International Journal for Equity in Health最新文献

{"title":"Individual identities and stigma inequalities: insights from the experience of people affected by podoconiosis in Rwanda.","authors":"Jean Paul Bikorimana, Josephine Mukabera, Gail Davey, Peter John Mugume, Papreen Nahar","doi":"10.1186/s12939-025-02638-5","DOIUrl":"10.1186/s12939-025-02638-5","url":null,"abstract":"<p><strong>Introduction: </strong>Podoconiosis is a Skin Neglected Tropical Disease (SNTD) that affects impoverished individuals in tropical regions. While there is a substantial understanding of the stigma associated with podoconiosis, little is known about the podoconiosis-related stigma experience based on individual identities, such as gender, class, age, location and physical ability. Due to the power differentials associated with these identities, individuals experience health problems differently, resulting in health disparities. This paper aims to discuss the inequalities related to podoconiosis stigma due to individual identities, informing policies and practices to reduce podoconiosis stigma-related disparities.</p><p><strong>Methods: </strong>This paper draws on a qualitative research approach to explore how individual identities shape the experience of podoconiosis stigma among affected people. Qualitative methods, including participant observation, interviews, focus group discussions, and key informant interviews with persons affected, family members, community health workers, and representatives, were employed. Data were thematically analysed.</p><p><strong>Results: </strong>Our findings reveal the complex nature of podoconiosis stigma-related inequality rooted in individual identities. We identified three main themes: (1) the importance of cultural norms and traditions in shaping social positioning, (2) Uneven stigma experience, and (3) the importance of one's social positioning in coping with stigma due to podoconiosis. Certain stigmatised individuals or groups face higher levels of stigma than others. Affected individuals are often associated with culturally defined identities. Those with oppressive identities experience significantly more stigma compared to those with positive identities, because of cultural interpretations linked to class, ability, gender, and age. Poor married women and men, young girls, and disabled individuals with podoconiosis encounter greater stigma than their peers.</p><p><strong>Conclusion: </strong>This paper illuminates that the podoconiosis stigma inequalities are shaped by individuals' identities related to gender, age, economic status, and bodily ability. Individuals with oppressive identities endure more stigma than others., and this differential stigma experience enhances the understanding of how disparities in stigma associated with podoconiosis or other SNTDs underpin health inequities. Such insights suggest integrating interventions to reduce podoconiosis stigma with others, such as gender equality education, economic empowerment programs, fostering positive identities and social inclusion, thus reducing disparities.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"254"},"PeriodicalIF":4.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socio-cultural challenges and mental health needs of female sex workers in Bangladesh: a call for culturally sensitive interventions.","authors":"Md Ashiquir Rahaman, Farah Tabassum Shamma","doi":"10.1186/s12939-025-02544-w","DOIUrl":"10.1186/s12939-025-02544-w","url":null,"abstract":"<p><p>Female sex workers (FSW) in Bangladesh face multifaceted socio-cultural, legal, and economic challenges that significantly impact their mental health and well-being. With an estimated population of 200,000, FSW enter the profession primarily due to poverty, trafficking, forced marriage, and gender-based violence. The legal status of sex work remains ambiguous, exposing FSW to exploitation, violence, and limited access to justice. Stigma rooted in religious and cultural beliefs leads to exclusion from community and religious life, while children of FSW face social rejection and educational barriers. Studies report high prevalence of depression, anxiety, PTSD, and substance use disorders among Bangladeshi FSW, yet access to mental health services remains limited due to provider bias, legal obstacles, and lack of tailored interventions. Systemic barriers also restrict access to healthcare, banking, welfare, and vocational training. Addressing these issues requires culturally sensitive, community-based mental health interventions, including peer-led support, trauma-informed care, and sensitization of service providers. Policy reforms to decriminalize sex work and promote human rights are essential for sustainable change. Future research should explore community-driven strategies, the role of religious institutions in stigma reduction, and the specific needs of FSW and their children to inform effective, inclusive interventions and policy development.