减少医疗服务提供者的偏见：来自坦桑尼亚、布基纳法索和巴基斯坦的实验证据
Reducing Bias Among Health Care Providers: Experimental Evidence from Tanzania, Burkina Faso and Pakistan
The Economic Journal · 2025 · [{"name": "Zachary Wagner", "affiliation": ["University of Southern California", "Southern States University"]}, {"name": "Corrina Moucheraud", "affiliation": ["New York University"]}, {"name": "Manisha Shah", "affiliation": ["University of California, Berkeley"]}, {"name": "Alexandra Wollum", "affiliation": ["University of California, Los Angeles", "Ibis Reproductive Health"]}, {"name": "Willa Friedman", "affiliation": ["University of Houston"]}, {"name": "William H. Dow", "affiliation": ["University of California, Berkeley"]}]
中文摘要
医疗服务提供者的偏见可能导致医疗服务质量低下和不良健康结果，并可能加剧差距。我们采用随机对照试验，评估了一项旨在减少计划生育服务提供者对年轻女性偏见的干预措施，试验覆盖坦桑尼亚、布基纳法索和巴基斯坦的227家诊所。该干预向服务提供者讲解针对年轻女性的偏见，促进其与其他服务提供者就偏见展开交流，并向偏见最少的诊所颁发非金钱性质的公开奖励。十二个月后，该干预减少了服务提供者带有偏见的态度和观念，并使咨询更加全面。与对照组诊所相比，服务对象也认为自己在干预组诊所获得了更好的对待。尽管报告的偏见有所减少，但在避孕方法发放方面是否发生变化，我们发现的证据并不一致。
Abstract
Abstract Bias among health care providers can lead to poor-quality care and poor health outcomes, and it can exacerbate disparities. We use a randomised controlled trial to evaluate an intervention to reduce family planning provider bias towards young women in 227 clinics in Tanzania, Burkina Faso and Pakistan. The intervention educated providers about bias towards young women, facilitated communication about bias with other providers and offered non-financial public awards to clinics with the least biased care. After twelve months, the intervention led to less biased attitudes and beliefs among providers and more comprehensive counselling. Clients also perceived better treatment at intervention clinics compared to control clinics. Despite reductions in reported bias, we find mixed evidence regarding changes in method dispensing.