Understanding where parents take their sick children and why it matters: a multi-country analysis

Hodgins, Stephen; Pullum, Thomas W.; Dougherty, Leanne

doi:10.9745/ghsp-d-13-00023

Cited by 22 publications

(19 citation statements)

References 6 publications

(4 reference statements)

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Section: Discussionmentioning

confidence: 80%

“…Country variations in care seeking for childhood infections, including pneumonia, have been reported previously [ 16 , 17 ]. We concur with the conclusions of the Hodgins study [ 16 ] that programs should be adjusted to country specific needs based on identified barriers. Our data clearly show that both care seeking from ‘appropriate’ providers and childhood pneumonia mortality is high in Uganda, suggesting that the quality of care available to these children may be sub-standard or that children present for care late, as has been reported in other studies [ 18 , 19 , 20 ].…”

Section: Discussionmentioning

confidence: 80%

“…As Quinley & Govindasamy have reported, drug shops do often function as de facto clinics [ 36 ]. Strategies for improving the quality of care in these service delivery points may be an important program strategy to consider [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

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Care Seeking Behaviour for Children with Suspected Pneumonia in Countries in Sub-Saharan Africa with High Pneumonia Mortality

et al. 2015

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Pneumonia is the leading cause of childhood mortality in sub-Saharan Africa (SSA). Because effective antibiotic treatment exists, timely recognition of pneumonia and subsequent care seeking for treatment can prevent deaths. For six high pneumonia mortality countries in SSA we examined if children with suspected pneumonia were taken for care, and if so, from which type of care providers, using national survey data of 76530 children. We also assessed factors independently associated with care seeking from health providers, also known as ‘appropriate’ providers. We report important differences in care seeking patterns across these countries. In Tanzania 85% of children with suspected pneumonia were taken for care, whereas this was only 30% in Ethiopia. Most of the children living in these six countries were taken to a primary health care facility; 86, 68 and 59% in Ethiopia, Tanzania and Burkina Faso respectively. In Uganda, hospital care was sought for 60% of children. 16–18% of children were taken to a private pharmacy in Democratic Republic of Congo (DRC), Tanzania and Nigeria. In Tanzania, children from the richest households were 9.5 times (CI 2.3–39.3) more likely to be brought for care than children from the poorest households, after controlling for the child’s age, sex, caregiver’s education and urban-rural residence. The influence of the age of a child, when controlling for sex, urban-rural residence, education and wealth, shows that the youngest children (<2 years) were more likely to be brought to a care provider in Nigeria, Ethiopia and DRC. Urban-rural residence was not significantly associated with care seeking, after controlling for the age and sex of the child, caregivers education and wealth. The study suggests that it is crucial to understand country-specific care seeking patterns for children with suspected pneumonia and related determinants using available data prior to planning programmatic responses.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 80%

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Care Seeking Behaviour for Children with Suspected Pneumonia in Countries in Sub-Saharan Africa with High Pneumonia Mortality

et al. 2015

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“…Launched in February 2010, Text4baby , for example, has gained wide media attention, winning awards from the United States Office of Science and Technology in 2010 and the Public Relations Society of America in 2011. The Text4baby program uses the health belief model to support mothers through prenatal care text messages [ 8 ]. More recently, a consortium of partners including Johnson & Johnson, United States Agency for International Development, United Nations Foundation, and the mHealth Alliance created an alliance to improve maternal health by leveraging mobile technology to deliver health information to mothers in India, South Africa, and Bangladesh [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

App-Supported Promotion of Child Growth and Development by Community Health Workers in Kenya: Feasibility and Acceptability Study

