A household perspective on access to health care in the context of HIV and disability: a qualitative case study from Malawi.
A household perspective on access to health care in the context of HIV and disability: a qualitative case study from Malawi.
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DOI：
10.1186/s12914-016-0087-x
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发表时间：
2016-04-01
影响因子：
3
通讯作者：
Eide AH
中科院分区：
文献类型：
--
作者：
Braathen SH;Sanudi L;Swartz L;Jürgens T;Banda HT;Eide AH
在许多低收入国家，公平获得卫生保健是一项挑战。人口中最脆弱的部分面临更大的挑战，因为他们的脆弱性放大了一般人口的问题。这意味着直系家庭和大家庭中的非正式照护者负担沉重。然而，研究未能解释这些个人和家庭所面临的特殊挑战。为了从基础上建立一个证据基础，我们提出了一个单一的案例研究来探索和理解个人经历，尊重故事的独特之处，同时也利用个人故事来提出关于更大背景的问题。我们使用单一的定性案例研究方法，对向残疾人和艾滋病毒感染者提供护理的障碍、促进因素和后果提供深入的、情境和家庭视角。这项研究的结果强调了照顾艾滋病毒阳性和残疾家庭成员给已经贫困的家庭带来的负担，以及对支持的需求，不仅是对艾滋病毒阳性和残疾的人，而是对整个家庭。残疾和艾滋病毒不仅影响个人，而且影响整个家庭，无论是直接的还是长期的。考虑个人和家庭所面临的挑战之间的相互关联性是至关重要的。健康（身心）、残疾、就业、教育、基础设施（交通/地形）和贫穷等问题都是相互关联和相互关联的，应该作为一个整体加以处理，以确保保健方面的公平。
Equitable access to health care is a challenge in many low-income countries. The most vulnerable segments of any population face increased challenges, as their vulnerability amplifies problems of the general population. This implies a heavy burden on informal care-givers in their immediate and extended households. However, research falls short of explaining the particular challenges experienced by these individuals and households. To build an evidence base from the ground, we present a single case study to explore and understand the individual experience, to honour what is distinctive about the story, but also to use the individual story to raise questions about the larger context. We use a single qualitative case study approach to provide an in-depth, contextual and household perspective on barriers, facilitators, and consequences of care provided to persons with disability and HIV. The results from this study emphasise the burden that caring for an HIV positive and disabled family member places on an already impoverished household, and the need for support, not just for the HIV positive and disabled person, but for the entire household. Disability and HIV do not only affect the individual, but the whole household, immediate and extended. It is crucial to consider the interconnectedness of the challenges faced by an individual and a household. Issues of health (physical and mental), disability, employment, education, infrastructure (transport/terrain) and poverty are all related and interconnected, and should be addressed as a whole in order to secure equity in health.