Gender inequity in health: why it exists and how we can change it

Background. Tuberculosis (TB) notification in South Africa has increased six-fold over the past two decades, mainly because of the HIV epidemic. Objectives. To describe the sociodemographic and outcome characteristics of TB patients, and to identify risk factors associated with TB treatment outcomes stratified by HIV status. Methods. A cross-sectional study was used to analyse data from the Cape Town Metro East geographical service area (GSA) electronic TB register (ETR.Net), including adult patients aged ≥15 years who initiated TB treatment between 1 July 2011 and 30 June 2012. Results. TB case notification in the GSA was 922 per 100 000 population. Of the 12 672 TB patients registered, 50.5% were co-infected with HIV. The death rate in co-infected patients was 5.4% v. 2.8% in HIV-negative patients, the rate of treatment success 66.6% v. 73.5%, and the rate of unfavourable treatment outcome 28.1% v. 23.7%. The Khayelitsha subdistrict had the highest proportion of TB burden (37.0%) and co-infection (47.6%). Fourteen percent of patients had extrapulmonary TB, 65.9% of whom were co-infected with HIV. In the multivariate analysis, HIV infection (relative risk (RR) 1.2), retreatment (RR 1.4) and sputum smear microscopy not done (RR 1.4) were significantly associated with unfavourable treatment outcome. The Eastern (RR 0.9) and Northern (RR 0.7) subdistricts were less likely to have unfavourable outcomes compared with Khayelitsha. In the stratified analysis, retreatment and smear not done were significant risk factors for an unfavourable treatment outcome in both co-infected and HIV-negative patients. Conclusions. The burdens of both TB and co-infection were high in this community, although HIV prevalence varied. Mortality was higher and treatment completion lower in co-infected patients than in those who were HIV-negative. Co-infection, previous TB treatment and smear not done were significant risk factors for an unfavourable outcome in all patients.

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“…In contrast to other studies, [36] the present study showed no difference in treatment outcome between the sexes.…”

Section: Researchcontrasting

confidence: 55%

Influence of HIV and other risk factors on tuberculosis

Mahtab

Coetzee

2017

S Afr Med J

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“…Great attention should be given to girl's and women's health (30) as well as to the health condition of their babies being born; early childhood development (ECD) program should be implemented (31); girls' and boys' education should be facilitated; living and working condition and social support should be improved for everyone; and a healthy, happy, and flourishing life should be facilitated for the elderly. In addition, measures should be taken against inequity in wealth, resources, and social power; the obstacles should be recognized and proper measures should be taken to remove them (32).…”

Section: Resultsmentioning

confidence: 99%

Health System, Health Equity

et al. 2017

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Many health issues have their roots in social aspects of everyday life. In this regard, health should be considered not only a biological matter but also more importantly a social subject. In this study, we reviewed important aspects that should be acknowledged by health system in achieving health equity, considering social determinants of health (SDH). Google Scholar was searched with relevant key words. We also reviewed the documents of world health organization (WHO) relevant to SDH and health equity. Finally, based on this review, we have presented the measures that should be taken by health system to achieve health equity.

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“…Various studies also agree that women's empowerment provides better access to health and wellness. 23,24,25 The Sikkim model of empowerment by involving woman in various small and medium scale industry have always got good returns. Moreover Goa's open culture and assertiveness of women brings out the sense of empowerment among women.…”

Section: Nutritional Status and Anaemiamentioning

confidence: 99%