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"252"},"PeriodicalIF":4.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of the healthcare access barrier scale (HABS).","authors":"Min Hu, Yusheng Jia, Xiaoyu Wang, Jinsui Zhang, Danyang Wei, Wen Chen","doi":"10.1186/s12939-025-02624-x","DOIUrl":"10.1186/s12939-025-02624-x","url":null,"abstract":"<p><strong>Background: </strong>Measuring healthcare access barriers is crucial for improving service equity. However, existing tools often lack a holistic, process-integrated approach. This study addresses this gap by developing and validating the Healthcare Access Barriers Scale (HABS), a new instrument that holistically assesses barriers before, during, and after medical visits.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 2,009 Shanghai residents. HABS was developed based on Penchansky and Thomas's Theory of Access and Saurman's modification. Exploratory and confirmatory factor analyses (EFA, CFA) were used to assess its structure. Reliability and validity were tested using Cronbach's alpha and model fit indices.</p><p><strong>Results: </strong>EFA and CFA supported a six-factor structure of the HABS, corresponding to six key dimensions of access barriers: unawareness, unavailability, inaccessibility, inadaptability, unaffordability, and unacceptability. The HABS demonstrated strong reliability (Cronbach's α = 0.974) and a good fit for the six-factor model (CFA: Comparative Fit Index [CFI] = 0.937, Tucker-Lewis Index [TLI] = 0.930, Root Mean Square Error of Approximation [RMSEA] = 0.069). The two most pronounced barriers were financial constraints (mean of unaffordability dimension = 3.26) and lack of awareness (unawareness = 3.19), highlighting cost burdens and health literacy gaps in this population.</p><p><strong>Conclusions: </strong>The HABS is a valid and reliable instrument for measuring perceived healthcare access barriers in urban populations, offering a more holistic, process-integrated assessment by capturing obstacles across the full continuum of care - before, during, and after healthcare visits. This unified scale can facilitate assessment of systematic barriers, comparisons across settings, and identification of target areas for intervention. Future use of the HABS may inform policies and programs aimed at improving access to health services and equity.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"251"},"PeriodicalIF":4.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of inequitable access to parkinson's disease care: a critical interpretive synthesis.","authors":"Sharon Koehn, Neil Drummond, Lisa Jasper, Anh Nq Pham, Karen Leung, Denise Cloutier, Marguerite Wieler, C Allyson Jones","doi":"10.1186/s12939-025-02538-8","DOIUrl":"10.1186/s12939-025-02538-8","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) is a leading cause of neurological disability among older adults, with an age-standardized global prevalence in 2021 of 139/100,000 and projected to increase by 112% by 2050. People living with PD experience seven times worse health status than the general population. Access to diagnosis, care, and support is particularly challenged by intersecting social and healthcare system complexities. This Critical Interpretive Synthesis aimed to identify mechanisms through which barriers interact to create inequitable access to PD care among underserved populations.</p><p><strong>Methods: </strong>We searched five bibliographic databases (MEDLINE, Embase, CINAHL, PsychINFO, and Scopus) for English-language sources (2005 to 2024). Inclusion criteria encompassed peer-reviewed articles, books, dissertations, and organizational reports mentioning underserved older adults with PD and their care partners. Analysis followed Critical Interpretive Synthesis methodology, combining systematic review strategies with meta-ethnography and grounded theory techniques. Two investigators independently screened citations, with analysis guided by Candidacy 2.0 and Intersectionality frameworks.</p><p><strong>Results: </strong>Of 1,281 identified studies, 96 met inclusion criteria. United States studies dominated (56%), with quantitative analyses of electronic medical records comprising 66% of evidence. Analysis revealed three interrelated mechanisms shaping access inequities: (1) complex interplay between regional factors and healthcare delivery systems creating variable landscapes of access, (2) provider biases and judgments serving as critical gatekeeping points, and (3) intersectional effects of multiple marginalized identities compounding disadvantage. These mechanisms interact systematically, creating self-reinforcing cycles where social marginalization increases both disease progression and barriers to appropriate care.