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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
The impact of distance of residence from a peripheral health facility on pediatric health utilisation in rural western Kenya
Tropical Medicine and International Health, Volume 14, No. 1, Year 2009
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Description
Objective To explore the impact of distance on utilisation of peripheral health facilities for sick child visits in Asembo, rural western Kenya. Methods As part of a demographic surveillance system (DSS), censuses of all households in the Asembo population of 55 000 are conducted three times a year, data are collected at all outpatient pediatric visits in seven DSS clinics in Asembo, and all households are GIS-mapped and linkable to a child's unique DSS identification number. Between May 1, 2003 and April 30, 2004, 3501 clinic visits were linked to 2432 children among 10 973 DSS-resident children < 5 years of age. Results Younger children and children with more severe illnesses travelled further for clinic visits. The median distance travelled varied by clinic. The rate of clinic visits decreased linearly at 0.5 km intervals up to 4 km, after which the rate stabilised. Using Poisson regression, controlling for the nearest DSS clinic for each child, socio-economic status and maternal education, and accounting for household clustering of children, for every 1 km increase in distance of residence from a DSS clinic, the rate of clinic visits decreased by 34% (95% CI, 31-37%) from the previous kilometer. Conclusion Achieving equity in access to health care for children in rural Kenya will require creative strategies to address a significant distance-decay effect in health care utilisation. © 2008 Blackwell Publishing Ltd.
Authors & Co-Authors
Feikin, Daniel R.
United States, Atlanta
Centers for Disease Control and Prevention
Kenya, Nairobi
Kenya Medical Research Institute
United States, Atlanta
National Center for Preparedness, Detection, and Control of Infectious Diseases
Nguyen, Ly Minh
United States, Atlanta
National Center for Preparedness, Detection, and Control of Infectious Diseases
Adazu, Kubaje
Kenya, Nairobi
Kenya Medical Research Institute
Ombok, Maurice Ochieng
Kenya, Nairobi
Kenya Medical Research Institute
Audi, Allan O.
Kenya, Nairobi
Kenya Medical Research Institute
United States, Atlanta
National Center for Preparedness, Detection, and Control of Infectious Diseases
Slutsker, Laurence
Kenya, Nairobi
Kenya Medical Research Institute
United States, Atlanta
Centers for Disease Control and Prevention
Lindblade, Kim A.
Kenya, Nairobi
Kenya Medical Research Institute
United States, Atlanta
Centers for Disease Control and Prevention
Statistics
Citations: 214
Authors: 7
Affiliations: 3
Identifiers
Doi:
10.1111/j.1365-3156.2008.02193.x
ISSN:
13602276
e-ISSN:
13653156
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Cross Sectional Study
Study Locations
Kenya