Dissertation: Health Care Seeking in Nicaragua: Researching the Interface Between Economics, Cultural Understanding, and Practical Logic

健康和疾病是在社会背景下经历的。对于生活在贫困中的人，寻求保健的决定是在考虑如何分配稀缺资源以满足多个家庭成员的需求的情况下做出的。许多国际卫生文献都集中在影响寻求卫生保健的社会文化因素上。然而，关于经济因素直接或间接限制或促进贫困家庭寻求保健战略的方式，几乎没有进行过研究。拟议的研究将审查社会文化因素、经济和社会关系如何在尼加拉瓜的贫穷和低中等收入家庭的保健和资源决策中发挥作用，尼加拉瓜是一个儿童发病率和死亡率以及产妇死亡率较高的国家。这位研究人员是亚利桑那大学人类学研究生，他利用参与者观察和半结构化访谈，在一年的时间里前瞻性地跟踪调查了Masaya部门一个市政当局的50户农村家庭。需要在当地背景下进行人种学研究，以评估影响健康寻求的多种因素在实际疾病发作期间是如何表达出来的。除了为有前途的女科学家提供博士培训外，拟议的研究还将有助于填补尼加拉瓜贫困人口当代健康问题人种学研究匮乏的空白，并评估理论和方法在寻求保健研究中的跨文化适用性。

Health and disease are experienced within social contexts. For people living in poverty, health care seeking decisions are made in conjunction with considerations of how to allocate scarce resources to meet the needs of multiple household members. Much of the international health literature has focused on sociocultural factors that impact health care seeking. Yet little research has been conducted on the ways that economic factors directly and indirectly constrain or facilitate health care seeking strategies in poor households. The proposed study will examine how sociocultural factors, economics, and social relations articulate in health care and resource decision-making among poor and lower middle income households in Nicaragua, a country with high rates of child morbidity and mortality as well as high rates of maternal mortality. Utilizing participant observation and semi-structured interviews, the researcher, an anthropology graduate student at the University of Arizona, will prospectively follow fifty rural households in a municipality of the department of Masaya over the course of a year. Ethnographic research is needed in local contexts to assess how multiple factors impacting on health seeking articulate during actual illness episodes. In addition to providing doctoral training for a promising woman scientist, the proposed study will help fill the gap in the paucity of ethnographic research into contemporary health issues for Nicaraguans living in poverty, and assess the cross-cultural applicability of theoretical and methodological approaches to the study of health care seeking.