“I Wish I Had AIDS”: A qualitative study on access to health care services for HIV/AIDS and diabetic patients in Cambodia

作者

  • C Men University Research Co. LLT. Cambodia
  • B Meessen Institute for Tropical Medicine, Antwerp
  • M van Pelt MoPoTsyo Patient Information Centre, Phnom Penh
  • W Van Damme Institute for Tropical Medicine, Antwerp
  • H Lucas Institute for Development Studies, Brighton

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https://doi.org/10.5195/hcs.2012.67

关键词:

Cambodia, Poor, access to health care, chronic disease, HIV/AIDS, diabetes

摘要

Financially stricken Cambodian patients with diabetes and HIV/AIDS typically encounter multiple, serious barriers to effective care. This process may extend over many years and involve numerous rounds of diagnosis and treatment as the disease progresses from initial symptoms to longer term complications. Living with both the impact of the disease and this ongoing struggle for care can severely disrupt the everyday life of both sufferers and their families.

Our retrospective study adopted qualitative research methods to collect data from HIV/AIDS and diabetic patients enrolled and not enrolled in treatment programs at varying institutions in urban and rural settings. Using purposive sampling techniques, a total of 25 HIV/AIDS and 45 diabetic patients were recruited. Semi-structured and open-ended interviews were used to collect information on patient experiences of different phases in the on-going process of seeking care and treatment. The findings indicate that both HIV/AIDS and diabetic patients encounter multiple supply- and demand-side barriers to care at different stages of their illness. More strikingly, our research findings suggest that supply-side barriers, for example rationing systems or targeting strategies that limit access to free treatment or social assistance, are substantially higher for diabetic patients. This perceived inequity had a profound impact on diabetic patients to the extent that some “wished they had HIV/AIDS”.

These findings suggest that there is an urgent need to widen the focus of health care to address the substantial and increasing burden of disease resulting from diabetes and other serious chronic disorders in Cambodia and many other low/middle income countries.

 

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Chean Men is Deputy Director for Research-Community Based Health. He has researched and published extensively on health equity, financing and access. In addition to this, Dr. Men has led important expert-patient Q&A panels, as well as keynote events

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Dr. Bruno Messsen is a health economist in the Department of Public Health, ITM. Dr. Meessen is a has extensive experience with health intervention studies

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Maurits van Pelt is the Director of the MoPoTsyo Patient Information Centre in Cambodia

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Dr. Wim Van Damme is a professor in the Department of Public Health, ITM. He is an expert in health policy who has been involved intensively in health care organization and in research in Cambodia for nearly 10 years. When he was the medical co-coordinator for Médecins Sans Frontières in Cambodia (1999-2002), he launched that country’s first health equity fund.

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Dr. Henry Lucas is a statistician focusing on health management information systems and the financing of health care in rural China. He is also interested in micro-computer based economic planning models using social accounting matrices, information systems for human resource planning, and social indicators. He is Director, Statistics for Development Policy, IDS

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已出版

2012-03-23

期

卷 2 编号 1 (2012): Health System Dynamics and Barriers

栏目

Articles

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