</p><p><strong>Conclusions: </strong>Improving PD care access requires coordinated interventions addressing multiple intersecting barriers simultaneously. For policy and management, this includes targeted funding for infrastructure, systematic provider education addressing knowledge gaps and biases, and integration of community-based solutions with formal healthcare. Future research should examine how informal care networks can enhance access in diverse healthcare contexts.</p><p><strong>Registration: </strong>The scoping review on which this Critical Interpretive synthesis builds is registered with Open Science Framework: https://doi.org/10.17605/OSF.IO/2T7KG .</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"250"},"PeriodicalIF":4.1,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal mortality in Peru: trends, determinants, inequalities, and the impact of COVID-19.","authors":"Gabriela Soto-Cabezas, Adrián Vásquez-Mejía, Fabiola Gil, Mary Reyes, Romina Juscamaita, Alfredo Oyola, Lorena Talavera Romero, Oscar J Mujica, Antonio Sanhueza, Cesar V Munayco","doi":"10.1186/s12939-025-02588-y","DOIUrl":"10.1186/s12939-025-02588-y","url":null,"abstract":"","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"248"},"PeriodicalIF":4.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in primary health care service experiences and urban-suburban disparities among Shanghai residents: a two-year comparative study.","authors":"Yang Sen, Li Wanyu, Shi Jianwei, Shi Leiyu, Ma Le, Pan Ying, Wang Yang, Gu Chao, Zhang Hanzhi, Guo Mengruo, Jin Hua, Yu Dehua","doi":"10.1186/s12939-025-02633-w","DOIUrl":"10.1186/s12939-025-02633-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Primary health care (PHC) is central to achieving universal health coverage, yet longitudinal assessments of residents' experiences-especially regarding urban-suburban disparities-remain scarce. This study aims to examine changes in PHC service experiences among Shanghai residents between 2023 and 2024, identify urban-suburban differences, and explore key influencing factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A two-wave cross-sectional survey was conducted at 248 community health centers in Shanghai from May to June in 2023 and 2024. The Chinese version of the Primary Care Assessment Tool-Adult Short Version (PCAT-AS) was used. Propensity score matching ensured comparability between survey waves. Descriptive statistics, hypothesis testing, and multiple linear regression were employed to assess temporal changes, regional disparities, and associated predictors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Residents reported significantly improved PHC experiences in 2024 across all domains (P &lt; 0.001), with the largest gains in service comprehensiveness (+ 0.23) and referral coordination (+ 0.18). Urban residents consistently reported better experiences in continuity, service delivery, and cultural competence, while suburban residents rated higher in first-contact accessibility and service availability. Improvements from 2023 to 2024 were most notable in first-contact accessibility (Δ = +0.11) and comprehensiveness (Δ = +0.10), though domains such as family-centeredness and cultural competence showed limited progress (Δ = +0.01). Multivariate analyses identified residential location, chronic disease burden, psychological distress, and self-rated health as significant predictors of overall PCAT scores. Suburban residence was associated with lower scores (B = - 1.59, P &lt; 0.001), while comorbidities (B = 1.94, P &lt; 0.001) and psychological distress (B = 2.06, P &lt; 0.001) were linked to higher scores.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study demonstrates that while overall perceptions of PHC services among permanent residents in Shanghai improved significantly compared to the previous year-particularly in terms of service comprehensiveness and referral coordination-urban-suburban disparities persist. Specifically, urban residents reported more favorable experiences in first-contact utilization, continuity of care, and cultural competence, whereas suburban residents expressed better perceptions of first-contact accessibility and service availability. Notably, the urban-suburban gaps in first-contact accessibility and service comprehensiveness narrowed between 2023 and 2024, suggesting a positive trajectory toward greater equity in basic health service delivery. Multivariate regression analysis further indicated that residential location, chronic disease burden, psychological distress, and self-rated health status were significant determinants of residents' PHC experiences. Based on these findings, we recommend the implementation of mo","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"246"},"PeriodicalIF":4.