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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
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, Volume 13, No. 1, Article 157, Year 2013
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Description
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. © 2013Diaz et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Diaz, Theresa
Unknown Affiliation
George, Asha S.
United States, Baltimore
Johns Hopkins University
Rao, Sowmya R.
United States, Worcester
University of Massachusetts Chan Medical School
United States
Va Medical Center
Bangura, Peter Soulaiman
Unknown Affiliation
McMahon, Shannon A.
United States, Baltimore
Johns Hopkins University
Kabano, Augustin
United States, New York
Unicef
Statistics
Citations: 70
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.1186/1471-2458-13-157
ISSN:
14712458
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Study Approach
Qualitative
Quantitative
Study Locations
Sierra Leone