title: Gender and leprosy: case studies in Indonesia, Nigeria, Nepal and Brazil.
abstract: There appear to be regional differences in gender ratios of leprosy patients being diagnosed and treated. In Asian countries, more men than women are registered whilst in Africa female patients outnumber males. The Netherlands Leprosy Relief (NLR) therefore initiated research into factors underlying these regional gender differences. Between 1997 and 1999, leprosy control teams in Indonesia, Nigeria, Nepal and Brazil supported by social/public health scientists, conducted comparative exploratory research. They looked at three groups of potential explanatory factors: biological, socio-cultural/economic and service-related. The studies were partially quantitative (analysis of the records of patients who according to prescription could have completed treatment) and partially qualitative (interviews/focus group discussions with patients, their relatives, community members and health staff on perceptions of leprosy, its socio-economic consequences, treatment and cure). Biological factors appeared similar in the four countries: irrespective of the M/F ratio, more men than women were registered with multibacillary (MB) leprosy. Strong traditions, the low status of women, their limited mobility, illiteracy and poor knowledge of leprosy appeared to be important sociocultural factors explaining why women were under reporting. Yet, accessible, well reputed services augmented female participation and helped to diminish stigma, which in three out of the four societies seemed greater for women than for men. These positive effects could still be higher if the services would enhance community and patient education with active participation of patients and ex-patients themselves.
authors.affiliation: Royal Tropical Institute, Amsterdam, The Netherlands. corlienv@tiscali.nl
authors.forename: Corlien M
authors.initials: CM
authors.lastname: Varkevisser
authors.forename: Peter
authors.initials: P
authors.lastname: Lever
authors.forename: Ogoh
authors.initials: O
authors.lastname: Alubo
authors.forename: Kamala
authors.initials: K
authors.lastname: Burathoki
authors.forename: Cut
authors.initials: C
authors.lastname: Idawani
authors.forename: Tatiana M A
authors.initials: TM
authors.lastname: Moreira
authors.forename: Phillip
authors.initials: P
authors.lastname: Patrobas
authors.forename: Media
authors.initials: M
authors.lastname: Yulizar
mesh_terms: D001938:Brazil / Q000453:epidemiology; D005069:Evaluation Studies as Topic; D005260:Female; D005783:Gender Identity; D007722:Health Knowledge, Attitudes, Practice; D054625:Healthcare Disparities; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007407:Interviews as Topic; D007918:Leprosy / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D009390:Nepal / Q000453:epidemiology; D009549:Nigeria / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D011287:Prejudice; D036301:Qualitative Research; D017678:Sex Distribution; D012737:Sex Factors; D012934:Social Isolation; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires