Increasing urbanization and population density, and persisting
inequities in health outcomes across socioeconomic groupings have raised
concerns internationally regarding the health of the urban poor.
These concerns are also evident
in Cambodia, which prompted the design of a study to identify and describe the
main barriers to access to health services by the poor in the capital city,
Phnom Penh. Sources and Methods Main sources of data were through a household
survey, followed by in-depth qualitative interviews with mothers, local
authorities and health centre workers in four very poor communities in Phnom
Penh. Main findings Despite low incomes and education levels, the study
communities have moderate levels of access to services for curative and
preventive care.
However, qualitative findings
demonstrate that households contextualize poor health and health access in
terms of their daily living conditions, particularly in relation to
environmental conditions and social insecurity. The interactions of low
education, poor living conditions and high food costs in the context of low and
irregular incomes reinforce a pattern of "living from moment to
moment" and results in a cycle of disadvantage and ill health in these
communities.
There were three main factors
that put poor communities at a health disadvantage; these are the everyday
living conditions of communities, social and economic inequality and the extent
to which a society assesses and acts on inequities in their health care access.
Conclusions: In order to improve
access to health and health services for the urban poor, expansion of public
health functions and capacities will be required, including building partnerships
between health providers, municipal authorities and civil society.
Author: Sann Chan SoeungJohn
GrundyHean SokhomDiana Chang BlancRasoka Thor
Credits/Source: International
Journal for Equity in Health 2012, 11:46
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