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[拉丁美洲妇女和儿童获得医疗服务的障碍 拉丁美洲妇女和儿童获得卫生服务的障碍]

[Barriers to access to health services for women and children in Latin AmericaBarreiras de acesso aos serviços de saúde para mulheres e crianças na América Latina].

作者信息

Houghton Natalia, Báscolo Ernesto, Jara Lilia, Cuellar Catharina, Coitiño Andrés, Del Riego Amalia, Ventura Edgar

机构信息

Organización Panamericana de la Salud Washington D.C. Estados Unidos de América Organización Panamericana de la Salud. Washington D.C., Estados Unidos de América.

出版信息

Rev Panam Salud Publica. 2022 Jul 20;46:e94. doi: 10.26633/RPSP.2022.94. eCollection 2022.

Abstract

OBJECTIVE

Determine whether an association exists between access barriers reported by women aged 15-49 years and the use of essential health services for women and children in Latin America.

METHODS

Cross-sectional study using multivariate logistic regression models based on the demographic and health surveys of Bolivia, the Dominican Republic, Guatemala, Guyana, Haiti, Honduras, Nicaragua, and Peru.

RESULTS

Geographical and financial barriers, the need to obtain permission to visit the doctor, or not wanting to go alone to a health facility significantly reduced the likelihood of completing prenatal checkups and having an assisted delivery. Women who reported difficulties obtaining permission to visit the doctor were less likely to have had a Pap smear in the past two or three years, to complete vaccination of their children, and to seek care for children with acute respiratory infection. Not wanting to go to a health center alone reduced the likelihood of using modern contraceptives.

CONCLUSIONS

Women who reported barriers to access had a statistically significant lower probability of using essential health services for themselves and their children. Strategies aimed at removing barriers should focus not only on improving the range of services offered, but also address issues related to norms, gender roles, and women's empowerment if sustainable progress toward universal access is to be made.

摘要

目的

确定15 - 49岁女性报告的就医障碍与拉丁美洲妇女和儿童基本医疗服务利用情况之间是否存在关联。

方法

基于玻利维亚、多米尼加共和国、危地马拉、圭亚那、海地、洪都拉斯、尼加拉瓜和秘鲁的人口与健康调查,采用多变量逻辑回归模型进行横断面研究。

结果

地理和经济障碍、看医生需要获得许可,或不想独自前往医疗机构,显著降低了完成产前检查和进行助产的可能性。报告看医生难以获得许可的女性,在过去两三年进行巴氏涂片检查、完成子女疫苗接种以及为患急性呼吸道感染的儿童寻求治疗的可能性较小。不想独自前往健康中心降低了使用现代避孕方法的可能性。

结论

报告存在就医障碍的女性为自己和子女使用基本医疗服务的概率在统计学上显著较低。如果要在普及医疗服务方面取得可持续进展,旨在消除障碍的策略不仅应侧重于扩大服务范围,还应解决与规范、性别角色和妇女赋权相关的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18bd/9299390/3492a8adc54b/rpsp-46-e94_Figure1.jpg

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