Determinants of provider choice for malaria treatment: Experiences from The Gambia
Determinants of provider choice for malaria treatment: Experiences from The Gambia
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DOI：
10.1016/j.socscimed.2008.04.007
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发表时间：
2008-08-01
影响因子：
5.4
通讯作者：
Stevens, Warren
中科院分区：
文献类型：
--
作者：
Wiseman, Virginia;Scott, Anthony;Stevens, Warren
据估计，疟疾每年造成100万人死亡，其中绝大多数在撒哈拉以南非洲。其中许多死亡是由于延误寻求治疗和不遵守药物制度。虽然有越来越多的研究描述了影响疟疾治疗寻求的因素，但对这些因素在不同环境中的相对权重知之甚少。本研究估计了冈比亚法拉芬尼地区疟疾治疗需求的两种模式。第一项研究了在家庭外寻求疟疾治疗与不治疗或自我保健的决定因素，第二项研究确定了以决定在家庭外寻求疟疾治疗为条件的提供者选择的决定因素。提供者包括医院、保健中心和“其他”，其中包括药房、售货亭、小商贩、邻居和传统治疗师。结果表明，老年人更有可能选择自我护理或不接受治疗。患病时间越长或发烧越严重，就越有可能寻求家庭以外的治疗。一年中的时间和社区基础设施的可用性在这两种模式中发挥了关键作用。贫困家庭和富拉族家庭更有可能去“其他”医疗机构，而不是去医院。这些研究结果的政策和方法的影响进行了讨论。(C)2008爱思唯尔有限公司保留所有权利。
Malaria is responsible for an estimated one million deaths per year, the vast majority in sub-Saharan Africa. Many of these deaths are attributed to delays in seeking treatment and poor adherence to drug regimes. While there are a growing number of studies describing the factors influencing treatment seeking for malaria, far less is known about the relative weight given to these factors in different settings. This study estimates two models of demand for malaria treatment in the Farafenni region of The Gambia. The first examines the determinants of seeking malaria treatment outside the home versus no treatment or self-care while the second identifies the determinants of provider choice conditional on having decided to seek malaria treatment outside the home. Providers included hospital: health centre; and 'other' which included pharmacies, kiosks: petty traders; neighbours; and traditional healers. Results show that older people were more likely to opt for self-care, or no treatment. The longer the time spent ill or the more severe the fever, the more likely a treatment was sought outside the home. Time of the year and availability of community infrastructure played a key role in both models. Poorer households and those from the Fula ethnic group were much more likely to visit an 'other' provider than a hospital. The policy and methodological implications of these findings are discussed. (C) 2008 Elsevier Ltd. All rights reserved.