International Journal of Health Policy and Management

International Journal of Health Policy and Management

Social Determinants of Equity in Access to Healthcare for Tuberculosis Patients in Republic of Macedonia – Results from a Case-Control Study

Document Type : Original Article

Authors
Dance Gudeva Nikovska 1
Fimka Tozija 2
1 Department of Social Medicine, Faculty of Medicine, University Ss. Cyril and Methodius, Skopje, Macedonia
2 National Institute of Public Health, Department of Social Medicine, Faculty of Medicine, University Ss. Cyril and Methodius, Skopje, Macedonia
10.15171/ijhpm.2014.89
Abstract
Background
Health is a complex phenomenon and equity as a basic human right an integral part of constitutions in almost all countries in the world. In Republic of Macedonia (RM), Tuberculosis (TB) is clustered regionally and in certain ethnic groups. The main objective of this study was to analyze Social Determinants of Health (SDH) and equity in access to healthcare services for TB patients in RM, aimed at complex analysis of factors that cause inequities.
 
Methods
Case-control study was conducted in the period March–December, 2013; “cases” are households of TB patients registered in the period July, 2012–June, 2013 and controls are households with no TB patients in their immediate vicinity. World Health Organization (WHO) World Health Survey questionnaire was used to
collect data.
 
Results
Analysis of SDH of TB patients shows that patients are mostly males, of lower socio-economic status, are less educated, unemployed and TB is clustered in certain ethnic groups. Analysis of access has identified these determinants as important barriers in access to health services.
 
Conclusion
The study has documented the basic SDH of TB patients in RM, as well as barriers in access to healthcare, providing useful baseline information to facilitate determination where to concentrate future efforts.
Keywords
Equity
Social Determinants of Health (SDH)
Tuberculosis (TB) Patients
Macedonia
Subjects
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  • Received Date 29 June 2014
  • Revised Date 21 September 2014
  • Accepted Date 21 September 2014
  • First Published Date 21 September 2014
  • Published Date 01 September 2014