尼日利亚贫民窟中基层咨询网络对求医决策的使用、特点和影响：一项横断面调查。

Use, characteristics and influence of lay consultation networks on treatment-seeking decisions in slums of Nigeria: a cross-sectional survey.

机构信息

Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK

Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.

出版信息

BMJ Open. 2023 May 16;13(5):e065152. doi: 10.1136/bmjopen-2022-065152.

DOI:10.1136/bmjopen-2022-065152

PMID:37192804

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10193090/

Abstract

OBJECTIVES

To describe the use, characteristics and influence of lay consultants on treatment-seeking decisions of adults in slums of Nigeria.

DESIGN

Cross-sectional survey using a pre-piloted questionnaire.

SETTINGS

Two slum communities in Ibadan city, Nigeria.

PARTICIPANTS

480 adults within the working age group (18-64).

RESULTS

Most respondents (400/480, 83.7%) spoke to at least one lay consultant during their last illness/health concern. In total, 683 lay consultants were contacted; all from personal networks such as family and friends. No respondent listed online network members or platforms. About nine in 10 persons spoke to a lay consultant about an illness/health concern without intending to seek any particular support. However, almost all (680/683, 97%) lay consultants who were contacted provided some form of support. Marital status (OR=1.92, 95% CI: 1.10 to 3.33) and perceiving that an illness or health concern had some effects on their daily activities (OR=3.25, 95% CI: 1.94 to 5.46) had a significant independent association with speaking to at least one lay consultant. Age had a significant independent association with having lay consultation networks comprising non-family members only (OR=0.95, 95% CI: 0.92 to 0.99) or mixed networks (family and non-family members) (OR=0.97, 95% CI: 0.95 to 0.99), rather than family-only networks. Network characteristics influenced individual treatment decisions as participants who contacted networks comprising non-family members only (OR=0.23, 95% CI: 0.08 to 0.67) and dispersed networks (combination of household, neighbourhood and distant network members) (OR=2.04, 95% CI: 1.02 to 4.09) were significantly more likely to use informal than formal healthcare, while controlling for individual characteristics.

CONCLUSIONS

Health programmes in urban slums should consider engaging community members so, when consulted within their networks, they are able to deliver reliable information about health and treatment-seeking.

摘要

目的

描述在尼日利亚贫民窟寻求治疗的成年人中，非专业顾问的使用、特征和影响。

设计

使用预试验问卷的横断面调查。

地点

尼日利亚伊巴丹市的两个贫民窟社区。

参与者

480 名 18-64 岁的劳动年龄组成年人。

结果

大多数受访者（400/480，83.7%）在最近一次患病/健康问题期间至少与一名非专业顾问谈过话。总共联系了 683 名非专业顾问；均来自家庭和朋友等个人网络。没有受访者列出在线网络成员或平台。大约十分之九的人在没有打算寻求任何特定支持的情况下，与非专业顾问谈论疾病/健康问题。然而，几乎所有（680/683，97%）联系过的非专业顾问都提供了某种形式的支持。婚姻状况（OR=1.92，95%CI：1.10 至 3.33）和认为疾病或健康问题对其日常活动有一定影响（OR=3.25，95%CI：1.94 至 5.46）与与至少一名非专业顾问交谈有显著的独立关联。年龄与非专业顾问网络中仅包含非家庭成员（OR=0.95，95%CI：0.92 至 0.99）或混合网络（家庭和非家庭成员）（OR=0.97，95%CI：0.95 至 0.99）而非仅家庭网络有显著的独立关联。网络特征影响个人的治疗决策，因为仅联系非家庭成员网络（OR=0.23，95%CI：0.08 至 0.67）和分散网络（家庭、邻里和远方网络成员的组合）（OR=2.04，95%CI：1.02 至 4.09）的参与者更有可能选择非正式医疗保健而非正式医疗保健，同时控制个人特征。