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30个低收入和中等收入国家年轻人获得医疗保健的障碍。

Barriers to accessing health care among young people in 30 low-middle income countries.

作者信息

Nachiappan Nitish, Mackinnon Shona, Ndayizeye Jean P, Greenfield Geva, Hargreaves Dougal

机构信息

School of Public Health Imperial College School of Medicine London UK.

Division of Basic Medical Sciences University of Global Health Equity Kigali Rwanda.

出版信息

Health Sci Rep. 2022 Jul 20;5(4):e733. doi: 10.1002/hsr2.733. eCollection 2022 Jul.

Abstract

BACKGROUND

Previous studies focusing on high-income countries have shown that young people often face greater barriers to accessing healthcare than older adults. However, in low-middle income countries (LMICs), there have been a paucity of cross-country, quantitative studies highlighting these barriers.

AIM

This exploratory study aims to provide a scoping review of the publicly available Demographic and Heath Survey (DHS) data with a view to form the basis for further work.

MATERIALS AND METHODS

Data on insurance coverage, agency, and access to evidence-based family planning from 30 countries in the DHS were compared between age groups. Data on 586,250 participants 15-24 years (33% male) and 854,660 participants 25-49 years (16% male) from 30 LMICs were analyzed.

RESULTS

Significantly greater barriers to accessing healthcare were observed across six variables in younger population when compared to older adults across all survey questions with an average of 8.4% point difference. Also, there was wide country-level variation: the maximum differences between age groups were 33% points; Rwanda was the only country with no age differences.

DISCUSSION

This study highlights several possible themes for future research into improving access to healthcare for young people. These themes include more detailed evaluation of country-specific policies to reduced barriers to healthcare for young people and further research into the causative factors that can influence healthcare utilization by young people.

CONCLUSION

Our analysis showcases increased barriers to healthcare access for young people in LMICs. We argue that they can only be improved by targeted policies and direct community engagement.

摘要

背景

以往针对高收入国家的研究表明,年轻人在获得医疗保健服务方面往往比老年人面临更大的障碍。然而,在中低收入国家(LMICs),缺乏突出这些障碍的跨国定量研究。

目的

这项探索性研究旨在对公开可用的人口与健康调查(DHS)数据进行范围审查,以便为进一步的工作奠定基础。

材料与方法

比较了DHS中30个国家不同年龄组在保险覆盖、自主性以及获得循证计划生育服务方面的数据。对来自30个中低收入国家的586250名15 - 24岁参与者(33%为男性)和854660名25 - 49岁参与者(16%为男性)的数据进行了分析。

结果

在所有调查问题中,与老年人相比,年轻人在六个变量上获得医疗保健服务的障碍显著更大,平均差异为8.4个百分点。此外,国家层面存在很大差异:年龄组之间的最大差异为33个百分点;卢旺达是唯一一个不存在年龄差异的国家。

讨论

本研究突出了未来改善年轻人获得医疗保健服务研究的几个可能主题。这些主题包括更详细地评估各国为减少年轻人医疗保健障碍而制定的政策,以及进一步研究影响年轻人医疗保健利用的因果因素。

结论

我们的分析表明,中低收入国家年轻人在获得医疗保健服务方面的障碍有所增加。我们认为,只有通过有针对性地制定政策和直接让社区参与,才能改善这种情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b77b/9297382/d5a67114b903/HSR2-5-e733-g002.jpg

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