Development of a proxy wealth index for women utilizing emergency obstetric care in Bangladesh
Development of a proxy wealth index for women utilizing emergency obstetric care in Bangladesh
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DOI：
10.1093/heapol/czm022
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发表时间：
2007-09-01
影响因子：
3.2
通讯作者：
Fitzmaurice, Ann
中科院分区：
文献类型：
--
作者：
Pitchforth, Emma;van Teijlingen, Edwin;Fitzmaurice, Ann
人们越来越关注获得保健服务方面的不公平现象，因此呼吁进行例行数据收集，以改进监测。对孟加拉国等许多发展中国家来说，增加产科急诊的提供和接受对改善孕产妇健康至关重要。然而，至关重要的是，所有社会经济地位的妇女都应从中受益。本文描述了用于评估孟加拉国妇女住院时社会经济地位的代理财富指数的发展和验证。现有的贫穷评估工具不适合在这方面使用，因为它们太长，或者需要在家庭或社区一级进行管理。我们试图开发一种指标数量有限的工具，以便快速给药并避免干扰治疗。我们还打算开发一种实用的工具，以便能够在该领域计算分数。本文概述了包括选择和加权指标、分配代理财富分数和验证分数在内的步骤。从孟加拉国人口和健康调查（DHS）数据中选择的指标可以比较使用EmOC的妇女与更广泛人口中的妇女之间的社会经济地位。事实证明，该工具使用方便快捷，为妇女及其家人所接受。通过因子分析验证了该工具的有效性。我们与国土安全部的数据比较表明，使用EmOC的女性明显比更广泛人群中的女性富有。本文讨论了这种情况的影响，以及代理财富指数的优势和局限性。在繁忙的医院环境中，代理财富指数有可能作为一种实用和快速的评估贫困状况的手段。这种工具可以监测获得治疗的公平性，并确定最无力负担治疗的人，使现有的任何支付保健费用的机制能够及时应用，从而避免延误治疗危及生命的并发症。
There are increasing concerns regarding inequities in access to health care, and hence calls for routine data collection to improve monitoring. For many developing countries, such as Bangladesh, increasing the availability and uptake of emergency obstetric care (EmOC) is vital in improving maternal health. It is crucial, however, that women of all socio-economic status benefit from this. This paper describes the development and validation of a proxy wealth index for assessing women's socio-economic status in Bangladesh as they are admitted to hospital. Existing poverty assessment tools are unsuitable for use in this context as they are too lengthy or need to be administered at household or community level. We sought to develop a tool with a limited number of indicators to allow quick administration and avoid interference with treatment. We also aimed to develop a pragmatic tool to be able to calculate a score in the field. The steps, involving selecting and weighting indicators, assigning a proxy wealth score and validating the score, are outlined. Indicators were selected from the Bangladeshi Demographic and Health Survey (DHS) data, which allowed comparison of socio-economic status between women using EmOC and those in the wider population. The tool proved quick and easy to use and was acceptable to women and their families. The validity of the tool was established by means of factor analysis. Our comparison with DHS data suggested that women using EmOC were significantly wealthier than women in the wider population. The implications of this, as well as the strengths and limitations of the proxy wealth index, are discussed. The proxy wealth index offers potential as a pragmatic and quick means of assessing poverty status in a busy hospital setting. Such a tool may enable monitoring of equity in access to treatment and identification of those least able to afford treatment, to enable any mechanisms in place to pay for care to be applied in a timely fashion, so avoiding delays in treating life-threatening complications.