Study On Gender And Health Equity In Poor Rural Areas

1.ObjectivesThrough investigating the health status and behavior of seeking health services of the women and girls in poor rual areas, and analyzing the characterization and factors of utilizing health resources, to research the feasible strategies of improving the gendered health equity, and provide evidences and comments to the policy-makers.2.MethodsLiteriture study method. Read the relevant studies and documents to learn what theothers have done and the current conditions. Use the local materials and information of sociology, statisticology and other health data.Semi-structural interview and focus group discussion. To investigate the attitudes to gender and health equity of government, health services provider and users.Data analysis. Use gender analysis methods for the qualitative data and Miicrosoft Excel and SPSS (version12.0) for the quatititive data.3.Results3.1 Gerder equity in the social living.The investigation shows that there are significant differences between women and men on the decisions in households such as the important expenditures and issues. Most of those dicisions were decided by the husband or both, few were by wife only.The head of the household is always adult men who has absolute position and rights than other members. The best foods is always allocated to the elder, younger and husband sequencely, compared that the housewife ates the left. The wife always goes to the bed later and get up earlier than husband. In using family planning methods, absolutely most choices will be ligation and cervix ring which related the women's body, only less than 1% men received reining.There is relative equity during the process of rural work. The men do the heavy work and the women do the light which is also the tradition of the China.Under the limited economic conditions, the girls face higer risks of losing school education than boys, and also the worse nutrition. There are still throwing girl babies happened occationally.In the households the position of women are always lower than men, girls lower than boys, housewives lower than children and elders.In the process of attending selection of village committee, there is significantly lower participation of women than men.Gerdered social norms affect the nutrition, health hygiene, recognization to the health problems, behavior of seeking health services and obtaining of services, and furthermore the health status and well-being of the women and girls. The gendered norms showed different styles in different stages of the human being and was strengthened along with the aging.3.2 Health delivery system and gender equityShown from the survey of health delivery system, the counties health system could not provide the adequate services based on the gender equity. The infrastructure, equipments and the skills of health staffs could not meet the health needs of the population, especially the women and girls.Evidences show that the women obtained less health services than men. The non-gendered symptoms of women were treated as the ordinary. Sometimes the health needs of the women were"neglected"by the other members in the households because of their lower position. The gendered norms resulted that more resources were allocated to men. The women and girls may suffer more serious health damage than other members because of the less resources control even they need more reproductive health services.The institution survey shows that the women health workers occupied more less important and lower payment positions than men workers, even though there are more women health workers than men in the absolute numbers.3.3 Health financing and gender equityThe attibution from the total health expenditure to the poorest and poorer people (five groups based on the income) on was 6.21% and 10.14% respectively, but the attribution to the richest and richer was 30.44% and 37.73% respectively. It's quite lower of the poor than the rich. For the subsidy on outpatient and inpatient sercives, the poorest obtained 15.05% and 5.75% respectively, compared with the richest obtained 27.48% and 30.60% respectively. The equity and efficiency was low.The government did not consider gender issues during the process of health resources allocation. The resources were simply transferred to MCH and family planning such like this.3.4 Health status and gender equityTwo-week mobility was 225‰and 197‰respectively of women and men. The sub-group of 35-44 years old was both the highest, 28.7% and 35.1% respectively. About the self-judged illness, more men felt ordinary but more women felt serious, the ratio is 48% and 39.2% respectively.Of those never seeking health services people, men 37.5% and women 62.5%, including 12.5% girls. The reasons of never seeing doctor were mainly no money, no time or unbelieve the doctors.The average cost of those self-treated was 78 Yuan of men and 56 Yuan of women, having statistic difference.The mobility of chronic diseases is 99.3‰using the case number devided by total number, women is lower than men. But if using the mobility number devided by total number, the rate is 110.4‰, women is higher than men. It may indicate that women is likely easier going to illness than men.The self-reported RTIs is high but relatively less women going to see doctor. The deficiency of the actural health behaviors reflected the insufficiency and inequity of women in health service utilization.The average times of immunization of girls were less than the boys, having statistic significant.Generally, the health status of women and girls was worse than the men and boys. And the women seeking less health services than men.4.Policy comments4.1 Enhance the education to the population and women, including the women health workers, and increase the capacity of women.4.2 Set up laws to regulate the equal social norms and eliminate the gender bias.4.3 The government staff should be trained on the knowledge of gerder equity and gender analysis methods. The gender equity during the process of health resources allocation should be strengthened. Encourage the gender mainstreaming.4.4 The health delivery system should change to optimize the service items, increase the responsiveness and efficiency to meet the health needs of women and girls.4.5 Set up effective health security system. At the same time of increasing the health budget to the rural residents, the government should explore the strategies of improving gender health equity of financing process and subsidiary process.4.6 Empowering the women and communities and leave spaces and conditions to women for their gender equity development.4.7 Organize and support researches on gender and health equity issues. The course of gender and health equity may be arranged into the education of graduated students in the future in the fields of social medicine, public health and health policies.5. Innovations of the study5.1 The study researched the health equity issues from the perspective of gender. The other former health equity studies mainly focused on financing process and health outcomes in different economic status and areas, rarely discussed the relation of gender and health equity. This study concluded the inequity between women and men with evidences and raised practical suggestions to the policy makers. It's innovative in the current native studies.5.2 The study did the research based on the women in families and communities. It has more practical values than women individual based.