Health access livelihood framework reveals potential barriers in the control of schistosomiasis in the Dongting Lake area of Hunan Province, China

Balen, Julie, Liu, Zhao-Chun, McManus, Donald P., Raso, Giovanna, Utzinger, Juerg, Xiao, Shui-Yuan, Yu, Dong-Bao, Zhao, Zheng-Yuan and Li, Yue-Sheng (2013) Health access livelihood framework reveals potential barriers in the control of schistosomiasis in the Dongting Lake area of Hunan Province, China. PLoS Neglected Tropical Diseases, 7 8: e2350.1-e2350.11. doi:10.1371/journal.pntd.0002350


Author Balen, Julie
Liu, Zhao-Chun
McManus, Donald P.
Raso, Giovanna
Utzinger, Juerg
Xiao, Shui-Yuan
Yu, Dong-Bao
Zhao, Zheng-Yuan
Li, Yue-Sheng
Title Health access livelihood framework reveals potential barriers in the control of schistosomiasis in the Dongting Lake area of Hunan Province, China
Journal name PLoS Neglected Tropical Diseases   Check publisher's open access policy
ISSN 1935-2727
1935-2735
Publication date 2013-08-01
Sub-type Article (original research)
DOI 10.1371/journal.pntd.0002350
Open Access Status DOI
Volume 7
Issue 8
Start page e2350.1
End page e2350.11
Total pages 11
Place of publication San Francisco, CA, United States
Publisher Public Library of Science
Collection year 2014
Language eng
Formatted abstract
Background: Access to health care is a major requirement in improving health and fostering socioeconomic development. In the People's Republic of China (P.R. China), considerable changes have occurred in the social, economic, and health systems with a shift from a centrally planned to a socialist market economy. This brought about great benefits and new challenges, particularly for vertical disease control programs, including schistosomiasis. We explored systemic barriers in access to equitable and effective control of schistosomiasis.

Methodology: Between August 2002 and February 2003, 66 interviews with staff from anti-schistosomiasis control stations and six focus group discussions with health personnel were conducted in the Dongting Lake area, Hunan Province. Additionally, 79 patients with advanced schistosomiasis japonica were interviewed. The health access livelihood framework was utilized to examine availability, accessibility, affordability, adequacy, and acceptability of schistosomiasis-related health care.

Principal Findings: We found sufficient availability of infrastructure and human resources at most control stations. Many patients with advanced schistosomiasis resided in non-endemic or moderately endemic areas, however, with poor accessibility to disease-specific knowledge and specialized health services. Moreover, none of the patients interviewed had any form of health insurance, resulting in high out-of-pocket expenditure or unaffordable care. Reports on the adequacy and acceptability of care were mixed.

Conclusions/Significance: There is a need to strengthen health awareness and schistosomiasis surveillance in post-transmission control settings, as well as to reduce diagnostic and treatment costs. Further studies are needed to gain a multi-layered, in-depth understanding of remaining barriers, so that the ultimate goal of schistosomiasis elimination in P.R. China can be reached.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Public Health Publications
 
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