Access to health care, reproductive health and disability: A large scale survey in Sierra Leone
This is the first study to compare health status and access to health care services between disabled and non-disabled men and women in urban and peri-urban areas of Sierra Leone. It pays particular attention to access to reproductive health care services and maternal health care for disabled women. A cross-sectional study was conducted in 2009 in 5 districts of Sierra Leone, randomly selecting 17 clusters for a total sample of 425 households. All adults who were identified as being disabled, as well as a control group of randomly selected non-disabled adults, were interviewed about health and reproductive health. As expected, we showed that people with severe disabilities had less access to public health care services than non-disabled people after adjustment for other socioeconomic characteristics (bivariate modelling). However, there were no significant differences in reporting use of contraception between disabled and non-disabled people; contrary to expectations, women with disabilities were as likely to report access to maternal health care services as did non-disabled women. Rather than disability, it is socioeconomic inequality that governs access to such services. We also found that disabled women were as likely as non-disabled women to report having children and to desiring another child: they are not only sexually active, but also need access to reproductive health services. We conclude that disparity in access to government-supported health care facilities constitutes a major and persisting health inequity between persons with and without disabilities in Sierra Leone. Ensuring equal access will require further strengthening of the country’s health care system. Furthermore, because the morbidity and mortality rates of pregnant women are persistently high in Sierra Leone, assessing the quality of services received is an important priority for future research.
Volume (Year): 73 (2011)
Issue (Month): 10 ()
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- Deon Filmer & Lant Pritchett, 2001. "Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India," Demography, Springer;Population Association of America (PAA), vol. 38(1), pages 115-132, February.
- Deon Filmer, 2008. "Disability, Poverty, and Schooling in Developing Countries: Results from 14 Household Surveys," World Bank Economic Review, World Bank Group, vol. 22(1), pages 141-163, January.
- Brazier, Ellen & Andrzejewski, Catherine & Perkins, Margaret E. & Themmen, Ellen M. & Knight, Rodney J. & Bassane, Brahima, 2009. "Improving poor women's access to maternity care: Findings from a primary care intervention in Burkina Faso," Social Science & Medicine, Elsevier, vol. 69(5), pages 682-690, September.
- Glei, Dana A. & Goldman, Noreen & Rodríguez, Germán, 2003. "Utilization of care during pregnancy in rural Guatemala: does obstetrical need matter?," Social Science & Medicine, Elsevier, vol. 57(12), pages 2447-2463, December.
- Sen, Amartya, 1995. "Inequality Reexamined," OUP Catalogue, Oxford University Press, number 9780198289289.
- Bornemisza, Olga & Ranson, M. Kent & Poletti, Timothy M. & Sondorp, Egbert, 2010. "Promoting health equity in conflict-affected fragile states," Social Science & Medicine, Elsevier, vol. 70(1), pages 80-88, January.
- Gyimah, Stephen Obeng & Takyi, Baffour K. & Addai, Isaac, 2006. "Challenges to the reproductive-health needs of African women: On religion and maternal health utilization in Ghana," Social Science & Medicine, Elsevier, vol. 62(12), pages 2930-2944, June.
- Elwan, Ann, 1999. "Poverty and disability : a survey of the literature," Social Protection and Labor Policy and Technical Notes 21315, The World Bank.
- Magadi, Monica Akinyi & Madise, Nyovani Janet & Rodrigues, Roberto Nascimento, 2000. "Frequency and timing of antenatal care in Kenya: explaining the variations between women of different communities," Social Science & Medicine, Elsevier, vol. 51(4), pages 551-561, August.
- Trani, Jean-Francois & Bakhshi, Parul & Noor, Ayan A. & Lopez, Dominique & Mashkoor, Ashraf, 2010. "Poverty, vulnerability, and provision of healthcare in Afghanistan," Social Science & Medicine, Elsevier, vol. 70(11), pages 1745-1755, June.
- Furnée, Carina A. & Pfann, Gerard A., 2010. "Individual vulnerability and the nurturing state: The case of self-reported health and relative income," Social Science & Medicine, Elsevier, vol. 71(1), pages 125-133, July.
- Gage, Anastasia J., 2007. "Barriers to the utilization of maternal health care in rural Mali," Social Science & Medicine, Elsevier, vol. 65(8), pages 1666-1682, October.
- Yeo, Rebecca & Moore, Karen, 2003. "Including Disabled People in Poverty Reduction Work: "Nothing About Us, Without Us"," World Development, Elsevier, vol. 31(3), pages 571-590, March.
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