Gender-related factors affecting health seeking for neglected tropical diseases: findings from a qualitative study in Ethiopia.


Journal

PLoS neglected tropical diseases
ISSN: 1935-2735
Titre abrégé: PLoS Negl Trop Dis
Pays: United States
ID NLM: 101291488

Informations de publication

Date de publication:
12 2019
Historique:
received: 06 06 2019
accepted: 11 10 2019
entrez: 13 12 2019
pubmed: 13 12 2019
medline: 26 2 2020
Statut: epublish

Résumé

Despite known gender-specific differences in terms of prevalence, transmission and exposure to neglected tropical diseases (NTDs), there is limited discussion of the influence of gender in NTD programmes and interventions. There is a paucity of research on how gender interacts with NTD service provision and uptake. This study, part of broader implementation research in Ethiopia, applied a gender lens to health seeking for five NTDs: lymphatic filariasis, podoconiosis, schistosomiasis, soil-transmitted helminth infection and trachoma. The study was conducted in a district of the Southern Nations, Nationalities, and Peoples' Region of Ethiopia where the five NTDs are prevalent. A qualitative methodology was adopted to explore participants' perspectives and experiences. Data generation methods included 20 interviews and four focus group discussions. Community members, volunteer Health Development Army leaders, Health Extension Workers and a range of health workers at the health post, health centre and hospital level (n = 59) were purposively sampled. Interviews and focus group discussions were audio recorded, transcribed verbatim into English then analysed through open coding, drawing on constant comparative methods. Gender related factors affected care seeking for NTDs and were described as reasons for not seeking care, delayed care seeking and treating NTDs with natural remedies. Women faced additional challenges in seeking health care due to gender inequalities and power dynamics in their domestic partnerships. Participants recommended raising community awareness about NTDs, however this remains problematic due to gender and social norms around appropriate discourse with members of the opposite gender. The findings from this study provide crucial insights into how gender interacts with accessing health services, at different levels of the health system. If we are committed to leaving no one behind and achieving universal health coverage, it is essential to address gender disparities to access and utilisation of interventions delivered by national NTD programmes.

Sections du résumé

BACKGROUND
Despite known gender-specific differences in terms of prevalence, transmission and exposure to neglected tropical diseases (NTDs), there is limited discussion of the influence of gender in NTD programmes and interventions. There is a paucity of research on how gender interacts with NTD service provision and uptake. This study, part of broader implementation research in Ethiopia, applied a gender lens to health seeking for five NTDs: lymphatic filariasis, podoconiosis, schistosomiasis, soil-transmitted helminth infection and trachoma.
METHODOLOGY/PRINCIPAL FINDINGS
The study was conducted in a district of the Southern Nations, Nationalities, and Peoples' Region of Ethiopia where the five NTDs are prevalent. A qualitative methodology was adopted to explore participants' perspectives and experiences. Data generation methods included 20 interviews and four focus group discussions. Community members, volunteer Health Development Army leaders, Health Extension Workers and a range of health workers at the health post, health centre and hospital level (n = 59) were purposively sampled. Interviews and focus group discussions were audio recorded, transcribed verbatim into English then analysed through open coding, drawing on constant comparative methods. Gender related factors affected care seeking for NTDs and were described as reasons for not seeking care, delayed care seeking and treating NTDs with natural remedies. Women faced additional challenges in seeking health care due to gender inequalities and power dynamics in their domestic partnerships. Participants recommended raising community awareness about NTDs, however this remains problematic due to gender and social norms around appropriate discourse with members of the opposite gender.
CONCLUSIONS/SIGNIFICANCE
The findings from this study provide crucial insights into how gender interacts with accessing health services, at different levels of the health system. If we are committed to leaving no one behind and achieving universal health coverage, it is essential to address gender disparities to access and utilisation of interventions delivered by national NTD programmes.

Identifiants

pubmed: 31830026
doi: 10.1371/journal.pntd.0007840
pii: PNTD-D-19-00902
pmc: PMC6907747
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0007840

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Alexandra Wharton-Smith (A)

Malaria Consortium, London, United Kingdom.

Christian Rassi (C)

Malaria Consortium, London, United Kingdom.

Esey Batisso (E)

Malaria Consortium, Hawassa, Ethiopia.

Giuseppina Ortu (G)

Malaria Consortium, London, United Kingdom.

Rebecca King (R)

The Nuffield Centre for International Health & Development, University of Leeds, Leeds, United Kingdom.

Misganu Endriyas (M)

Regional Health Bureau, Hawassa, Ethiopia.

Helen Counihan (H)

Malaria Consortium, London, United Kingdom.

Prudence Hamade (P)

Malaria Consortium, London, United Kingdom.

Dawit Getachew (D)

Malaria Consortium, Addis Ababa, Ethiopia.

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Classifications MeSH