摘要
发展中国家的健康公平问题已经引起国际社会关注 ,性别造成的不公平在女童中更为突出。该文利用1993年及 1998年两次全国卫生服务调查结果 ,对中国儿童健康状况和卫生服务可及性指标进行分析 ,发现性别差异造成的不公平现象十分明显。在各组儿童中 ,贫困农村地区的女孩处于两个极端 :在健康状况方面 ,她们是最差的 ,而在享受最基本的卫生服务方面 ,她们却获得最少 (在患危重疾病应当住院治疗的女孩中竟有 2 8.6 %未能获得住院治疗服务 ) ,这至少也是与近年来中国 5岁以下女孩死亡率比男孩增高有关的因素之一。这个现象在发展中国家普遍存在 ,但在35个发展中国家的国家卫生服务调查中 ,由于采用一般指标 (如两周患病率 ,门诊利用率等 )却很难发现明显差异。该文使用因病卧床率及按医嘱应住院治疗却未能住的比例和患儿中未作任何处理的比例这几项比较敏感的指标进行分析 ,证明了这个事实。关于影响贫困农村地区女孩的卫生服务可及性的有关社会因素 ,本文根据因病卧床天数和卧床率这两个反映患危重疾病状况指标与医生建议住院治疗指标的强烈反差这一令人费解的事实 。
Health equity in developing countries had been paid attention by international society. The inequity caused by gender was severer to the girl child. This paper analyzed the health status of Chinese child and accessibility index of health service using results of national health service surveys in 1993 and 1998. The results showed that the inequity caused by gender was obvious. In all groups, the girl child in poor rural area lay in two extremes that their health status was worst while the health service they enjoyed was least (there were 28.6% girl child who could not admit to hospital among the girl child who suffered from severe diseases and need to admit to hospital.). At least, this was one of reasons that mortality of girl child under 5 year-old was higher than that of boy child during 5 years recently. This phenomenon was popular in developing countries. However, it was difficult to find out obvious difference in national health service surveys in 35 countries for using general index, such as morbidity rate in two weeks, utilization rate of outpatient department. This paper proved this fact using several more sensitive index, such as lying in bed rate for disease, rate of non-admitting to hospital but should have admitted to hospital according to prescription, rate without any cure. This paper discussed the social factors that influenced the accessibility of health service to the girl child in term of the fact of the great gap between index of reflecting the severity of diseases that were Day's lying in bed and rate of lying in bed and index of admitting to hospital.
出处
《中国卫生事业管理》
2001年第7期434-437,共4页
Chinese Health Service Management
关键词
卫生服务调查
女孩健康状况
健康公平
农村
Health service survey Health status of the girl child Health equity
