The impact of “male clinics” on health-seeking behaviors of adult men in rural Kenya
Autoři:
Justine Dowden aff001; Ivy Mushamiri aff002; Eric McFeely aff001; Donald Apat aff003; Jilian Sacks aff001; Yanis Ben Amor aff001
Působiště autorů:
Center for Sustainable Development, Earth Institute, Columbia University, New York, NY, United States of America
aff001; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
aff002; Columbia Global Centers East and Southern Africa, Nairobi, Kenya
aff003
Vyšlo v časopise:
PLoS ONE 14(11)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0224749
Souhrn
Background
In most parts of the world, men access health services less frequently than women, and this trend is unrelated to differences in need for services. While male involvement in healthcare as partners or fathers has been extensively studied, less is known about the health-seeking behavior of men as clients themselves. This interventional research study aimed to determine how the introduction of male-friendly clinics impacted male care-seeking behavior and to describe the reasons for accessing services among men in rural Kenya.
Methods and findings
We questioned men to assess utilization and perceptions of existing health clinics, then designed and evaluated a “male clinics” intervention where dedicated male health workers were hired for one year to offer routine, free services exclusively to men within existing healthcare facilities. Results were compared between data from Male Clinics in specific health facilities, the same facilities concurrently, nearby control facilities concurrently, and intervention facilities historically.
Costs of services, distance to facilities, and quality of care were the main barriers to healthcare access reported. The number of total visits was significantly higher than control groups (p<0·0001). In the intervention group, 18·6% of visits were for a checkup compared to almost none in control groups. The most common diagnoses overall were upper respiratory tract infections, malaria and injury. A major limitation of this study is the non-comparability in information captured using the Male Clinic registers compared to control registers.
Conclusions
Costs and quality of services deter men from seeking healthcare. The introduction of male-friendly health services could encourage men to seek preventive care and increase service uptake.
Klíčová slova:
Quality of care – Fungal diseases – Behavior – Malaria – Behavioral and social aspects of health – Hypertension – Health systems strengthening
Zdroje
1. Promundo and UNFPA. Strengthening CSO-Government Partnerships to Scale Up Approaches to Engaging Men and Boys for Gender Equality and SRHR: A Tool for Action. Washington, DC, New York: Promundo-US, UNFPA; 2016.
2. Aluisio A, Richardson BA, Bosire R, John-Stewart G, Mbori-Ngacha D, Farquhar C. Male antenatal attendance and HIV testing are associated with decreased infant HIV infection and increased HIV-free survival. Journal of acquired immune deficiency syndromes (1999). 2011;56(1):76–82.
3. Farquhar C, Kiarie JN, Richardson BA, Kabura MN, John FN, Nduati RW, et al. Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission. Journal of acquired immune deficiency syndromes (1999). 2004;37(5):1620–6.
4. Mak J, Mayhew SH, von Maercker A, Integra Research Team IR, Colombini M. Men's use of sexual health and HIV services in Swaziland: a mixed methods study. Sexual health. 2016;13(3):265–74. doi: 10.1071/SH15244 27028455
5. Theuring S, Mbezi P, Luvanda H, Jordan-Harder B, Kunz A, Harms G. Male involvement in PMTCT services in Mbeya Region, Tanzania. AIDS and behavior. 2009;13 Suppl 1:92–102.
6. Msuya SE, Mbizvo EM, Hussain A, Uriyo J, Sam NE, Stray-Pedersen B. Low male partner participation in antenatal HIV counselling and testing in northern Tanzania: implications for preventive programs. AIDS care. 2008;20(6):700–9. doi: 10.1080/09540120701687059 18576172
7. Becker S, Mlay R, Schwandt HM, Lyamuya E. Comparing couples' and individual voluntary counseling and testing for HIV at antenatal clinics in Tanzania: a randomized trial. AIDS and behavior. 2010;14(3):558–66. doi: 10.1007/s10461-009-9607-1 19763813
8. John FN, Farquhar C, Kiarie JN, Kabura MN, John-Stewart GC. Cost effectiveness of couple counselling to enhance infant HIV-1 prevention. International journal of STD & AIDS. 2008;19(6):406–9.
9. Manjate Cuco RM, Munguambe K, Bique Osman N, Degomme O, Temmerman M, Sidat MM. Male partners' involvement in prevention of mother-to-child HIV transmission in sub-Saharan Africa: A systematic review. SAHARA J: journal of Social Aspects of HIV/AIDS Research Alliance. 2015;12:87–105.
10. Audet CM, Blevins M, Chire YM, Aliyu MH, Vaz LME, Antonio E, et al. Engagement of Men in Antenatal Care Services: Increased HIV Testing and Treatment Uptake in a Community Participatory Action Program in Mozambique. AIDS and Behavior. 2016;20(9):2090–100. doi: 10.1007/s10461-016-1341-x 26906021
11. Barker G, Ricardo C, Nascimento M, Olukoya A, Santos C. Questioning gender norms with men to improve health outcomes: evidence of impact. Global public health. 2010;5(5):539–53. doi: 10.1080/17441690902942464 19513910
12. Camlin CS, Ssemmondo E, Chamie G, El Ayadi AM, Kwarisiima D, Sang N, et al. Men "missing" from population-based HIV testing: insights from qualitative research. AIDS care. 2016;28 Suppl 3:67–73.
