ABSTRACT
Dans le sillage de l'élaboration d'une nouvelle carte sanitaire pour le Sénégal, le Ministre de la santé en aprofité pour évaluer l'ancienne carte qui a couvert la période 2009-2013. Le volet de l'accessibilité de cette évaluation a été faite avec l'utilisation du Rayon Moyen d'Action Théorique (RMAT). Les résultats ont permis de constater une implantation non optimale des nouvelles infrastructures, des disparités importantes entre régions concernant les réductions des distances
Subject(s)
Health Facilities , Health Services Accessibility , Healthcare Disparities , SenegalABSTRACT
The study investigated the magnitude of social inequities in access to subsidised healthcare services among people living with HIV and AIDS (PLWHA) in Nigeria. Structured interviews were conducted with 1 056 PLWHA selected from 60 community based support groups in 12 local government areas across 3 Nigerian states and the federal capital territory; using a multi-stage cluster sampling method. Data were collected on socio-economic characteristics of the respondents; awareness about location of health facilities; current health status; distance to facilities; and utilisation and expenditure on healthcare. The socio-economic characteristics of the respondents were used to compare their level of access to healthcare services from antiretroviral therapy (ART) sites and government hospitals. Awareness about location of health facilities was generally high (?79) among the respondents but higher among males; urban dwellers and those in highest wealth class (p 0.05). About 60 of rural PLWHA and 55.2 of those in the lowest wealth class reported illness compared with 49.4 of urban residents and 47.4 of those in the highest wealth class. However; PLWHA in urban areas utilised government hospitals more than those in rural areas while rural PLWHA and those in the lowest wealth class travelled longer distances to ART sites (p 0.05). PLWHA in lowest wealth class and females faced catastrophic health expenditure of 67.6 and 55.5of their monthly income respectively. Social inequities were observed in the subsidised HIV-treatment programme in Nigeria. Expansion of ART sites in rural areas and decentralisation of HIV care at government hospitals will reduce travel distance and transport costs and ensure universal access to healthcare services among PLWHA
Subject(s)
Acquired Immunodeficiency Syndrome , Anti-Retroviral Agents , HIV Infections , Healthcare DisparitiesABSTRACT
We explored the effects on health of both household asset inequality and political armed conflict in Sudan. Using the 2010 Sudan household survey; we evaluated the role of both household asset distribution (measured by the Gini coefficient) and armed conflict status at the state level. We measured associations with six health-related outcomes: life expectancy; infant mortality; height-for-age (stunting); adequacy of food consumption; teenage birth rates and vaccination coverage for young children. For each of six measures of health in Sudan; outcomes were significantly worse in the states with more unequal asset distribution; with correlation coefficients ranging between -0.56 (stunting) and -0.80 (life expectancy). Conflict status predicted worse outcomes. Wealth redistribution in the more unequal states; as well as a political resolution of conflict; may improve population health