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越南老年人能否公平获得医疗和社会护理?护理提供者的观点。

Is equitable access to health and social care possible for Vietnamese older adults? Care providers' perspectives.

作者信息

Vo Man Thi Hue, Nakamura Keiko, Tran Dai Tri Han, Moncatar T J Robinson T

机构信息

College of Public Health Sciences, Chulalongkorn University, Chulalongkorn soi 62, Bangkok 10330, Thailand.

Department of Global Health Entrepreneurship, Division of Public Health, Institute of Science Tokyo, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8510, Japan.

出版信息

Int Health. 2025 Jun 25. doi: 10.1093/inthealth/ihaf066.

Abstract

BACKGROUND

Despite growing initiatives to support older adults, disparities in accessing health and social care services persist in developing countries such as Vietnam. Insufficient evidence exists on how to improve equitable access to these services. This study aimed to determine care workers' perceptions of disparities in service accessibility and potential solutions in facilitating equal access for older adults.

METHODS

A qualitative study included 27 focus group discussions and in-depth interviews conducted using a semi-structured questionnaire with 171 health and social care workers in Thua Thien Hue Province, Vietnam in 2019. Inductive thematic analysis was used to identify the perceived disparities and solutions.

RESULTS

Three main themes emerged concerning these disparities: socio-economic and geographic barriers, cultural stigma and access gaps for disadvantaged communities. To facilitate equitable access, it was perceived crucial to enhance social protection coverage and benefits, empower community-based care and localized programs and implement targeted interventions.

CONCLUSIONS

The findings indicate persistent disparities. However, effective implementation of social health protection, fostering community engagement and targeted interventions can be beneficial in narrowing these gaps. The findings suggest that achieving equitable access for Vietnam's aging population is within reach through a more comprehensive social protection system.

摘要

背景

尽管支持老年人的举措不断增加,但在越南等发展中国家,获取卫生和社会护理服务方面的差距依然存在。关于如何改善这些服务的公平获取,现有证据不足。本研究旨在确定护理人员对服务可及性差距的看法以及促进老年人平等获取服务的潜在解决方案。

方法

2019年,在越南承天顺化省对171名卫生和社会护理人员进行了一项定性研究,包括27次焦点小组讨论和使用半结构化问卷进行的深入访谈。采用归纳主题分析法来确定感知到的差距和解决方案。

结果

出现了关于这些差距的三个主要主题:社会经济和地理障碍、文化污名以及弱势社区的获取差距。为促进公平获取,人们认为加强社会保护覆盖范围和福利、增强基于社区的护理和本地化项目以及实施有针对性的干预措施至关重要。

结论

研究结果表明差距依然存在。然而,有效实施社会健康保护、促进社区参与和有针对性的干预措施可能有助于缩小这些差距。研究结果表明,通过更全面的社会保护系统,越南老年人口实现公平获取是可以实现的。

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