13. Courtenay WH. Constructions of masculinity and their influence on men's well-being: a theory of gender and health. Social Science & Medicine. 2000;50(10):1385–401.
14. Addis ME, Mahalik JR. Men, masculinity, and the contexts of help seeking. American Psychologist. 2003;58(1):5–14. doi: 10.1037/0003-066x.58.1.5 12674814
15. World Health Organization. Engaging men and boys in changing gender-based inequity in health: Evidence from programme interventions. Geneva; 2007.
16. van Loenen T, van den Berg MJ, Faber MJ, Westert GP. Propensity to seek healthcare in different healthcare systems: analysis of patient data in 34 countries. BMC Health Services Research. 2015;15.
17. Haskew J, Turner K, Rø G, Ho A, Kimanga D, Sharif S. Stage of HIV presentation at initial clinic visit following a community-based HIV testing campaign in rural Kenya. BMC Public Health. 2015;15(1):16.
18. Millennium Villages Project [Available from: http://millenniumvillages.org/the-villages/sauri-kenya/].
19. Jivetti BA. Exploring the Impact of the Millennium Village Promise on Community Networks: The Case of Sauri Millennium Village in Western Kenya. Columbia, Missouri: University of Missouri; 2012.
20. Population Estimates-Siaya County. 2017.
21. Baker P, Dworkin SL, Tong S, Banks I, Shand T, Yamey G. The men’s health gap: men must be included in the global health equity agenda. Bulletin of the World Health Organization. 2014;92(8):618–20. doi: 10.2471/BLT.13.132795 25197149
22. Hardee K, Croce-Galis M, Gay J. Are men well served by family planning programs? Reproductive Health. 2017;14(1):14. doi: 10.1186/s12978-017-0278-5 28115004
23. Mmari K, Oseni O, Fatusi AO. STI Treatment-Seeking Behaviors Among Youth in Nigeria: Are There Gender Differences? International Perspectives on Sexual and Reproductive Health. 2010;36(2):72–9. doi: 10.1363/ipsrh.36.072.10 20663743
24. Voeten HACM, O’Hara HB, Kusimba J, Otido JM, Ndinya-Achola JO, Bwayo JJ, et al. Gender Differences in Health Care-Seeking Behavior for Sexually Transmitted Diseases: A Population-Based Study in Nairobi, Kenya. Sexually Transmitted Diseases. 2004;31(5):265–72. doi: 10.1097/01.olq.0000124610.65396.52 15107627
25. Mak J, Mayhew SH, Maercker Av, Colombini IRT, Manuela. Men's use of sexual health and HIV services in Swaziland: a mixed methods study. Sexual Health (Online). 2016;13(3):265–74.
26. Springer KW, Mouzon DM. "Macho Men" and Preventive Health Care: Implications for Older Men in Different Social Classes. Journal of Health and Social Behavior. 2011;52(2):212–27. doi: 10.1177/0022146510393972 21490311
27. Ukwaja KN, Alobu I, Nweke CO, Onyenwe EC. Healthcare-seeking behavior, treatment delays and its determinants among pulmonary tuberculosis patients in rural Nigeria: a cross-sectional study. BMC Health Services Research. 2013;13(1):25.
28. 90-90-90: An ambitious treatment target to help end the AIDS epidemic. Geneva, Switzerland: UNAIDS; 2014 October. Report No.: JC2684.
29. Kenya Health Workforce Report: The Status of Healthcare Professionals in Kenya, 2015. Nairobi, Kenya: Kenya Ministry of Health; 2016.
Článok vyšiel v časopise
PLOS One
2019 Číslo 11
- Metamizol jako analgetikum první volby: kdy, pro koho, jak a proč?
- Nejasný stín na plicích – kazuistika
- Masturbační chování žen v ČR − dotazníková studie
- Úspěšná resuscitativní thorakotomie v přednemocniční neodkladné péči
- Dlouhodobá recidiva a komplikace spojené s elektivní operací břišní kýly
Najčítanejšie v tomto čísle
- A daily diary study on maladaptive daydreaming, mind wandering, and sleep disturbances: Examining within-person and between-persons relations
- A 3’ UTR SNP rs885863, a cis-eQTL for the circadian gene VIPR2 and lincRNA 689, is associated with opioid addiction
- A substitution mutation in a conserved domain of mammalian acetate-dependent acetyl CoA synthetase 2 results in destabilized protein and impaired HIF-2 signaling
- Molecular validation of clinical Pantoea isolates identified by MALDI-TOF