2型糖尿病治疗和管理的性别差异:孟加拉国达卡城市贫民窟人口的定性研究

IF 4.1 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
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
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引用次数: 0

摘要

背景:超过8000万南亚人患有2型糖尿病(T2D)。尽管越来越多的人认识到性别有助于疾病的预防、治疗和结果,但在全球范围内,关于性别和糖尿病的研究很少,特别是在贫困和典型的父权制环境中,在这些环境中,性别等级可能更为明显。我们探讨了性别角色、资源的性别获取和控制以及社会规范的差异如何导致孟加拉国城市贫民窟T2D治疗和管理中的性别差异。方法:数据于2021年1月至4月在孟加拉国达卡市Bauniabadh贫民窟收集,采用8次关键信息访谈(KII)和60次深度访谈(IDI),男女人数相同,年龄在35岁或以上,至少在本研究前两年确诊为T2D。进行了内部和跨性别分析。我们采用积极和消极偏差的方法来了解t2dm治疗和管理差异的潜在因素。结果:个体、家庭和结构因素对T2D的管理构成了性别挑战。与男子相比,妇女更容易受到财政和时间限制,这是由于家庭和社会中严格的性别角色和歧视性权利造成的。在寻求医疗时,妇女比男子采用更多的应对策略来应对经济拮据。强大的家庭经济状况、相关关系和家庭的支持是男性在管理T2D方面表现出色的基础。家庭经济状况是妇女取得成绩的必要条件,但不是充分条件。此外,妇女的经济赋权、代理权、发言权和权力似乎是优化T2D管理的关键。结论:研究结果强调了为T2D量身定制方案和政策的重要性,以减少T2D管理中的性别不平等。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Gender differences in type 2 diabetes treatment and management: a qualitative study in an urban slum population from Dhaka, Bangladesh.

Background: 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.

Methods: 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.

Results: 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.

Conclusions: The findings highlight the importance of tailored programmes and policies for T2D to reduce gender inequities T2D management.

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来源期刊
CiteScore
7.80
自引率
4.20%
发文量
162
审稿时长
28 weeks
期刊介绍: International Journal for Equity in Health is an Open Access, peer-reviewed, online journal presenting evidence relevant to the search for, and attainment of, equity in health across and within countries. International Journal for Equity in Health aims to improve the understanding of issues that influence the health of populations. This includes the discussion of political, policy-related, economic, social and health services-related influences, particularly with regard to systematic differences in distributions of one or more aspects of health in population groups defined demographically, geographically, or socially.
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