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东非低收入国家十分之六的年轻女性在获得医疗保健方面存在问题:对2016年至2021年近期人口与健康调查的多层次分析

Six in ten female youths in low-income East African countries had problems in accessing health care: a multilevel analysis of recent demographic and health surveys from 2016-2021.

作者信息

Tiruneh Misganaw Guadie, Fenta Eneyew Talie, Endeshaw Destaw, Eshetu Habitu Birhan, Adal Ousman, Tareke Abiyu Abadi, Kebede Natnael, Delie Amare Mebrat, Bogale Eyob Ketema, Anagaw Tadele Fentabel

机构信息

Department of Health Systems and Policy, Institute of Public Health, College Medicine and Health Sciences, University of Gondar, Gondar, P.O. Box: 196, Ethiopia.

Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.

出版信息

BMC Health Serv Res. 2024 Apr 26;24(1):533. doi: 10.1186/s12913-024-10934-z.

Abstract

BACKGROUND

Access to health care services is a basic human right, and an individual's health and overall quality of life may suffer as a result of barriers to accessing health services. Access to comprehensive and quality health care is fundamental for promoting and maintaining health, preventing and treating diseases, and reducing premature deaths. However, only half of the African population has access to modern health services. Therefore, this study aimed to assess the health care access and associated factors among female youths in low-income East African countries.

METHODS

This study used secondary data from 2016 to 2021 demographic and health surveys of 7 low-income East African countries. A total weighted sample of 51,064 youths was included. A multilevel binary logistic regression was employed to identify the associated factors of access to health care since the data has a hierarchical structure. Adjusted Odds Ratio (AOR) with a 95% confidence interval (CI) at a p-value less than 0.05 was used to measure the association of variables whereas Intra-class correlation coefficient (ICC), Median Odds Ratio (MOR), and proportional change in variance (PCV) were used to measure random effects.

RESULT

The overall magnitude of access to healthcare among female youths in low-income East African countries was 38.84% (95% CI: 38.41, 39.26). Youth's educational level, rich wealth status, media exposure, and community level education were the positive while higher youth's age and rural residence were the negative predictors of access to healthcare among female youths. Besides, living in different countries compared to Burundi was also an associated factor for accessing healthcare in low-income East African countries.

CONCLUSION

About six in ten female youths were not accessing health care in low-income East African countries. Therefore, to increase healthcare access, health managers and policymakers needed to develop strategies to improve the poor household wealth index, and redistribution of health services for rural residents. The decision-makers and program planners should also work on increasing access to education and media exposure for youths. Further research including health system and quality of service-related factors for accessing healthcare should also be considered by researchers.

摘要

背景

获得医疗保健服务是一项基本人权,由于获得医疗服务存在障碍,个人的健康和整体生活质量可能会受到影响。获得全面和优质的医疗保健是促进和维持健康、预防和治疗疾病以及减少过早死亡的基础。然而,只有一半的非洲人口能够获得现代医疗服务。因此,本研究旨在评估东非低收入国家女性青年的医疗保健可及性及其相关因素。

方法

本研究使用了2016年至2021年7个东非低收入国家人口与健康调查的二手数据。纳入了总共51,064名青年的加权样本。由于数据具有层次结构,采用多水平二元逻辑回归来确定获得医疗保健的相关因素。使用p值小于0.05时的调整优势比(AOR)和95%置信区间(CI)来衡量变量之间的关联,而组内相关系数(ICC)、中位数优势比(MOR)和方差比例变化(PCV)用于衡量随机效应。

结果

东非低收入国家女性青年获得医疗保健的总体比例为38.84%(95%CI:38.41,39.26)。青年的教育水平、富裕的财富状况、媒体曝光率和社区教育水平是积极因素,而较高的青年年龄和农村居住情况则是女性青年获得医疗保健的负面预测因素。此外,与布隆迪相比,生活在不同国家也是东非低收入国家获得医疗保健的一个相关因素。

结论

在东非低收入国家,约十分之六的女性青年无法获得医疗保健。因此,为了增加医疗保健的可及性,卫生管理人员和政策制定者需要制定策略,以改善贫困家庭的财富指数,并为农村居民重新分配医疗服务。决策者和项目规划者还应致力于增加青年接受教育和接触媒体的机会。研究人员也应考虑进一步开展包括医疗系统和与获得医疗保健相关的服务质量因素的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfcd/11046753/544ce51cc005/12913_2024_10934_Figa_HTML.jpg

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