Literacy and healthcare-seeking among women with low educational attainment: analysis of cross-sectional data from the 2011 Nepal demographic and health surveyReportar como inadecuado




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International Journal for Equity in Health

, 12:95

First Online: 13 December 2013Received: 08 July 2013Accepted: 01 December 2013DOI: 10.1186-1475-9276-12-95

Cite this article as: Lam, Y., Broaddus, E.T. & Surkan, P.J. Int J Equity Health 2013 12: 95. doi:10.1186-1475-9276-12-95

Abstract

IntroductionResearch suggests that literacy plays a key role in mediating the relationship between formal education and care-seeking among women in developing countries. However, little research has examined literacy’s role independently from formal education. This differentiation is important, as literacy programs and formal schooling entail distinct intervention designs and resources, and may target different groups. To assess the relationship between literacy and healthcare-seeking among Nepali women of low educational attainment, we analyzed data from the 2011 Nepal Demographic and Health Survey DHS.

MethodsFrom the 2011 Nepal DHS, our sample consisted of 7,020 women who had attained at most a primary school level of education, and a subsample of 4,875 women with no formal schooling whatsoever. We assessed associations between literacy and four healthcare-seeking outcomes: whether women identified -getting permission- as a barrier to accessing care; whether women identified -not wanting to go alone- as a barrier; whether among women who were married-partnered, the woman had some say in making decisions about her own health; and whether among women who experienced symptoms related to sexually-transmitted infections STIs in the past year, treatment was sought. We performed simple and multiple logistic regressions, which adjusted for several socio-demographic covariates.

ResultsLiteracy was associated with some aspects of healthcare-seeking, even after adjusting for socio-demographic covariates. Among women with no more than primary schooling, literate women’s odds of identifying -getting permission- as a barrier to healthcare were 23% less than illiterate women’s odds p = 0.04. For married-partnered women, odds of having some say in making decisions related to their health were 37% higher p = 0.002 in literate than illiterate women. Comparing literate to illiterate women in the subsample with no formal schooling, odds of reporting -getting permission- as a barrier were 35% lower p = 0.01, odds of having a decision-making say were 57% higher p < 0.001, and odds of having sought care for experiences of STI-related symptoms were 86% higher p = 0.04.

ConclusionsFurther research should be undertaken to determine whether targeted literacy programs for those past normal schooling age lead to improved healthcare-seeking among Nepali women with little or no formal education.

KeywordsNepal Literacy Women Agency Healthcare decision-making Care-seeking Healthcare access Social epidemiology Social determinants of health Electronic supplementary materialThe online version of this article doi:10.1186-1475-9276-12-95 contains supplementary material, which is available to authorized users.

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Autor: Yukyan Lam - Elena T Broaddus - Pamela J Surkan

Fuente: https://link.springer.com/







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