Private individual ambulatory health care providers in Madhya Pradesh province, India
Autor/in:
Costa, Ayesha; Eriksson, Bo; Diwan, Vinod K.
Quelle: Journal of Public Health, 17 (2009) 4, S 235-241
Inhalt: Background: Ambulatory health care services are a major contributor to the large and inequitable health financing burdens (largely out-of-pocket) faced by households in India. The private sector has a virtual monopoly over ambulatory curative services in rural and urban India. Despite this, there is little knowledge about who these providers are, their numbers, distribution, and activities. Aim: This study describes the numbers, gender, distribution, and characteristics of private individual ambulatory care providers in Madhya Pradesh (60.4 million people), one of India’s largest provinces. It discusses the suitability of this provider mix to deal with maternal and child health, a major health priority in the province. Method: A survey enlisting all health care providers was conducted in the 52,117 villages and 394 towns of the province. Results: There were 14,046 private qualified physicians (12.5% women), 57,684 qualified paramedics (3.4% women), and 89,090 unqualified providers (10% women) providing ambulatory services in individual setups. In addition, 55,393 traditional birth attendants provided home-based intranatal care. The macro organization of these providers in this setting is presented. Given the high levels of maternal and child mortality in the province, excessive reliance is placed on less than competent providers as these present lower access barriers. Conclusion: Given the public health priorities in this province (maternal and child health), the provider mix is not optimally suited to the populations’ needs. There is a lack of competent qualified care required to deal with the major causes of morbidity and mortality, particularly in rural areas. Access to qualified women providers is low. The lack of a cadre of qualified midwives possibly contributes to some of the high maternal mortality observed in this province.
Schlagwörter:gender; Gender; Human resources; Maldistribution; Health services India
Predictors of work ability in occupations with psychological stress
Titelübersetzung:Vorhersage der Arbeitsfähigkeit in Berufen mit psychologischem Stress
Autor/in:
Seibt, Reingard; Spitzer, Silvia; Blank, Matthes; Scheuch, Klaus
Quelle: Journal of Public Health, 17 (2008) 1, S 9-18
Inhalt: Aim: This study aimed to detect health- and work-related predictors of poor and good work ability in teachers (TE) and office workers (OW). Method: Work ability and its influence factors were analyzed in 100 female TE and 60 female OW aged between 25 and 60 years. The work ability was evaluated with the work ability index questionnaire and the health status with the vitality measurement system®. In addition, cardiac risk factors, burnout risk, as well as the working demands and effort-reward ratio were taken into account. Predictors of work ability were analyzed by using a CHAID analysis. The number of complaints represents the best predictor to divide both occupational groups into subgroups with different work abilities (criterion variable). Results: Poor work ability is caused by many complaints and cardiovascular risk factors. By contrast, excellent work ability is associated with few complaints, the occupation “office workers,” a younger vital functional age, and the absence of burnout symptoms, which means in comparison with OW, TE have a 1.6 times higher risk for impaired work ability. Furthermore, the absence of burnout symptoms is a resource of TE, whereas OWs tend to have a younger vital functional age compared to their calendrical age. Although this analysis is able to explain 61.2% of the influence on impaired work ability, research for further causes must be undertaken. Conclusion: The results reflect the positive effect of a high educational level and a challenging job on the preservation of good work ability. Moreover, they draw the attention to the psychological and psychosocial strains of TE. TEs are exposed more frequently to feeling overstrained; this probably effects a higher retirement rate due to illness.
Changes in secondary pharmacological prevention of acute coronary syndromes and stroke after hospital discharge: a 6-month follow-up study of German primary care patients
Quelle: Journal of Public Health, 17 (2008) 1, S 3-7
Inhalt: Aim: This study examined modifications in secondary preventive medication between the time of hospital discharge (HD) and during a 6-month follow-up treatment of outpatients with acute coronary syndromes (ACS) and stroke. Subjects and methods: During a 6-month period, a health diary was completed on a weekly basis by 98 patients who were initially hospitalised with ACS and 29 patients with strokes in the Cologne area (Germany). Changes in medication between the time of HD and follow-up treatment (weeks 2, 12, and 24) were recorded. Results: On average, patients with ACS took six medications, whereas patients with stroke took five medications per day. ACS patients received beta-blockers (96%), lipid-lowering agents (80%), and angiotensin-converting enzyme (ACE) inhibitors (64%) at HD, and no changes in medication were made during follow-up treatment. However, there was a significant decrease in prescriptions of clopidogrel among ACS patients within 6 months, and about 13% of ACS patients did not receive an antiplatelet agent at any time. Stroke patients received beta-blockers (50%), lipid-lowering agents (67%), and antiplatelet agents, such as acetylsalicylic acid (57%) or clopidogrel (27%), at the time of HD, and no significant changes in medication were instituted during follow-up treatment. Conclusion: Treatment of ACS patients with the combination of acetylsalicylic acid and clopidogrel was insufficient, although it has been shown that this combination is highly effective in secondary prevention of ACS. Besides medical reasons, the cost-containment restrictions (“medication budget”) for German physicians might explain the observed failure of guideline-oriented medication. Furthermore, no changes in medications occurred regarding blood-pressure- and lipid-lowering agents.