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare attitudes toward depression in Latin America: a latent class analysis from Argentina, Chile, Ecuador, Peru, and Venezuela using the Spanish-validated revised depression attitude questionnaire (SR-DAQ).","authors":"Marco Faytong-Haro, Genesis Camacho-Leon, Robert Araujo-Contreras, Stephanie Gallegos, Hans Mautong, Karla Robles-Velasco, Romina Dominguez, Andrea Mendez Colmenares, Ricardo X Noriega Espinoza, Fernando Peña, Keila Carrera-Mejias, Guillermo Leon-Samaniego, Claudia Reytor-González, Cristina Núñez-Vásquez, Ivan Cherrez-Ojeda, Daniel Alejandro Simancas-Racines","doi":"10.1186/s12939-025-02612-1","DOIUrl":"10.1186/s12939-025-02612-1","url":null,"abstract":"<p><strong>Background: </strong>Depression significantly impacts health systems worldwide, particularly in Latin America, where cultural stigmatization and misconceptions about mental health deter individuals from seeking help. Healthcare professionals' attitudes toward depression may affect its prevention, diagnosis and treatment.</p><p><strong>Objective: </strong>To categorize Latin American healthcare professionals' attitudes towards diagnosis and management of depression in subgroups using the Spanish-validated Revised Depression Attitude Questionnaire (SR-DAQ).</p><p><strong>Methods: </strong>A cross-sectional study surveyed 2,409 professionals using SR-DAQ from 2019 to 2022. Latent class analysis and multinomial logistic regression were used to identify attitude classes and explore demographic influences.</p><p><strong>Results: </strong>Among our sample, four attitude classes were identified: Depression Skeptics (21%), Depression Cautious (33%), Depression Neutrals (18%), and Depression Advocates (28%). Gender and medical subspecialty significantly influenced class membership, with females and mental health specialists more likely to be part of the Advocates.</p><p><strong>Conclusion: </strong>The study reveals varied attitudes towards depression among Latin American healthcare professionals, suggesting the need for tailored public health strategies to enhance effective depression care and management.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"249"},"PeriodicalIF":4.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health & nature: a critical review of historical perspectives to support narratives for change.","authors":"Miquel Amengual-Moreno, Lucinda Cash-Gibson, Laila Vivas, Eliana Martínez-Herrera, Adrián Almazán, Juan M Pericàs, Joan Benach","doi":"10.1186/s12939-025-02550-y","DOIUrl":"10.1186/s12939-025-02550-y","url":null,"abstract":"<p><strong>Introduction: </strong>The ongoing ecosocial crisis threatens the health of our planet, as ecological boundaries are overreached and social needs remain unmet. Achieving health equity and sustainable development requires re-evaluating the interconnections between nature and health, including the social narratives shaping this relationship. The ways in which we construct and adopt these narratives-consciously or not-translates into different implications for research, policy and practice. This study critically analyses the historical evolution of how the health-nature relationship is conceptualised in the scientific literature, and classifies the different eco-social values and theoretical considerations embedded within each emerging perspective. By raising awareness of the diverse perspectives used and their implications for research, policy and practice, the findings aim to provide a conceptual guide for narratives that aim to drive change towards health equity and sustainable practices.</p><p><strong>Methods: </strong>We conducted a critical review to identify the main perspectives of the health-nature relationship in the scientific literature over the past 60 years, and to categorize them based on their ecological theoretical positions, ranging from anthropocentric to non-anthropocentric. Snowballing techniques were applied to include other relevant literature.</p><p><strong>Results: </strong>Our review identified eight main perspectives on the health-nature relationship during this time period: Environmental health, Ecology of health, Holistic medicine, Political ecology of health, Eco Health, One Health, Planetary Health, and Indigenous traditions. We then classified them by their consideration of nature, and ecological positions.</p><p><strong>Discussion and conclusions: </strong>Our results found diverse and evolving perspectives on the health-nature relationships, with anthropocentric to non-anthropocentric ecological theoretical positions embedded within them. When selecting and applying perspectives to support transformation, researchers and policymakers should have a clear idea of the implicit and explicit theoretical positions embedded within them. Researchers, policy makers, and practitioners should carefully consider these findings when selecting frameworks to guide narratives of change, and interventions aiming to address the political, ecological, economic, and cultural drivers of environmental degradation, human and natural exploitation, and social and health inequalities that our planet is struggling with. Recognizing these varied perspectives presents an opportunity to embrace diverse epistemologies that can inspire positive ecosocial change and foster a more sustainable and equitable relation between human societies with nature.