Equity of access to and utilization of reproductive health services in Thailand: national Reproductive Health Survey data, 2006 and 2009

Kongsri, Suratchada; Limwattananon, Supon; Sirilak, Supakit; Prakongsai, Phusit; Tangcharoensathien, Viroj

doi:10.1016/s0968-8080(11)37569-6

Cited by 35 publications

(23 citation statements)

References 13 publications

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“…However, the burden and risk of exclusion women face remain unquantified due to the lack of an appropriate instrument for measuring their ability to overcome barriers to healthcare. In current research practice, inequalities in access to healthcare and risk of exclusion are often indirectly estimated by comparing patterns of achieved utilization between socio-economic groups of individuals [34-37]. Although these indirect evaluations have contributed to identifying groups who likely fail to receive needed care, utilization-based estimations of disadvantage are potentially problematic for at least two reasons.…”

Section: Introductionmentioning

confidence: 99%

Measuring women's perceived ability to overcome barriers to healthcare seeking in Burkina Faso

2012

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BackgroundIn sub-Saharan Africa, women must overcome numerous barriers when they need modern healthcare. Respect of gender norms within the household and the community may still influence women's ability to obtain care. A lack of gender-sensitive instruments for measuring women's ability to overcome barriers compromises attempts to adequately quantify the burden and risk of exclusion they face when seeking modern healthcare. The aim of this study was to create and validate a synthetic measure of women's access to healthcare from a publicly available and possibly internationally comparable population-based survey.MethodSeven questionnaire items from the Burkina Faso 2003 DHS were combined to create the index. Cronbach's alpha coefficient was used to test the reliability of the index. Exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were applied to evaluate the factorial structure and construct validity of the index while taking into account the hierarchical structure of the data.ResultsThe index has a Cronbach's alpha of 0.75, suggesting adequate reliability. In EFA, three correlated factors fitted the data best. In CFA, the construct of perceived ability to overcome barriers to healthcare seeking emerged as a second-order latent variable with three domains: socioeconomic barriers, geographical barriers and psychosocial barriers. Model fit indices support the index's global validity for women of reproductive age in Burkina Faso. Evidence for construct validity comes from the finding that women's index scores increase with household living standard.ConclusionThe DHS items can be combined into a reliable and valid, gender-sensitive index quantifying reproductive-age women's perceived ability to overcome barriers to healthcare seeking in Burkina Faso. The index complies conceptually with the sector-cross-cutting capability approach and enables measuring directly the perceived access to healthcare. Therefore it can help to improve the design and evaluation of interventions that aim to facilitate healthcare seeking in this country. Further analyses may examine how far the index applies to similar contexts.

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Section: Introductionmentioning

confidence: 99%

Measuring women's perceived ability to overcome barriers to healthcare seeking in Burkina Faso

2012

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“…first trimester ANC for women and their partners, and births at health centers and hospitals with SBA [20]. However, a recent communitybased study in Northern Thailand revealed that Hmong women used ANC and had hospital births less often than these national statistics for Thai women --no ANC at 8% versus 1.1% and no SBA at 12.7% versus 0.3% [21].…”

Section: Discussionmentioning

confidence: 96%

‘We all decided’: The variations of Hmong Family-Based Decision-Making about Maternity Care in Thailand

Culhane‐Pera¹,

Sriphetcharawut²

2015

J Preg Child Health

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“…This finding supports the results of the Multiple Indicator Cluster Survey carried out by the National Statistical Office of Thailand from December 2005 to February 2006 which showed that the inequity of delivery by skilled birth attendants was related to economic, educational and geographic disparity [14]. However, the National Reproductive Health Survey, which was conducted in 2006 and 2009 in Thailand, reported a narrow gap of delivery by skilled birth attendants across geographic areas, women's level of education and household wealth [15]. …”

Section: Discussionmentioning

confidence: 99%

Effect of health insurance on delivery care utilization and perceived delays and barriers among southern Thai women

Liabsuetrakul

Oumudee

2011

BMC Public Health

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BackgroundFinancial reform aims to overcome the problems of financial barriers and utilization of health services. However, it is unclear whether financial reforms or health insurance can reduce delays and/or barriers or if there are still other important obstacles for preventing pregnant women accessing delivery care. This study aimed to assess the effect of health insurance and other factors on delivery care utilization and the perception of delays and barriers to delivery care among women living in Songkhla province, Thailand.MethodsA cross-sectional study was conducted from November 2007 to December 2008. Women who delivered at hospital or home in the areas of participating hospitals in four districts were interviewed at 24- or 48-hours postpartum. The impact of health insurance and other factors on outcomes of interest was assessed using multivariate logistic regression.ResultsOf 2,847 women, 2,822 delivered at a hospital and 25 at home, of which 80% and 40% had health insurance for delivery care, respectively. Muslims, low educated women, those who thought they could not use health insurance for delivery care and those less willing to seek care at their delivery place were more likely to give birth at home. Perception of delays to seeking care, reaching a hospital and receiving care was reduced in women insured by civil servant medical benefit. Women insured by universal coverage and social security perceived a lower delay in reaching a hospital but a higher delay in receiving care. Low education, unwillingness to seek care, out-of-pocket payment, worry about cost of delivery care, transportation difficulties, low perception of receiving good care or a perception of being treated badly were also associated with delays and barriers to health care. Almost all (93%) agreed that health insurance could reduce financial barriers for accessing services. However, having health insurance influenced them to seek care, reach a hospital, and receive care quickly in 50%, 32%, and 23% of the women, respectively.ConclusionsHealth insurance has a significant impact on perceived delays and barriers, but not place of delivery. Socio-economic determinants continue to play an important role for place of delivery and perceived delays and barriers.

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Equity of access to and utilization of reproductive health services in Thailand: national Reproductive Health Survey data, 2006 and 2009

Cited by 35 publications

References 13 publications

Measuring women's perceived ability to overcome barriers to healthcare seeking in Burkina Faso

Measuring women's perceived ability to overcome barriers to healthcare seeking in Burkina Faso

‘We all decided’: The variations of Hmong Family-Based Decision-Making about Maternity Care in Thailand

Effect of health insurance on delivery care utilization and perceived delays and barriers among southern Thai women

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