EFFECTS OF SOCIOECONOMIC DISADVANTAGE AND WOMENS STATUS ON WOMENS HEALTH IN CAMEROON

Research on the effects of socioeconomic disadvantage and women's stat us on women's health is important For policy makers in developing coun tries, where limited resources make it crucial to use existing materna l and child health care resources to the best advantage. Using a commu nity-based data set collected prospectively in Cameroon, this study at tempts to understand the extent to which socioeconomic factors and wom en's status have influences on women's health. The most import ant fin ding is that the burden of illness rests disproportionately on the eco nomically disadvantaged women and on those with low social status. The long-term effects of social disadvantage are apparent in the excesses of morbidity among women who are not employed at the time of their ch ildren's birth, women living in poor neighborhoods, and those living i n households without modern amenities. The maternal morbidity patterns during the postpartum period indicate that the women's reports of the ir recovery and health status from childbirth extend far beyond the fi rst few weeks that previous studies have focused on. From a theoretica l perspective, this study has demonstrated the importance of the ''int ermediate'' framework for the study of women's health: the operations of effects of a number of background characteristics are mediated by m ore proximate determinants of women's health. These results remain rob ust even after controlling for other measured factors and after correc ting for unmeasured heterogeneity and sample selection; this helps to dismiss the potential influence of some artifacts. While this study su ggests that there are opportunities within the existing health care sy stem for meeting many of the health care needs of the socially disadva ntaged, further biobehavioral and psychosocial research is needed to d etermine how women's status and social disadvantage influence the dema nd for health care services, in order to ensure equitable as well as a more effective delivery of health care services and to break the vici ous circle of disadvantage. (C) 1997 Elsevier Science Ltd.