ABSTRACT

Vietnam recently demonstrated a skewed sex ratio at birth. Little research has examined postnatal impacts of son preference in Vietnam, such as in child health care seeking. Past research in other Asian countries with son preference has found that parents are more likely to take sons to a health facility when they are sick, to do so more promptly, and invest more resources in care, than daughters. Using data from a paediatric hospital emergency department, we analyse gender differences in illnesses, referral patterns, and outcomes among children to understand how gender disparities in paediatric hospital admissions arise. Almost twice as many boys were brought into the facility as girls. Compared to girls, boys were significantly more likely to have bypassed lower-level facilities and entered care at the tertiary facility, controlling for severity of illness and socio-demographic characteristics. This suggests parents provide preferential treatment to boys, potentially leading to excess morbidity among girls who become ill. However, we find no significant differences in delay of care seeking or evidence of provider bias. Ensuring that girls are able to access appropriate, quality care when needed, will improve equity of access to care for all children.

摘要

越南最近显示出出生时的性别比例存在偏差。很少有研究检查过越南儿子偏好对产后的影响，例如在寻求儿童保健方面。过去在亚洲其他具有儿子偏爱的国家中进行的研究发现，父母生病的父母比女儿更容易将儿子带到医疗机构，病情要迅速，并在护理上投入更多资源。利用儿科医院急诊科的数据，我们分析了儿童在疾病，转诊方式和结局方面的性别差异，以了解儿科医院入院的性别差异是如何产生的。带进该设施的男孩几乎是女孩的两倍。与女孩相比，男孩更有可能绕过低级机构而进入第三级机构，控制疾病的严重程度和社会人口特征。这表明父母对男孩提供了优惠待遇，有可能导致生病的女孩发病率过高。但是，我们发现就医延误或提供者偏见的证据无显着差异。确保女孩能够在需要时获得适当的优质照料，将提高所有儿童获得照料的公平性。