were 0.971 (SE: 0.003) and 0.968 (IQR: 1-0.95), respectively. Number of non-traders was 58 (46.4%) who reported perfect health utility. However, the mean of health utility among traders was 0.946 (SE: 0.002). Only type 1 (Clitoridectomy) and type 2 (Excision) FGM/C were seen in this study. Women with Type 1 FGM/C had significantly lower health utility value (Mean: 0.968, Median: 0.957) than their type 2 counterparts (Mean: 0.987, Median: 1.00). Moreover, women in the age group of 31-45 years (Mean: 0.962, Median: 0.956), single (Mean: 0.950, Median: 0.954), divorced (Mean: 0.951, Median: 0.950), employed (Mean: 0.959, Median: 0.956), and with supplementary insurance (Mean: 0.962, Median: 0.950) had significantly lower health utility than their counterparts.
CONCLUSION
FGM/C affects physical and psychological well-being of these individuals, resulting in a lack of personal and marital satisfaction, which ultimately leads to a 3% reduction in their health related quality of life. Therefore, preventing from this practice is very important and should be considered by health system policy makers more than before.
背景
女性生殖器切割（FGM/C）是对妇女人权的明显侵犯，并且会对健康产生不利且不可逆转的影响。在全球范围内，有超过 2 亿名妇女和女童遭受了 FGM/C。目前尚未对 FGM/C 的效用价值进行评估，因此我们设计了这项研究，首次在全球范围内提取 FGM/C 的健康效用价值。
方法
在伊朗的一项横断面研究中，由经过培训的助产士对 125 名接受 FGM/C 手术的女孩和妇女进行检查，以确定其类型。此外，还完成了一份问卷，以确定这些个体的社会人口统计学因素并提取其健康效用。健康效用采用时间权衡法进行测量，并应用双限删失回归模型确定社会人口统计学因素对健康效用的影响。
结果
FGM/C 女性的健康效用平均值和中位数分别为 0.971（SE：0.003）和 0.968（IQR：1-0.95）。58 名（46.4%）非交易者报告了完美的健康效用。然而，交易者的健康效用平均值为 0.946（SE：0.002）。本研究仅观察到 1 型（阴蒂切除术）和 2 型（切除术）FGM/C。1 型 FGM/C 的女性健康效用值明显低于 2 型女性（平均值：0.968，中位数：0.957）（平均值：0.987，中位数：1.00）。此外，31-45 岁（平均值：0.962，中位数：0.956）、单身（平均值：0.950，中位数：0.954）、离婚（平均值：0.951，中位数：0.950）、就业（平均值：0.959，中位数：0.956）和有补充保险（平均值：0.962，中位数：0.950）的女性的健康效用明显低于其同龄人。
结论
FGM/C 会影响这些个体的身心健康，导致个人和婚姻满意度下降，最终导致其健康相关生活质量下降 3%。因此，预防这种做法非常重要，卫生系统决策者应该比以往更加重视这一点。
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