Addressing Gaps in Men's Health Literacy and Health Seeking in Mozambique: A Case for Differentiated Care for HIV and CVD

解决莫桑比克男性健康素养和寻求健康方面的差距：针对艾滋病毒和心血管疾病的差异化护理案例

• 批准号: MR/S013253/1
• 负责人: Karina Kielmann
• 金额: $ 25.37万
• 依托单位: Queen Margaret University
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2019
• 资助国家: 英国
• 起止时间: 2019 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FS013253%2F1
• 关键词: Addressing; Gaps; Men; Health; Literacy

As in other parts of the world, men are more likely to delay health care seeking and drop out of care than women in Southern Africa. There is evidence for men's gaps in health care for tuberculosis and HIV, and increasingly for non-communicable diseases (NCD) such as diabetes and hypertension which are on the rise in the region. However, due to emphasis on women and children in the global health agenda, men's health gaps have been neglected and there is limited regional data on their awareness, decision-making, and actions with regards to seeking health care. In this project, we focus on the case of cardiovascular disease (CVD) in HIV-positive men in Mozambique, a country where poverty, conflict, and migration for work have influenced men's health and their vulnerability to disease. Our project aims to contribute data for the development of 'differentiated' care strategies, that is models of care that are responsive to men's health needs and adapted to local systems processes and resource constraints. Mozambique has a high burden of infectious diseases (ID) as well as a growing burden of NCD, and men have lower levels of awareness, control, and uptake of treatment for both ID and NCD. Our project is based in a large urban district of Maputo and will use a range of qualitative and quantitative methods to explore aspects of men's health literacy and health-seeking. A literature review and mapping of men's health interventions in Mozambique will examine current approaches and assumptions. Facility-based observations and interviews with health providers and male patients with HIV and CVD will look at how their pathways to care are influenced by social, structural, and systems-related factors. A community-based survey and a nested qualitative study will use different measures to compare data on health literacy, self-perceived health and household influences on men's health seeking behaviour. Data from these different sources will be used to develop models of processes and pathways to care for men. Finally, we will consult with our project partners, researchers and stakeholders in the fields of health and gender to share findings and discuss how these can potentially inform strategies to strengthen men's engagement with HIV and CVD services. We expect to deliver timely insights for the systems response to HIV/CVD co-morbidity in men. Further, our partnership will provide a solid interdisciplinary platform for the development of a larger proposal that can implement and evaluate health systems strategies to address the chronic health needs of male migrants and mobility across borders in the Southern African region.

与世界其他地区一样，在南部非洲，男性比女性更有可能推迟寻求医疗保健并退出医疗保健。有证据表明，男子在结核病和艾滋病毒以及糖尿病和高血压等非传染性疾病(NCD)方面的卫生保健方面存在差距，这些疾病在该地区呈上升趋势。然而，由于在全球卫生议程中强调妇女和儿童，男子的健康差距被忽视，关于他们在寻求保健方面的认识、决策和行动的区域数据有限。在这个项目中，我们重点关注莫桑比克艾滋病毒阳性男性的心血管疾病(CVD)病例，在这个国家，贫困、冲突和移民工作影响了男性的健康和他们对疾病的脆弱性。我们的项目旨在为制定“差异化”护理战略贡献数据，即响应男性健康需求并适应当地系统流程和资源限制的护理模式。莫桑比克的传染病负担很重，非传染性疾病的负担也越来越重，男子对传染病和非传染性疾病的认识、控制和接受治疗的水平较低。我们的项目总部设在马普托的一个大城区，将使用一系列定性和定量方法来探索男子健康素养和寻求健康的各个方面。对莫桑比克男子健康干预措施的文献回顾和地图绘制将审查目前的方法和假设。以机构为基础的观察和对卫生服务提供者和艾滋病毒和心血管疾病男性患者的访谈将考察他们的护理途径如何受到社会、结构和系统相关因素的影响。一项基于社区的调查和一项嵌套的定性研究将使用不同的衡量标准来比较有关健康素养、自我健康和家庭对男性寻求健康行为的影响的数据。来自这些不同来源的数据将被用来开发照顾男性的过程和途径的模型。最后，我们将与我们在卫生和性别领域的项目合作伙伴、研究人员和利益攸关方协商，分享研究结果，并讨论这些研究结果如何潜在地为加强男子参与艾滋病毒和心血管疾病服务的战略提供参考。我们期望为应对男性艾滋病毒/心血管疾病共病的系统反应提供及时的见解。此外，我们的伙伴关系将为制定一项更大的提案提供一个坚实的跨学科平台，该提案可以执行和评估卫生系统战略，以解决南部非洲地区男性移民的长期保健需求和跨界流动问题。

项目成果

Changing men or changing health systems? A scoping review of interventions, services and programmes targeting men's health in sub-Saharan Africa.

• DOI: 10.1186/s12939-021-01428-z
• 发表时间: 2021-03-31
• 期刊: International journal for equity in health
• 影响因子: 4.8
• 作者: Beia T;Kielmann K;Diaconu K
• 通讯作者: Diaconu K