{"title":"社会文化因素对肯尼亚医疗保健可及性的影响:以肯尼亚内罗毕县为例","authors":"Davies N. Chelogoi, F. Jonyo, H. Amadi","doi":"10.4236/jss.2020.85023","DOIUrl":null,"url":null,"abstract":"Access to public healthcare in Nairobi County is unequal among social \nclasses. Lower social classes have worse healthcare than either the upper or \nthe middle classes. These health inequalities are correlated with \nsocio-economic inequalities. The higher socio-economic classes have better \naccess to healthcare than the lower socio-economic classes. Higher incomes, \neducation, employment and wealth result in better health of the households in \nthe County. Unequal access to healthcare contributes to disparities in health \nstatus, increases costs for both the insured and the uninsured. Lack of access \nto healthcare reduces disposable incomes, particularly burdening the lower \nincome households. These households cannot afford the care they need. This has \nforced them to forego such care altogether. The objectives of the study were \nthree, namely: to evaluate the influence of demographic variables in access to \npublic healthcare, to evaluate the influence of socio-cultural factors in \naccess to public health care, and to evaluate the influence of institutional \nfactors in access to public healthcare. The study used descriptive design, \nspecifically, cross-sectional design for collection, measurements and analysis \nof data. The study took place in Nairobi County. The target population was \nhouseholds living in Nairobi County, where the sample was drawn from. The \nsampling techniques included multi-stage random sampling, random sampling, \nstratifies random sampling, cluster random \nsampling, convenient sampling and purposive sampling. The sample size was \nobtained using Chadha’s \nformula (2006) to arrive at 1066 sample size. \nData collection instruments included observations, face-to-face interviews, \nquestionnaires, in-depth interviews and focus group discussions. Qualitative \ndata was analyzed thematically but quantitative data was analyzed using \ndescriptive statistics. Data was analyzed using SPSS version 23. The results \nshow that there were positive correlations between independent and dependent \nvariables. The P-value was statistically \nsignificant. The results were not due to random chance and that P-0.01 < 0.05 and this confirms a \npositive relations ships between the variables. The relationships were mutually \ninclusive and highly correlated. On that basis, the null hypotheses were \nrejected and the alternate hypotheses accepted. The results show that \ndemographic (disposing), socio-cultural (need) and institutional (enabling) \nfactors influence access to healthcare. Socio-economic factors should be \naddressed to benefit all the households. Socio-cultural factors should be \ndistributed fairly among the households. Health systems should be improved and \nadequately financed to provide the requisite resources to all the households.","PeriodicalId":243720,"journal":{"name":"ERN: Microeconometric Studies of Health Markets (Topic)","volume":"520 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2020-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":"{\"title\":\"The Influence of Socio-Cultural Factors in Access to Healthcare in Kenya: A Case of Nairobi County, Kenya\",\"authors\":\"Davies N. Chelogoi, F. Jonyo, H. Amadi\",\"doi\":\"10.4236/jss.2020.85023\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Access to public healthcare in Nairobi County is unequal among social \\nclasses. Lower social classes have worse healthcare than either the upper or \\nthe middle classes. These health inequalities are correlated with \\nsocio-economic inequalities. The higher socio-economic classes have better \\naccess to healthcare than the lower socio-economic classes. Higher incomes, \\neducation, employment and wealth result in better health of the households in \\nthe County. Unequal access to healthcare contributes to disparities in health \\nstatus, increases costs for both the insured and the uninsured. Lack of access \\nto healthcare reduces disposable incomes, particularly burdening the lower \\nincome households. These households cannot afford the care they need. This has \\nforced them to forego such care altogether. The objectives of the study were \\nthree, namely: to evaluate the influence of demographic variables in access to \\npublic healthcare, to evaluate the influence of socio-cultural factors in \\naccess to public health care, and to evaluate the influence of institutional \\nfactors in access to public healthcare. 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引用次数: 3
