Social Factors That Affect Late Schistosomiasis Control In Hunan Province

OBJECTIVES To explore, from the perspective of social medicine, the importance of strengthening late stage schistosomiasis control and related social barriers to prevention and treatment of late stage schistosomiasis in Hunan Province, so as to provide decision-making basis for establishing strategies by related departments for late stage schistosomiasis control, by retrospectively reviewing the process of schistosomiasis control, related policies and data on epidemic situation, quantitatively studying social demography, socioeconomics,health seeking behavior, medical cost and living quality of the patients with late stage schistosomiasis, and qualitatively studying late stage schistosomiasis cases and anti-schistosomiasis professionals.METHODS Literature and document review was carried out to review the process and system of schistosomiasis control, and the changes in related policies and epidemic situation during the past 20 years. Self-made questionnaire and tables assessing life quality were used to collecting data by interviewing 94 late stage schistosomiasis patients. In-depth interviews were introduced to make qualitative study on 61 late stage schistosomiasis patients, 14 anti-schistosomiasis officials, 46 clinicians and 5 experts. Sampling was accidental and judgmental. Data analysis included secondary- analysis, trend analysis, t test, analytic comparison and illustration.RESULTS There are difference between existing and anticipative effectiveness on late stage schistosomiasis control in Hunan Province, and health resources couldn't correspond to the changes in epidemic situation. 94 late stage schistosomiasis patients were included in this study, with an average age of 56.55?0.01 and an average educational period of 4.73^3.93. 126 subjects were interviewed, including 61 late stage schistosomiasis patients, 65 clinicians, anti-schistosomiasis managers and experts. The patients with late stage schistosomiasis tend to be old, with lower education and income, much higher burden of medication cost, poor sense of their own health, and lack of an efficientiii"close-to-client" system. The financing of anti-schistosomiasis health care services poorly met the needs of anti-schistosomiasis control. Health resources lacked in quality, which made epidemic situation of late stage schistosomiasis under poor surveillance. Health services had poor accessibility and anti-schistosomiasis had lower science and technology. Anti-schistosomiasis institution only had limited ability to provide health services. Health resources integrated poorly in endemic areas, with lower reactivity and equity. Financing of anti-schistosomiasis system was difficult, lacking in coordination between each related departments, and thus lacking in health safeguard system and effective measures of social help.CONCLUSIONS Jt is very important for the prevention and treatment of late stage schistosomiasis. Social barriers to prevention and treatment of late stage schistosomiasis are related with the patients themselves, providers of health services and outer environment. The patients have poor sense of their own health and can't appropriately select health services. The ability to provide health services can't meet actual needs by anti-schistosomiasis system. Anti-schistosomiasis system lacks an efficient "close-to-client" system, and it's difficult to provide high-quality health services. The government doesn't carry out all-professional management of health system, which makes health resources difficult to integrate and thus have poor reactivity and equity. Difficulty in financing anti-schistosomiasis system and lack in coordination between departments make the residents short of necessary health safeguard system and effective measures of social help in epidemic areas. Late stage schistosomiasis control needs active support from related governmental departments, information exchange, resources integration and harmonization between anti-schistosomiasis institutions and other medical institutions, and active cooperation of late st...