Assessment of progress towards universal health coverage for people with disabilities in Afghanistan: a multilevel analysis of repeated cross-sectional surveys
Assessment of progress towards universal health coverage for people with disabilities in Afghanistan: a multilevel analysis of repeated cross-sectional surveys
复制标题
DOI：
10.1016/s2214-109x(17)30251-6
复制
发表时间：
2017-08-01
影响因子：
34.3
通讯作者：
Chandola, Tarani
中科院分区：
文献类型：
--
作者：
Trani, Jean-Francois;Kumar, Praveen;Chandola, Tarani
自2002年以来，阿富汗为实现全民健康覆盖做出了巨大努力。根据联合国可持续发展目标3，具体目标8，向所有人提供优质护理必须包括通常得不到充分服务的群体，包括残疾人。我们调查了国际社会对阿富汗卫生系统十年的投资是否为这一群体带来了高质量的医疗保健。方法我们使用了两项具有代表性的家庭调查的数据，一项是在2005年进行的，另一项是在2013年，在阿富汗的13个省进行的，其中包括有关活动限制和功能障碍，社会经济因素，医疗保健的感知可用性，以及满足保健需求的经验。我们使用多层次建模和测试的相互作用，调查因素与时间点之间的感知差异，以及是否村庄偏远影响的变化perception.Findings 2005年的调查包括334人，2013年的调查包括961人。2005年至2013年，残疾人的平均年龄、就业和资产水平略有上升，但教育水平有所下降。正规教育和较高的资产水平与更好的医疗服务和满足医疗需求的积极经验有关，而就业仅与后者有关。与2005年相比，2013年感知的医疗保健可用性和医疗保健需求覆盖率的积极经验显着恶化（2005年有227人[69%]认为服务可用，2013年为405人[44%]，p
Background Since 2002, Afghanistan has made much effort to achieve universal health coverage. According to the UN Sustainable Development Goal 3, target eight, the provision of quality care to all must include usually underserved groups, including people with disabilities. We investigated whether a decade of international investment in the Afghan health system has brought quality health care to this group.Methods We used data from two representative household surveys, one done in 2005 and one in 2013, in 13 provinces of Afghanistan, that included questions about activity limitations and functioning difficulties, socioeconomic factors, perceived availability of health care, and experience with coverage of health-care needs. We used multilevel modelling and tests for interaction to investigate factors associated with differences in perception between timepoints and whether village remoteness affected changes in perception.Findings The 2005 survey included 334 people, and the 2013 survey included 961 people. Mean age, employment, and asset levels of participants with disabilities increased slightly between 2005 and 2013, but the level of education decreased. Formal education and higher asset level were associated with improved availability of health care and positive experience with coverage of health-care needs, whereas being employed was only associated with the latter. Perceived availability of health care and positive experience with coverage of health-care needs significantly worsened in 2013 compared with in 2005 (227 [69%] perceived that services were available in 2005 vs 405 [44%] in 2013, p