Childhood diarrhoea management practices in Bangladesh: private sector dominance and continued inequities in care

Larson, Charles P.; Saha, Unnati Rani; Islam, Rafiqul; Roy, Nikhil

doi:10.1093/ije/dyl167

Cited by 65 publications

(59 citation statements)

References 16 publications

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“…The quality of care at private health facilities may also vary by income. 52 Among patients who can afford care, those with lower income may not receive as high level of care as those with higher income.…”

Section: Discussionmentioning

confidence: 99%

Availability and Quality of Emergency Obstetric and Newborn Care in Bangladesh

Wichaidit

Alam

Halder

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Bangladesh's maternal mortality and neonatal mortality remain unacceptably high. We assessed the availability and quality of emergency obstetric care (EmOC) and emergency newborn care (EmNC) services at health facilities in Bangladesh. We randomly sampled 50 rural villages and 50 urban neighborhoods throughout Bangladesh and interviewed the director of eight and nine health facilities nearest to each sampled area. We categorized health facilities into different quality levels (high, moderate, low, and substandard) based on staffing, availability of a phone or ambulance, and signal functions (six categories for EmOC and four categories for EmNC). We interviewed the directors of 875 health facilities. Approximately 28% of health facilities did not have a skilled birth attendant on call 24 hours per day. The least commonly performed EmOC signal function was administration of anticonvulsants (67%). The quality of EmOC services was high in 33% and moderate in 52% of the health facilities. The least common EmNC signal function was kangaroo mother care (7%). The quality of EmNC was high in 2% and moderate in 33% of the health facilities. Approximately one-third of health facilities lack 24-hour availability of skilled birth attendants, increasing the risk of peripartum complications. Most health facilities offered moderate to high quality services for EmOC and low to substandard quality for EmNC.

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Section: Discussionmentioning

confidence: 99%

Availability and Quality of Emergency Obstetric and Newborn Care in Bangladesh

Wichaidit

Alam

Halder

et al. 2016

The American Society of Tropical Medicine and Hygiene

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show abstract

“…63,64 Perhaps tellingly it is also omitted in the conceptual framework of the WHO Commission on Social Determinants of Health. 57 Studies to date have focused mainly on household-level disparities by socioeconomic or rural/urban status [65][66][67][68] or individual-(including intrahousehold-) level differences by gender or children's age. [69][70][71][72] With one or two exceptions, 47,71 no research has directly examined the role of (old) age as a determinant of differential healthcare access.…”

Section: Impacts On Progress Towards Achieving the Mdgsmentioning

confidence: 99%

Understanding and Advancing the Health of Older Populations in sub-Saharan Africa: Policy Perspectives and Evidence Needs

Aboderin

2010

Public Health Rev

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Background: Debate on policy challenges associated with the health of older populations in sub-Saharan Africa (SSA) has intensified in recent years, centering on a concern about older persons' vulnerability to ill-health and their exclusion from health services. Despite international policy calls and formal expressions of commitment on the part of SSA governments, comprehensive policy action has remained scant. The impasse reflects a lack of political will and an uncertainty about required policy approaches, engendered by wide gaps in understanding of old age-related health in the region. Purpose: The purpose of the paper is to pinpoint major approaches and areas of evidence needed as a priority to overcome the impasse in policy on ageing and health in SSA. Methodology: A critical review of relevant SSA and international scientific, policy and development literature conducted as part of a research project on Dimensions and determinants of health in old age in Kenya and Nigeria: implications for policy. Results: Six major areas of evidence and a spectrum of approaches are required to (i) strengthen the case on why action on old age-related health should be pursued in the SSA setting and (ii) clarify what concrete forms such action should take. Conclusion: A systematic research endeavour on the six areas is needed to advance policy and practice on the health of older populations in SSA. If accompanied by an explicit international comparative perspective such research also has the potential to significantly advance scientific debate on ageing and health globally.

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“…A study from Bangladesh displayed a similar pattern, finding that lower income children were more likely to seek treatment of diarrhea at unlicensed providers, and as a result, was less likely to receive ORT. 30 Another study from Lao found that facilities visited by poorer patients were less capable of providing diagnostics, examinations, or appropriate advice. 31 Recently, the global health community has emphasized the role of the private sector in filling voids in health care where the public sector is inadequate.…”

Section: Discussionmentioning

confidence: 99%

Private Sector Provision of Oral Rehydration Therapy for Child Diarrhea in Sub-Saharan Africa

Sood

Wagner²

2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Although diarrheal mortality is cheaply preventable with oral rehydration therapy (ORT), over 700,000 children die of diarrhea annually and many health providers fail to treat diarrheal cases with ORT. Provision of ORT may differ between for-profit and public providers. This study used Demographic and Health Survey data from 19,059 children across 29 countries in sub-Saharan Africa from 2003 to 2011 to measure differences in child diarrhea treatment between private for-profit and public health providers. Differences in treatment provision were estimated using probit regression models controlling for key confounders. For-profit providers were 15% points less likely to provide ORT (95% confidence interval [CI] 13-17) than public providers and 12% points more likely to provide other treatments (95% CI 10-15). These disparities in ORT provision were more pronounced for poorer children in rural areas. As private healthcare in sub-Saharan Africa continues to expand, interventions to increase private sector provision of ORT should be explored.

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Childhood diarrhoea management practices in Bangladesh: private sector dominance and continued inequities in care

Cited by 65 publications

References 16 publications

Availability and Quality of Emergency Obstetric and Newborn Care in Bangladesh

Availability and Quality of Emergency Obstetric and Newborn Care in Bangladesh

Understanding and Advancing the Health of Older Populations in sub-Saharan Africa: Policy Perspectives and Evidence Needs

Private Sector Provision of Oral Rehydration Therapy for Child Diarrhea in Sub-Saharan Africa

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