Do malaria control interventions reach the poor? A view through the equity lens
Do malaria control interventions reach the poor? A view through the equity lens
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DOI：
10.4269/ajtmh.2004.71.174
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发表时间：
2004-08-01
影响因子：
3.3
通讯作者：
Mills, A
中科院分区：
文献类型：
--
作者：
Barat, LM;Palmer, N;Mills, A
在发展中国家，疟疾比任何其他具有重大公共卫生重要性的疾病都更严重地影响到穷人，58%的疟疾病例发生在世界人口中最贫穷的20%。如果疟疾控制干预措施要达到预期的效果，它们必须覆盖发展中国家最贫穷的人群。不幸的是，越来越多来自效益-发生率分析的证据表明，许多旨在帮助穷人的公共卫生干预措施没有达到其预期目标。例如，在某些发展中国家，最贫穷的20%人口获得基本公共卫生服务的可能性是最贫穷的20%人口的2.5倍。在疟疾控制领域，少数研究已开始揭示不同财富状况在疟疾负担和获得治疗和预防服务方面的差异。这些早期研究发现，不同财富状况的人在发烧发病率方面没有明显差异，但在疟疾的后果和疟疾预防和治疗服务的使用方面确实显示出显著差异。需要进一步的研究来阐明造成这些差异的潜在因素，并检查与性别、社会阶层或其他因素有关的可能的不平等。为了产生影响并克服这种不公平现象，疟疾控制工作必须开始在规划设计、实施以及监测和评估中纳入与公平有关的方法。
Malaria, more than any other disease of major public health importance in developing countries, disproportionately affects poor people, with 58% of malaria cases occurring in the poorest 20% of the world's population. If malaria control interventions are to achieve their desired impact, they must reach the poorest segments of the populations of developing countries. Unfortunately, a growing body of evidence from benefit-incidence analyses has demonstrated that many public health interventions that were designed to aid the poor are not reaching their intended target. For example, the poorest 20% of people in selected developing countries were as much as 2.5 times less likely to receive basic public health services as the least-poor 20%. In the field of malaria control, a small number of studies have begun to shed light on differences by wealth status of malaria burden and of access to treatment and prevention services. These early studies found no clear difference in fever incidence based on wealth status, but did show significant disparities in both the consequences of malaria and in the use of malaria prevention and treatment services. Further study is needed to elucidate the underlying factors that contribute to these disparities, and to examine possible inequities related to gender, social class, or other factors. To achieve impact and overcome such inequities, malaria control efforts must begin to incorporate approaches relevant to equity in program design, implementation, and monitoring and evaluation.