Die besonderen Lebenslagen von Frauen mit Behinderung im Alter
Titelübersetzung:The special living arrangements of elderly handicapped women
Autor/in:
Strupp, Julia
Quelle: Sozialwissenschaftlicher Fachinformationsdienst soFid, (2008) Frauen- und Geschlechterforschung 2008/2, S 11-21
Inhalt: 'Erstmals erreichen Kohorten lebenslang behinderter Frauen und Männer das Rentenalter, da infolge des Euthanasie-Programms in der NS-Zeit von 1943 bis zum Ende des Regimes im Mai 1945 behinderte Menschen systematisch ermordet wurden. Die Erfahrungen mit älter werdenden und alten behinderten Menschen sind daher noch recht begrenzt. Geschlecht und Alter behalten eine zentrale Bedeutung für die Charakterisierung der Lebenslage behinderter Menschen, eine Mehrfachdiskriminierung behinderter Frauen ist in vielen Lebensbereichen nachweisbar. In der wissenschaftlichen Literatur zeigen sich Forschungsdesiderata: besonders Frauen mit Behinderung im Alter werden noch nicht angemessen wahrgenommen, ihre Problemlagen weitestgehend vernachlässigt, dabei ist evident, dass Benachteiligungen behinderter Frauen (und Mädchen) im Lebensverlauf kumulieren und durch die Betrachtung der Dimension Alter an Stärke zunehmen. In diesem Artikel werden die besonderen Bedürfnislagen von Frauen mit Behinderungen im Alter anhand vereinzelter Studien dargestellt. Des Weiteren wird die Relevanz dieser Thematik für die Forschung und Praxis herausgearbeitet.' (Autorenreferat)
Schlagwörter:need; Bedürfnis; gender; discrimination; alter Mensch; Benachteiligung; Behinderung; Behinderter; Alter; Diskriminierung; woman; old age; disability; elderly; handicapped; gender-specific factors; deprivation
SSOAR Kategorie:Frauen- und Geschlechterforschung, Gesundheitspolitik, Gerontologie, Alterssoziologie
A 'little world of your own': stigma, gender and narratives of venereal disease contact tracing
Autor/in:
Kampf, Antje
Quelle: Health, 12 (2008) 2, S 233-250
Inhalt: As in other countries, in order to protect the public from venereal disease (syphilis and gonorrhoea), contact tracing in New Zealand has been a public health strategy since the mid-20th century. So far, scholars have predominantly focused on the aspect of control of the cases traced. Based on a rare interview with a female contact tracer, together with a range of archival material, this article aims to expand the scholarship by focusing on the tracer instead of the patient. Using Erving Goffman's original concept of 'courtesy stigma', the article will show that his idea can be nuanced to take into account contact tracers and the ways in which this stigma can be refracted through gender. Working as a tracer had a distinct impact on her life and possibly even her marital status, which were compromised by secrecy, stigma, morality and the demands of public health policies — aspects that were, paradoxically, quite similar to those she traced. The courtesy stigma that contact tracers for venereal disease acquired limited their professional options, as well as isolated them in the non-stigmatized social world.
Schlagwörter:Stigma; gender; stigma; Gender; contact tracing; New Zealand; venereal disease
A Gendered Analysis of Labour Market Informalization and Access to Health in Chile
Autor/in:
Gideon, Jasmine
Quelle: Global Social Policy, 7 (2007) 1, S 75-94
Inhalt: Health sector reforms across Latin America are replacing the concept of risk-sharing across the population with more individualized approaches to accessing health care, and health insurance schemes have been advocated by the World Bank as a means of helping poor people overcome the risk of ill health. Yet at the same time the lowering of labour standards and the growth of informal workers means that for an increased number of workers, contributing to a health insurance scheme is not feasible. Drawing on evidence from Chile this article examines the gendered dimensions of these processes and highlights the ways in which the gender division of labour means that women are more adversely affected than men.
Arzneimittelversorgung von Frauen und Männern im höheren Lebensalter
Autor/in:
Glaeske, Gerd
Quelle: ZeS Report, 11 (2006) 1, S 11-13
Inhalt: "Die Arzneimittelversorgung von Frauen und Männern im höheren Lebensalter ist Gegenstand des Beitrags von Gerd Glaeske, in dem die Einflüsse von Alter und Geschlecht auf die Arzneimittelversorgung untersucht werden." [Autorenreferat]
Schlagwörter:medizinische Versorgung; gender; health care delivery system; medical care; Gesundheitswesen; health care; Alter; Gesundheitsversorgung; Gesundheitspolitik; Mann; woman; Einfluss; old age; influence; man; age; health policy; Lebensalter