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发展中国家的健康公平问题已经引起国际社会关注 ,性别造成的不公平在女童中更为突出。该文利用1993年及 1998年两次全国卫生服务调查结果 ,对中国儿童健康状况和卫生服务可及性指标进行分析 ,发现性别差异造成的不公平现象十分明显。在各组儿童中 ,贫困农村地区的女孩处于两个极端 :在健康状况方面 ,她们是最差的 ,而在享受最基本的卫生服务方面 ,她们却获得最少 (在患危重疾病应当住院治疗的女孩中竟有 2 8.6 %未能获得住院治疗服务 ) ,这至少也是与近年来中国 5岁以下女孩死亡率比男孩增高有关的因素之一。这个现象在发展中国家普遍存在 ,但在35个发展中国家的国家卫生服务调查中 ,由于采用一般指标 (如两周患病率 ,门诊利用率等 )却很难发现明显差异。该文使用因病卧床率及按医嘱应住院治疗却未能住的比例和患儿中未作任何处理的比例这几项比较敏感的指标进行分析 ,证明了这个事实。关于影响贫困农村地区女孩的卫生服务可及性的有关社会因素 ,本文根据因病卧床天数和卧床率这两个反映患危重疾病状况指标与医生建议住院治疗指标的强烈反差这一令人费解的事实 ,进行了初步探讨
The issue of health equity in developing countries has drawn the concern of the international community that gender inequalities are more prominent among girls. Based on the results of two national health service surveys conducted in 1993 and 1998, this article analyzes the indicators of children’s health and the accessibility of health services in China and finds that the inequities caused by gender differences are quite obvious. Among children in each group, girls in impoverished rural areas are at two extremes: they are the worst in terms of health status, and they receive the least access to basic health services (hospitalizations in critically ill conditions As a result, 22.6% of girls did not have access to inpatient treatment services), which is at least one of the factors related to the higher death rate of girls under 5 in China than boys in recent years. This phenomenon is prevalent in developing countries. However, in the national health service survey of 35 developing countries, it is difficult to find significant differences due to the adoption of general indicators (such as two-week prevalence and outpatient utilization). This article uses the fact that the bedridden rates and the proportion of those who can not stay after being hospitalized according to doctor’s orders and the proportion of children without any treatment are more sensitive indicators. Concerning the social factors affecting the accessibility of health services to girls in poor rural areas, based on the inexplicable number of days of bedridden and bed-ridden patients that reflect the strong contrast between indicators of critical illness and those recommended by doctors for hospitalization, Facts, conducted a preliminary discussion