Gender role and child health care utilization in Nepal

Department of Tropical Hygiene and Public Health, University of Heidelberg, INF 324, D-69120 Heidelberg, Germany.
Health Policy (Impact Factor: 1.91). 10/2005; 74(1):100-9. DOI: 10.1016/j.healthpol.2004.12.013
Source: PubMed


To study the gender role in child health care utilization in Nepal.
We analysed 8112 individual observations of age </=15 years from 2847 households in 274 communities, obtained from the 1996 Nepal Living Standard Survey. Four steps of a health seeking action, namely illness reporting, choosing an external care, choosing a specific health care provider, and spending money to treat the sick child, were examined using discrete/continuous choice models.
There was no statistically significant difference between boys and girls by demographic, socio-economic and geographical status in the sample. However, gender was associated with all four utilization decision steps. While the net effect of being a boy was modest in illness reporting (p<0.10), it appeared stronger in the choice of external care, in the choice of public provider and in the choice of expenditure with the private provider (p<0.05).
Gender role not only affects illness reporting but also affects the decision to choose a health care provider and how much to spend on the sick child, i.e. it affects the entire steps of a health seeking action.

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Available from: Rachel C Snow, Oct 03, 2014
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    • "The second interpretation is that cost differences reflect intrahousehold resource allocation that disadvantages girls. Several studies have documented reduced health expenditures for girls in low-income settings [26–29]. If resources are limiting care seeking for diarrhea, then it is plausible that girls will bear a greater burden in terms of missed treatment and the resulting negative outcomes. "
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    • "These results differ from previous population-based studies, which reported that girls experienced less chronic malnutrition than boys [32,33]. However, lower mean height-for-age Z-scores for girls might be explained by their increased exposure to inadequate care [34] and negative patterns of healthcare seeking behaviors [32,35,36], which could be aggravated by a mother’s lack of autonomy and control over family resources due to controlling behavior by her partner. Our results are in line with the findings from a cross-sectional study conducted in Nicaragua that found that young girls had higher odds of poor growth than boys [37]. "
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