Healthcare seeking for diarrhoea, malaria and pneumonia among children in four poor rural districts in Sierra Leone in the context of free health care: results of a cross-sectional survey
Authors
Diaz, TheresaGeorge, Asha S.
Rao, Sowmya R.
Bangura, Peter S.
Baimba, John B.
McMahon, Shannon A.
Kabano, Augustin
UMass Chan Affiliations
Department of Quantitative Health SciencesDocument Type
Journal ArticlePublication Date
2013-02-20Keywords
Child, PreschoolCross-Sectional Studies
Delivery of Health Care
Diarrhea
Female
Focus Groups
Health Services Accessibility
Humans
Infant
Malaria
Male
Parents
Patient Acceptance of Health Care
Pneumonia
Poverty Areas
Qualitative Research
*Rural Population
Sierra Leone
Health Services Administration
International Public Health
Maternal and Child Health
Pediatrics
Metadata
Show full item recordAbstract
BACKGROUND: To plan for a community case management (CCM) program after the implementation of the Free Health Care Initiative (FHCI), we assessed health care seeking for children with diarrhoea, malaria and pneumonia in 4 poor rural districts in Sierra Leone. METHODS: In July 2010 we undertook a cross-sectional household cluster survey and qualitative research. Caregivers of children under five years of age were interviewed about healthcare seeking. We evaluated the association of various factors with not seeking health care by obtaining adjusted odds ratios and 95% confidence limits using a multivariable logistic regression model. Focus groups and in-depth interviews of young mothers, fathers and older caregivers in 12 villages explored household recognition and response to child morbidity. RESULTS: The response rate was 93% (n=5951). Over 85% of children were brought for care for all conditions. However, 10.8% of those with diarrhoea, 36.5% of those with presumed pneumonia and 41.0% of those with fever did not receive recommended treatment. In the multivariable models, use of traditional treatments was significantly associated with not seeking outside care for all three conditions. Qualitative data showed that traditional treatments were used due to preferences for locally available treatments and barriers to facility care that remain even after FHCI. CONCLUSION: We found high healthcare seeking rates soon after the FHCI; however, many children do not receive recommended treatment, and some are given traditional treatment instead of seeking outside care. Facility care needs to be improved and the CCM program should target those few children still not accessing care.Source
Diaz T, George AS, Rao SR, Bangura PS, Baimba JB, McMahon SA, Kabano A. Healthcare seeking for diarrhoea, malaria and pneumonia among children in four poor rural districts in Sierra Leone in the context of free health care: results of a cross-sectional survey. BMC Public Health. 2013 Feb 20;13:157. doi: 10.1186/1471-2458-13-157. Link to article on publisher's siteDOI
10.1186/1471-2458-13-157Permanent Link to this Item
http://hdl.handle.net/20.500.14038/30079PubMed ID
23425576Related Resources
Link to Article in PubMedRights
Copyright 2013 Diaz et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.ae974a485f413a2113503eed53cd6c53
10.1186/1471-2458-13-157
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