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评估墨西哥尤卡坦农村地区 5 岁以下儿童的母亲和照顾者的医疗保健可及性。

Evaluating Access to Health Care in Mothers and Caregivers of Children under Five Years of Age in Rural Communities of Yucatán, Mexico.

机构信息

Department of Social Medicine, Center of Regional Researches "Dr. Hideyo Noguchi" Biomedical Unit, Health Sciences Campus, Autonomous University of Yucatan, Calle 59 Num. 490, Col. Centro, Merida 97000, Yucatan, Mexico.

Population Health Building/Hans Rosling Center, Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave. NE, Seattle, WA 98195, USA.

出版信息

Int J Environ Res Public Health. 2024 Sep 20;21(9):1243. doi: 10.3390/ijerph21091243.

Abstract

Populations in rural communities have more limited access to health care and attention than urban populations. The present study aimed to evaluate barriers to access to health care in mothers and caregivers of children under five years of age, twelve months after an educational intervention. The study was carried out from February to September 2022, and 472 mothers from eight communities in the state of Yucatán, in the southeast of the United Mexican States, participated. A comparative analysis was carried out on help-seeking times, obstacles to reaching it, and illnesses in children. The results revealed that the main barriers to access to care were long times to decide to seek help, lack of financial resources to pay for the transfer to another health unit, lack of someone to accompany the mother or caregiver when the child needed be transferred, and lack of transportation for the transfer. Disease knowledge remained at different levels in the eight communities; the significant differences occurred in four communities, one specifically for heart defects. It was concluded that, in the rural populations studied, there are barriers to access to health care which have to do with neglected social determinants, such as those related to conditions of gender, income, social support network, and the health system. Access to health care must be universal, so public health interventions should be aimed at reducing the barriers that prevent the population from demanding and using services in a timely manner.

摘要

农村社区的人口获得医疗保健和关注的机会比城市人口要少。本研究旨在评估在教育干预 12 个月后,5 岁以下儿童的母亲和照顾者获得医疗保健的障碍。该研究于 2022 年 2 月至 9 月进行,来自墨西哥东南部尤卡坦州的 8 个社区的 472 名母亲参与了研究。对寻求帮助的次数、寻求帮助的障碍以及儿童疾病进行了比较分析。结果表明,获得护理的主要障碍是决定寻求帮助的时间长、缺乏支付转移到另一个卫生单位的资金、缺乏在孩子需要转移时陪伴母亲或照顾者的人以及缺乏转移的交通工具。八个社区的疾病知识水平仍存在差异;有四个社区存在显著差异,一个社区专门针对心脏缺陷。结论是,在所研究的农村人群中,存在与被忽视的社会决定因素有关的医疗保健获取障碍,例如与性别、收入、社会支持网络和卫生系统有关的条件。医疗保健的获取必须是普遍的,因此公共卫生干预措施应旨在减少阻碍人口及时要求和使用服务的障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b1/11431122/e5efe630fa77/ijerph-21-01243-g001.jpg

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