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"247"},"PeriodicalIF":4.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The legality of weight discrimination in Canada: an environmental scan of case law and the limits of Canadian legislation.","authors":"Sarah Nutter, Rachel Waugh, Erin McEachran, Ashley Toor, Jacob Shelley, Angela S Alberga, Mary Forhan, Sara Fl Kirk, Taniya S Nagpal, Ian Patton, Ximena Ramos Salas, Shelly Russell-Mayhew","doi":"10.1186/s12939-025-02606-z","DOIUrl":"10.1186/s12939-025-02606-z","url":null,"abstract":"<p><p>Weight stigma negatively impacts people with higher weights across the lifespan as well as social contexts and can lead to weight discrimination. As weight is not a protected identity in Canadian human rights legislation, it is important to better understand how weight discrimination is being argued in Canada's legal system. The purpose of this environmental scan was to examine and describe Canadian case law and scholarly articles pertaining to the argumentation of weight discrimination in Canada. A three-step search process was taken to identify relevant cases and articles that included; (1) Boolean keyword searches in HeinOnline, WestLaw, and LexisPlus; (2) citation searching within all results that met inclusion criteria; and (3) a keyword search in CanLII. These searches yielded a total of 33 documents that were included for analysis, including 8 scholarly articles and 25 cases. Scholarly articles highlighted consistent criticisms of existing human rights protections for higher-weight people in Canada, mostly pertaining to Limitations of disability protections. Of the 25 cases included, 16 were unsuccessful and 9 were successful, with most cases related to employment (n = 19). Our findings point to significant gaps in Canada's legal system for identifying and correcting instances of weight discrimination. Current Canadian disability protections are inadequate for those who experience weight discrimination, especially those who do not experience disability due to their weight. Our results highlight that weight ought to be a bona fide human rights issue, independent from disability protections.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"244"},"PeriodicalIF":4.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender differences in type 2 diabetes treatment and management: a qualitative study in an urban slum population from Dhaka, Bangladesh.","authors":"Ruchira Tabassum Naved, Aloka Talukder, K M Thouhidur Rahman, Sohel Choudhury, Rajiv Chowdhury, John Danesh, Emanuele Di Angelantonio, Md Khalequzzaman, Md Alfazal Khan, Simon Griffin, Nick Mascie-Taylor","doi":"10.1186/s12939-025-02611-2","DOIUrl":"10.1186/s12939-025-02611-2","url":null,"abstract":"<p><strong>Background: </strong>More than 80 million South Asians are living with type 2 diabetes (T2D). Despite increasing recognition that gender contributes to the prevention, treatment and outcomes of diseases, studies on gender and diabetes are scarce globally and particularly in impoverished and typically patriarchal settings, where gender hierarchies might be more pronounced. We explored how differences in gender roles, gendered access to, and control over resources, and social norms contribute to gender differences in treatment and management of T2D in an urban slum of Bangladesh.</p><p><strong>Methods: </strong>Data were collected between January and April, 2021 from Bauniabadh slum in Dhaka city, Bangladesh using 8 Key Informant Interviews (KII) and 60 In-Depth Interviews (IDI), with equal numbers of women and men aged 35 years or more, and a confirmed diagnosis of T2D at least two years prior to the current study. Within and across gender analyses were performed. We used positive and negative deviance approaches to understand the factors underlying variation in treatment and management of T2D.</p><p><strong>Results: </strong>Individual, household and structural factors posed gendered challenges to management of T2D. Compared to men, women were more prone to financial and time constraints originating from rigid gender roles and discriminatory entitlements in the household and society. Women employed more coping strategies than men to deal with financial constraints when seeking medical treatment. Strong household financial status, relevant connections and support from the family underlied high-performance by men in the management of T2D. Household financial status was a necessary, but not sufficient condition for high-performance among women. In addition, women's economic empowerment, agency, voice and power appear to be key for optimising T2D management.</p><p><strong>Conclusions: </strong>The findings highlight the importance of tailored programmes and policies for T2D to reduce gender inequities T2D management.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"243"},"PeriodicalIF":4.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}