Does child gender determine household decision for health care in rural Thatta, Pakistan?

Nuruddin, Rozina; Hadden, Wilbur C.; Petersen, Matt; Lim, Meng-Kin

doi:10.1093/pubmed/fdp038

Cited by 25 publications

(21 citation statements)

References 34 publications

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“…Bypassing public PHC services for common childhood illness was more for boys than girls and this could be attributed to the society pediatrics' gender bias, explained by existence of strong sonpreference in Sudan, in line with studies of gender bias and health seeking actions in other African courtiers including Egypt, Tunisia, Morocco, and Nigeria [21][22][23]. Same findings are evident also from several studies from Asia including Nepal, Pakistan and China and Republic of Korea [24][25][26]. All the studies suggested that gender role affects the entire steps of child health care seeking action.…”

Section: Discussionsupporting

confidence: 61%

Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015

Ahmed¹

2017

SJPH

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Abstract:In Sudan despite the current implementation of universal health coverage policy, routine monitoring reports highlight that patients frequently bypass Primary Health Care (PHC) facilities in favor of higher-level hospitals, though hospitals are costly and time consuming. The main objective of this study was to study the extent of bypassing the public PHC facilities and factors associated with the decision of caretakers to bypass such facilities seeking care for their under-five year's children with common illnesses in Sharg-Alneel locality, 2015. The study proposed strategies and interventions to the Sudan government -Federal Ministry of Health (FMoH) -to improve PHC service utilization The study was cross-sectional comparative study, interviewer administered questionnaires and facility assessment checklist was used for data collection. The data was analysed using SPSS. The study interviewed 497 caretakers, 87% of them pursued health care for their children directly from secondary hospitals. The main reasons for bypassing the closest public health facilities were unavailability of doctors, lack of health insurance services and higher cost of services. The proportion of bypassing a PHC facility for child care is significantly associated with child sex, child age, presenting symptoms of diarrhea, fever, difficult breathing and severe vomiting, caretakers' occupation as well as the economic status. In a resource limited country, health policy to achieve universal health coverage is better to focus on quality of care as well as quantity. Community mobilization and interventions to improve access and utilization of quality PHC services are all recommended. Furthermore, more research on bypassing behaviour is also recommended.

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Section: Discussionsupporting

confidence: 61%

Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015

Ahmed¹

2017

SJPH

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“…For diarrhea, female children were less likely to get treatment from public HCP but the effect of gender bias was marginal. Gender bias against female child has been reported from some LMICs [21], [24], [36], [37], [40], [41]. However, there was no such bias for treatment of fever/cough in our study.…”

Section: Discussioncontrasting

confidence: 49%

“…Moreover, our analyses showed that children are likely to be treated outside, if they had severe symptoms (blood in stools, difficult or rapid breathing, and blocked chest/nose). Studies from LMICs have reported that children are likely to be taken for medical treatment if mother perceived the illness as serious [19], [21], [25], [35], [37]–[40].…”

Section: Discussionmentioning

confidence: 99%

“…Mothers’ perceptions about symptoms and their severity [19], [30]–[34], mothers’ beliefs about childhood illnesses [27], [35] and mothers’ ability to recognize the danger signs [16], [17], [36] are some important factors determining health care-seeking behavior or utilization of health care services. Studies on utilization of health services during childhood illness have reported that a significant proportion of children are not taken for medical care [37], child’s gender plays a role in illness reporting [38], decision to choose health care provider [39] and private sector health services are preferred over public sector [21], [29], [40].…”

Section: Introductionmentioning

confidence: 99%

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Utilization of Health Care Services for Childhood Morbidity and Associated Factors in India: A National Cross-Sectional Household Survey

2012

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BackgroundInformation about utilization of health services and associated factors are useful for improving service delivery to achieve universal health coverage.MethodsData on a sample of ever-married women from India Demographic and Health survey 2005–06 was used. Mothers of children aged 0–59 months were asked about child’s illnesses and type of health facilities where treatment was given during 15 days prior to the survey date. Type of health facilities were grouped as informal provider, public provider and private provider. Factors associated with utilization of health services for diarrhea and fever/cough was assessed according to Andersen’s health behavior model. Multinomial logistic regression analyses were done considering sampling weights for complex sampling design.ResultsA total of 48,679 of ever-married women reported that 9.1% 14.8% and 17.67% of their children had diarrhea, fever and cough respectively. Nearly one-third of the children with diarrhea and fever/cough did not receive any treatment. Two-thirds of children who received treatment were from private health care providers (HCPs). Among predisposing factors, children aged 1–2 years and those born at health facility (public/private) were more likely to be taken to any type of HCP during illness. Among enabling factors, as compared to poorer household, wealthier households were 2.5 times more likely to choose private HCPs for any illness. Children in rural areas were likely to be taken to any type of HCP for diarrhea but rural children were less likely to utilize private HCP for fever/cough. ‘Need’ factors i.e. children having severe symptoms were 2–3 times more likely to be taken to any type of HCP.ConclusionPrivate HCPs were preferred for treatment of childhood illnesses. Involvement of private HCPs may be considered while planning child health programs. Health insurance scheme for childhood illnesses may to protect economically weaker sections from out-of-pocket health expenditure during child illness.

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“…The sample size required used the following parameters: 80% power for detecting an estimated true effect of a magnitude of odds ratio 2.5, based on the probability of appropriate care (Po) of 30% in general population [13][14][15]. We estimated that 77 cases and two matched controls for each case (154 controls) were needed to fulfill the assumptions.…”

Section: Methodsmentioning

confidence: 99%

Predictors of diarrheal mortality and patterns of caregiver health seeking behavior in in Karachi, Pakistan

Qamar¹,

Zaman²,

Quadri³

et al. 2016

Journal of Global Health

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Predictors of diarrheal mortality and patterns of caregiver health seeking behavior in in Karachi, PakistanBackground Pakistan is unfortunately among the five countries that contributed to the most deaths due to diarrhea and pneumonia in 2010. To explore factors associated with diarrheal deaths we assessed care-seeking behavior and other predictors of diarrhea-related mortality in children in selected low-income peri-urban communities of Karachi, Pakistan.

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Does child gender determine household decision for health care in rural Thatta, Pakistan?

Cited by 25 publications

References 34 publications

Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015

Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015

Utilization of Health Care Services for Childhood Morbidity and Associated Factors in India: A National Cross-Sectional Household Survey

Predictors of diarrheal mortality and patterns of caregiver health seeking behavior in in Karachi, Pakistan

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