摘要
在内罗毕县,不同社会阶层获得公共保健的机会是不平等的。较低的社会阶层比上层或中产阶级拥有更差的医疗保健。这些健康不平等与社会经济不平等有关。较高的社会经济阶层比较低的社会经济阶层有更好的机会获得医疗保健。收入、教育、就业和财富的增加使该县家庭的健康状况得到改善。获得医疗保健的机会不平等造成了健康状况的差异,增加了参保人和未参保人的费用。缺乏获得医疗保健的机会减少了可支配收入,特别是给低收入家庭增加了负担。这些家庭负担不起他们需要的护理。这迫使他们完全放弃了这种照顾。本研究的目标有三个,即:评估人口变量对获得公共医疗服务的影响,评估社会文化因素对获得公共医疗服务的影响,以及评估制度因素对获得公共医疗服务的影响。本研究采用描述性设计,具体地说,采用横断面设计来收集、测量和分析数据。这项研究在内罗毕县进行。目标人群是居住在内罗毕县的家庭,样本是从那里抽取的。抽样技术包括多阶段随机抽样、随机抽样、分层随机抽样、整群随机抽样、方便抽样和目的抽样。样本量采用Chadha公式(2006)得到,样本量为1066。数据收集手段包括观察、面对面访谈、问卷调查、深入访谈和焦点小组讨论。定性资料采用专题分析,定量资料采用描述性统计分析。数据分析采用SPSS version 23。结果表明,自变量与因变量之间存在正相关关系。p值有统计学意义。结果不是由于随机机会和P-0.01 < 0.05,这证实了变量之间的正相关关系。这种关系是相互包容和高度相关的。在此基础上,零假设被拒绝,替代假设被接受。结果表明,人口(处置)、社会文化(需要)和体制(使能)因素影响获得保健的机会。应处理社会经济因素,使所有家庭受益。社会文化因素应在家庭中公平分配。应当改善卫生系统并为其提供充足的资金,以便向所有家庭提供必要的资源。
The Influence of Socio-Cultural Factors in Access to Healthcare in Kenya: A Case of Nairobi County, Kenya
Access to public healthcare in Nairobi County is unequal among social
classes. Lower social classes have worse healthcare than either the upper or
the middle classes. These health inequalities are correlated with
socio-economic inequalities. The higher socio-economic classes have better
access to healthcare than the lower socio-economic classes. Higher incomes,
education, employment and wealth result in better health of the households in
the County. Unequal access to healthcare contributes to disparities in health
status, increases costs for both the insured and the uninsured. Lack of access
to healthcare reduces disposable incomes, particularly burdening the lower
income households. These households cannot afford the care they need. This has
forced them to forego such care altogether. The objectives of the study were
three, namely: to evaluate the influence of demographic variables in access to
public healthcare, to evaluate the influence of socio-cultural factors in
access to public health care, and to evaluate the influence of institutional
factors in access to public healthcare. The study used descriptive design,
specifically, cross-sectional design for collection, measurements and analysis
of data. The study took place in Nairobi County. The target population was
households living in Nairobi County, where the sample was drawn from. The
sampling techniques included multi-stage random sampling, random sampling,
stratifies random sampling, cluster random
sampling, convenient sampling and purposive sampling. The sample size was
obtained using Chadha’s
formula (2006) to arrive at 1066 sample size.
Data collection instruments included observations, face-to-face interviews,
questionnaires, in-depth interviews and focus group discussions. Qualitative
data was analyzed thematically but quantitative data was analyzed using
descriptive statistics. Data was analyzed using SPSS version 23. The results
show that there were positive correlations between independent and dependent
variables. The P-value was statistically
significant. The results were not due to random chance and that P-0.01 < 0.05 and this confirms a
positive relations ships between the variables. The relationships were mutually
inclusive and highly correlated. On that basis, the null hypotheses were
rejected and the alternate hypotheses accepted. The results show that
demographic (disposing), socio-cultural (need) and institutional (enabling)
factors influence access to healthcare. Socio-economic factors should be
addressed to benefit all the households. Socio-cultural factors should be
distributed fairly among the households. Health systems should be improved and
adequately financed to provide the requisite resources to all the households.