Gender bias in careseeking practices in 57 low– and middle–income countries |
Authors: |
Janaína Calu Costa, Fernando C Wehrmeister, Aluísio JD Barros, and Cesar G Victora |
Source: |
Journal of Global Health, 7(1): 010418; DOI: 10.7189/jogh.07.010418 |
Topic(s): |
Child health Gender Health equity Inequality Son preference
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Country: |
More than one region
Multiple Regions
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Published: |
JUN 2017 |
Abstract: |
Background
Preventive and curative medical interventions can reduce child mortality. It is important to assess whether there is gender bias in access to these interventions, which can lead to preferential treatment of children of a given sex.
Methods
Data from Demographic and Health Surveys carried out in 57 low– and middle–income countries were used. The outcome variable was a composite careseeking indicator, which represents the proportion of children with common childhood symptoms or illnesses (diarrhea, fever, or suspected pneumonia) who were taken to an appropriate provider. Results were stratified by sex at the national level and within each wealth quintile. Ecological analyses were carried out to assess if sex ratios varied by world region, religion, national income and its distribution, and gender inequality indices. Linear multilevel regression models were used to estimate time trends in careseeking by sex between 1994 and 2014.
Findings
Eight out of 57 countries showed significant differences in careseeking; in six countries, girls were less likely to receive care (Colombia, Egypt, India, Liberia, Senegal and Yemen). Seven countries had significant interactions between sex and wealth quintile, but the patterns varied from country to country. In the ecological analyses, lower careseeking for girls tended to be more common in countries with higher income concentration (P?=?0.039) and higher Muslim population (P?=?0.006). Coverage increased for both sexes; 0.95 percent points (pp) a year among girls (32.9% to 51.9%), and 0.91 pp (34.8% to 52.9%) among boys.
Conclusion
The overall frequency of careseeking is similar for girls and boys, but not in all countries, where there is evidence of gender bias. A gender perspective should be an integral part of monitoring, accountability and programming. Countries where bias is present need renewed attention by national and international initiatives, in order to ensure that girls receive adequate care and protection. |
Web: |
http://www.jogh.org/documents/issue201701/jogh-07-010418.htm |
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