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。 对于生活贫困的人来说，在作出寻求保健的决定时，要考虑如何分配稀缺的资源，以满足多个家庭成员的需要。 许多国际卫生文献都集中在影响寻求医疗保健的社会文化因素。然而，很少有研究已经进行的方式，经济因素直接和间接地限制或促进医疗保健寻求战略在贫困家庭。 拟议的研究将探讨社会文化因素，经济和社会关系如何阐明在尼加拉瓜，一个儿童发病率和死亡率高，以及孕产妇死亡率高的国家的贫困和中低收入家庭的保健和资源决策。 利用参与观察和半结构化访谈，研究者，一个人类学研究生在亚利桑那大学，将前瞻性地跟踪50个农村家庭在一年的过程中，在马萨亚省的一个自治市。 民族志研究是需要在当地的情况下，以评估如何在实际疾病发作的多种因素影响健康寻求阐明。 除了为有前途的女科学家提供博士培训外，拟议的研究将有助于填补对生活贫困的尼加拉瓜人的当代健康问题进行人种学研究的不足的差距，并评估寻求保健的理论和方法的跨文化适用性。

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.