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Women's (health) work: A population-based, cross-sectional study of gender differences in time spent seeking health care in Malawi
BACKGROUND: There has been a notable expansion in routine health care in sub-Saharan Africa. While heath care is nominally free in many contexts, the time required to access services reflects an opportunity cost that may be substantial and highly gendered, reflecting the gendered nature of health ca...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303093/ https://www.ncbi.nlm.nih.gov/pubmed/30576388 http://dx.doi.org/10.1371/journal.pone.0209586 |
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author | Yeatman, Sara Chamberlin, Stephanie Dovel, Kathryn |
author_facet | Yeatman, Sara Chamberlin, Stephanie Dovel, Kathryn |
author_sort | Yeatman, Sara |
collection | PubMed |
description | BACKGROUND: There has been a notable expansion in routine health care in sub-Saharan Africa. While heath care is nominally free in many contexts, the time required to access services reflects an opportunity cost that may be substantial and highly gendered, reflecting the gendered nature of health care guidelines and patterns of use. The time costs of health care use, however, have rarely been systematically assessed at the population-level. METHODS: Data come from the 2015 wave of a population-based cohort study of young adults in southern Malawi during which 1,453 women and 407 men between the ages of 21 and 31 were interviewed. We calculated the time spent seeking health care over a two-month period, disaggregating findings by men, recently-pregnant women, mothers with children under two years old, and “other women”. We then extrapolated the time required for specific services to estimate the time that would be needed for each subpopulation to meet government recommendations for routine health services over the course of a year. RESULTS: Approximately 60% of women and 22% of men attended at least one health care visit during the preceding two months. Women spent six times as long seeking care as did men (t = -4.414, p<0.001), with an average 6.4 hours seeking care over a two-month period compared to 1 hour for men. In order to meet government recommendations for routine health services, HIV-negative women would need to spend between 19 and 63 hours annually seeking health care compared to only three hours for men. An additional 40 hours would be required of HIV-positive individuals initiating antiretroviral care. CONCLUSIONS: Women in Malawi spend a considerable amount of time seeking routine health care services, while men spend almost none. The substantial time women spend seeking health care exacerbates their time poverty and constrains opportunities for other meaningful activities. At the same time, few health care guidelines pertain to men who thus have little interaction with the health care system. Additional public health strategies such as integration of services for those services frequently used by women and specific guidelines and outreach for men are urgently needed. |
format | Online Article Text |
id | pubmed-6303093 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-63030932019-01-08 Women's (health) work: A population-based, cross-sectional study of gender differences in time spent seeking health care in Malawi Yeatman, Sara Chamberlin, Stephanie Dovel, Kathryn PLoS One Research Article BACKGROUND: There has been a notable expansion in routine health care in sub-Saharan Africa. While heath care is nominally free in many contexts, the time required to access services reflects an opportunity cost that may be substantial and highly gendered, reflecting the gendered nature of health care guidelines and patterns of use. The time costs of health care use, however, have rarely been systematically assessed at the population-level. METHODS: Data come from the 2015 wave of a population-based cohort study of young adults in southern Malawi during which 1,453 women and 407 men between the ages of 21 and 31 were interviewed. We calculated the time spent seeking health care over a two-month period, disaggregating findings by men, recently-pregnant women, mothers with children under two years old, and “other women”. We then extrapolated the time required for specific services to estimate the time that would be needed for each subpopulation to meet government recommendations for routine health services over the course of a year. RESULTS: Approximately 60% of women and 22% of men attended at least one health care visit during the preceding two months. Women spent six times as long seeking care as did men (t = -4.414, p<0.001), with an average 6.4 hours seeking care over a two-month period compared to 1 hour for men. In order to meet government recommendations for routine health services, HIV-negative women would need to spend between 19 and 63 hours annually seeking health care compared to only three hours for men. An additional 40 hours would be required of HIV-positive individuals initiating antiretroviral care. CONCLUSIONS: Women in Malawi spend a considerable amount of time seeking routine health care services, while men spend almost none. The substantial time women spend seeking health care exacerbates their time poverty and constrains opportunities for other meaningful activities. At the same time, few health care guidelines pertain to men who thus have little interaction with the health care system. Additional public health strategies such as integration of services for those services frequently used by women and specific guidelines and outreach for men are urgently needed. Public Library of Science 2018-12-21 /pmc/articles/PMC6303093/ /pubmed/30576388 http://dx.doi.org/10.1371/journal.pone.0209586 Text en © 2018 Yeatman et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Yeatman, Sara Chamberlin, Stephanie Dovel, Kathryn Women's (health) work: A population-based, cross-sectional study of gender differences in time spent seeking health care in Malawi |
title | Women's (health) work: A population-based, cross-sectional study of gender differences in time spent seeking health care in Malawi |
title_full | Women's (health) work: A population-based, cross-sectional study of gender differences in time spent seeking health care in Malawi |
title_fullStr | Women's (health) work: A population-based, cross-sectional study of gender differences in time spent seeking health care in Malawi |
title_full_unstemmed | Women's (health) work: A population-based, cross-sectional study of gender differences in time spent seeking health care in Malawi |
title_short | Women's (health) work: A population-based, cross-sectional study of gender differences in time spent seeking health care in Malawi |
title_sort | women's (health) work: a population-based, cross-sectional study of gender differences in time spent seeking health care in malawi |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303093/ https://www.ncbi.nlm.nih.gov/pubmed/30576388 http://dx.doi.org/10.1371/journal.pone.0209586 |
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