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Health Access Livelihood Framework Reveals Potential Barriers in the Control of Schistosomiasis in the Dongting Lake Area of Hunan Province,China
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نویسنده
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balen j. ,liu z.-c. ,mcmanus d.p. ,raso g. ,utzinger j. ,xiao s.-y. ,yu d.-b. ,zhao z.-y. ,li y.-s.
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منبع
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plos neglected tropical diseases - 2013 - دوره : 7 - شماره : 8
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چکیده
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Background:access to health care is a major requirement in improving health and fostering socioeconomic development. in the people's republic of china (p.r. china),considerable changes have occurred in the social,economic,and health systems with a shift from a centrally planned to a socialist market economy. this brought about great benefits and new challenges,particularly for vertical disease control programs,including schistosomiasis. we explored systemic barriers in access to equitable and effective control of schistosomiasis.methodology:between august 2002 and february 2003,66 interviews with staff from anti-schistosomiasis control stations and six focus group discussions with health personnel were conducted in the dongting lake area,hunan province. additionally,79 patients with advanced schistosomiasis japonica were interviewed. the health access livelihood framework was utilized to examine availability,accessibility,affordability,adequacy,and acceptability of schistosomiasis-related health care.principal findings:we found sufficient availability of infrastructure and human resources at most control stations. many patients with advanced schistosomiasis resided in non-endemic or moderately endemic areas,however,with poor accessibility to disease-specific knowledge and specialized health services. moreover,none of the patients interviewed had any form of health insurance,resulting in high out-of-pocket expenditure or unaffordable care. reports on the adequacy and acceptability of care were mixed.conclusions/significance:there is a need to strengthen health awareness and schistosomiasis surveillance in post-transmission control settings,as well as to reduce diagnostic and treatment costs. further studies are needed to gain a multi-layered,in-depth understanding of remaining barriers,so that the ultimate goal of schistosomiasis elimination in p.r. china can be reached. © 2013 balen et al.
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آدرس
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molecular parasitology laboratory,division of infectious diseases,queensland institute of medical research,brisbane,australia,school of population health,university of queensland,brisbane,australia,institute of global health innovation,imperial college london,london, United Kingdom, school of public health,central south university,changsha, China, molecular parasitology laboratory,division of infectious diseases,queensland institute of medical research,brisbane, Australia, département environnement et santé,centre suisse de recherches scientifiques en côte d'ivoire,abidjan,cote d'ivoire,department of epidemiology and public health,swiss tropical and public health institute,basel,switzerland,university of basel,basel, Switzerland, department of epidemiology and public health,swiss tropical and public health institute,basel,switzerland,university of basel,basel, Switzerland, school of public health,central south university,changsha, China, division of health education and intervention,national center for aids/std control and prevention,beijing, China, school of public health,central south university,changsha,china,hunan institute of parasitic diseases,yueyang, China, molecular parasitology laboratory,division of infectious diseases,queensland institute of medical research,brisbane,australia,hunan institute of parasitic diseases,yueyang, China
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Authors
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