Heerden¹,

Sen²,

Desmond³

et al. 2017

JMIR Mhealth Uhealth

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BackgroundEarly childhood is a critical phase of development. In low resource settings, monitoring this stage of development and providing appropriate and timely feedback is a challenge. Community-based service providers play a key role in promoting early childhood development in areas where government services are weak. These community-based service providers are also tasked with the collection of monitoring and evaluation data for donors and local government. Usually, collection of these data aims to provide accountability, learning, and correction leading to improvement. However, such data is rarely used beyond the accountability stage.ObjectiveThe purpose of this study was to test the feasibility and acceptability of the Information for Action (IFA) mobile phone app. The IFA app was designed for use by community health volunteers (CHVs), and repackages routinely collected data about children into useful, offline decision support for caregivers and program managers.MethodsThe IFA app was tested with a convenience sample of 10 CHVs in West Katweng’a, a sublocation of Rarieda subcounty in western Kenya. CHVs used the IFA app for 5 months as part of their regular home visits to households containing children aged 0 to 5 years, after which a qualitative assessment of the app was conducted. A total of 16 caregivers who received services from the CHVs were randomly selected to participate in 1 of 2 focus group discussions about their experience.ResultsThe app was reported to help facilitate interactive dialog between CHVs and caregivers, leading to improved quality of home visits. Caregivers described the app as shifting the relationship from feeling harassed by CHVs to experiencing genuine interest from CHVs. CHVs reported feasibility challenges primarily related to infrastructure. The limited battery life of mobile phones combined with the lack of readily available electricity made it difficult to keep the phones charged. CHVs reported initial anxiety as first-time mobile phones users, including concerns about using the IFA app. With time, increased levels of confidence were seen.ConclusionsAcceptability was high with both CHVs and caregivers, who reported an improvement in their client-provider relationship. A number of feasibility challenges were experienced.

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“…A study from India reported that 35% of caregivers consulted private practitioners and 16% went directly to a pharmacy [11]. A recent multicounty analysis of care seeking patterns of parents for their sick children showed that in South Asian countries including Pakistan care seeking was predominantly from the private sector, and community health workers were not an important source of care [12]. An analysis of demographic health survey and multiple indicators cluster survey datasets showed that among countries with high mortality due to childhood acute respiratory illnesses, Pakistan has the lowest (10%) public sector care utilization [13].…”

Section: Introductionmentioning

confidence: 99%

Caregivers’ Knowledge, Practices about Childhood Diarrhea and Pneumonia and their Perceptions of Lady Health Worker Program; Findings from NIGRAAN Implementation Research Project

Sangrasi¹,

Rabbani²,

Aftab³

et al. 2016

J Community Med Health Educ

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Background: Despite 60% coverage by Lady Health Worker (LHW) Program, 30% of child deaths in Pakistan are still due to diarrhea and pneumonia. Caregivers are an important stakeholder yet there is little information on their case management practices and utilization of LHW Program. This study explored caregivers' knowledge and practices about childhood diarrhea and pneumonia and utility of LHW services before and after a supportive supervision intervention. Methods: Cross sectional surveys were conducted with caregivers' (mothers) pre and post intervention in project NIGRAAN. The intervention aimed to improve LHSs clinical and supervisory skills of lady health supervisors in order to improve LHW performance and ultimately impact caregiver practices. 4250 households were surveyed. Questionnaire was adapted from PDHS 2012-13. Differences between intervention and control groups were assessed using chi square test. P-value of <0.05 was considered significant. Results: Comparing baseline to end line, there were significant overall improvements in caregivers' knowledge of loose motion (62 to 84%) and dehydration (12 to 18%) as signs and symptoms of childhood diarrhea. There was also a significant overall increase in caregivers' knowledge of presenting features of pneumonia-i.e. fever (58 to 86%), cough (51 to 61%) and breathing problems (25 to 57%). The proportion of caregivers seeking advice for diarrhea from public sector significantly improved in intervention arm from 20% to 29%. Private sector however remained overall preferred choice for care seeking. There was significant overall improvement in awareness about LHWs functioning (93 to 99%) and household visits (91 to 98%). Actual care seeking from LHWs however stayed low (≤ 0.3%) Conclusion: In order to improve utility and expand coverage of LHW Program interventions aimed at providing supportive supervision have the potential to improve caregiver practices and utilization of available services and decrease childhood deaths due to preventable illnesses.

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Understanding where parents take their sick children and why it matters: a multi-country analysis

Cited by 22 publications

References 6 publications

Care Seeking Behaviour for Children with Suspected Pneumonia in Countries in Sub-Saharan Africa with High Pneumonia Mortality

Care Seeking Behaviour for Children with Suspected Pneumonia in Countries in Sub-Saharan Africa with High Pneumonia Mortality

App-Supported Promotion of Child Growth and Development by Community Health Workers in Kenya: Feasibility and Acceptability Study

Caregivers’ Knowledge, Practices about Childhood Diarrhea and Pneumonia and their Perceptions of Lady Health Worker Program; Findings from NIGRAAN Implementation Research Project

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