scholarly journals The impact of equity factors on receipt of timely appropriate care for children with suspected malaria in eastern Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David Humphreys ◽  
Joan Nakayaga Kalyango ◽  
Tobias Alfvén
Keyword(s):  
Socioeconomic Position ◽  
Artemisinin Combination Therapy ◽  
Wealth Index ◽  
Household Wealth ◽  
Care Seeking ◽  
Dosing Schedule ◽  
Appropriate Care ◽  
Appropriate Treatment ◽  
The Impact ◽  
Eastern Uganda

Abstract Introduction Malaria accounts for more than one-tenth of sub-Saharan Africa’s 2.8 million annual childhood deaths, and remains a leading cause of post-neonatal child mortality in Uganda. Despite increased community-based treatment in Uganda, children continue to die because services fail to reach those most at risk. This study explores the influence of two key equity factors, socioeconomic position and rurality, on whether children with fever in eastern Uganda receive timely access to appropriate treatment for suspected malaria. Methods This was a cross-sectional study in which data were collected from 1094 caregivers of children aged 6–59 months on: illness and care-seeking during the previous two weeks, treatment received, and treatment dosing schedule. Additional data on rurality and household socioeconomic position were extracted from the Iganga-Mayuge Health and Demographic Surveillance Site (HDSS) database. A child was considered to have received prompt and appropriate care for symptoms of malaria if they received the recommended drug in the recommended dosing schedule on the day of symptom onset or the next day. Unadjusted and adjusted logistic regression models were developed to explore associations of the two equity factors with the outcome. The STROBE checklist for observational studies guided reporting. Results Seventy-four percent of children had symptoms of illness in the preceding two weeks, of which fever was the most common. Children from rural households were statistically more likely to receive prompt and appropriate treatment with artemisinin-combination therapy than their semi-urban counterparts (OR 2.32, CI 1.17–4.59, p = 0.016). This association remained significant following application of an adjusted regression model that included the age of the child, caregiver relationship, and household wealth index (OR 2.4, p = 0.036). Wealth index in its own right did not exert a significant effect for children with reported fever (OR for wealthiest quintile = 1.02, CI 0.48–2.15, p = 0.958). Conclusions The findings from this study help to identify the role and importance of two key equity determinants on care seeking and treatment receipt for fever in children. Whilst results should be interpreted within the limitations of data and context, further studies have the potential to assist policy makers to target inequitable social and spatial variations in health outcomes as a key strategy in ending preventable child morbidity and mortality.

scholarly journals The impact of equity factors on receipt of timely appropriate care for children with suspected malaria in eastern Uganda

2020 ◽  
Author(s):  
David Humphreys ◽  
Joan Nakayaga Kalyango ◽  
Tobias Alfven
Keyword(s):  
Socioeconomic Position ◽  
Artemisinin Combination Therapy ◽  
Wealth Index ◽  
Household Wealth ◽  
Care Seeking ◽  
Dosing Schedule ◽  
Appropriate Care ◽  
Appropriate Treatment ◽  
The Impact ◽  
Eastern Uganda

Abstract IntroductionMalaria accounts for more than one-tenth of sub-Saharan Africa’s 2.8 million annual childhood deaths, and remains a leading cause of post-neonatal child mortality in Uganda. Despite increased community-based treatment in Uganda, children continue to die because services fail to reach those most at risk. This study explores the influence of two key equity factors, socioeconomic position and rurality, on whether children with fever in eastern Uganda receive timely access to appropriate treatment for suspected malaria.MethodsData were collected from 1,094 caregivers of children aged 6-59 months on: illness and care-seeking during the previous two weeks, treatment received, and treatment dosing schedule. Additional data on rurality and household socioeconomic position were extracted from the Iganga-Mayuge Health and Demographic Surveillance Site (HDSS) database. A child was considered to have received prompt and appropriate care for symptoms of malaria if they received the recommended drug in the recommended dosing schedule on the day of symptom onset or the next day. Unadjusted and adjusted logistic regression models were developed to explore associations of the two equity factors with the outcome.ResultsSeventy-four percent of children had symptoms of illness in the preceding two weeks, of which fever was the most common. Children from rural households were statistically more likely to receive prompt and appropriate treatment with artemisinin-combination therapy than their semi-urban counterparts (OR 2.32, CI 1.17-4.59, p=0.016). This association remained significant following application of an adjusted regression model that included the age of the child, caregiver relationship, and household wealth index (OR 2.4, p = 0.036). Wealth index in its own right did not exert a significant effect for children with reported fever (OR for wealthiest quintile = 1.02, CI 0.48-2.15, p=0.958).ConclusionsThe findings from this study help to identify the role and importance of two key equity determinants on care seeking and treatment receipt for fever in children. Whilst results should be interpreted within the limitations of data and context, further studies have the potential to assist policy makers to target inequitable social and spatial variations in health outcomes as a key strategy in ending preventable child morbidity and mortality.

scholarly journals Factors associated with mothers’ health care-seeking behaviours for childhood fever in Burkina Faso: Findings from repeated cross-sectional household surveys

2021 ◽  
Author(s):  
Hermann Badolo ◽  
Aristide Romaric Bado ◽  
Hervé Hien ◽  
Nicolas Méda ◽  
Appunni Sathiya Susuman
Keyword(s):  
Health Care ◽  
Burkina Faso ◽  
Health Care Quality ◽  
Household Wealth ◽  
Care Quality ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Factors Associated ◽  
The Impact ◽  
Childhood Fever

Abstract IntroductionFever is one of the most frequent reasons for paediatric consultations in Burkina Faso, but health care-seeking behaviours and the factors associated with health care-seeking in the event of childhood fever are poorly documented. This study aims to help fill this gap.MethodsThis study used the data from the baseline and endline surveys conducted to evaluate the impact of the Performance-Based Financing (PBF) program in Burkina Faso. Univariate and multivariate binary logistic regression analyses were used to identify the factors associated with appropriate healthcare-seeking for childhood fever. Odds ratios (ORs) were estimated to assess the strength of associations and used 95% confidence intervals for significance tests. Data were cleaned, coded and analysed using Stata software version 16.1.ResultsAmong the children under five who had a fever, 75.19% and 79.76 sought appropriate health care in 2013 and 2017, respectively. Being 24–59 months old (AOR: 0.344, 95% CI: 0.182–0.649 in 2013) and 79,2% (AOR: 0. 208, 95% CI: 0.115–0.376 in 2017), living in a very wealthy household households (AOR: 2.014, 95% CI: 1.149–3.531 in 2013 and AOR: 2.165, 95% CI: 1.223–3.834 in 2017), having a mother with a secondary or higher level of education or having made at least four antenatal care visits were significantly associated with seeking appropriate health care for childhood fever. Living in an area where the health facility is safe was also significantly associated with seeking appropriate care for childhood fevers.ConclusionThe findings underscore the need for interventions that would improve appropriate health care-seeking among mothers for their children. These interventions could include mothers’ sensitization to the benefits of modern health care use, increasing women’s education, improving household wealth status, improving the level of prenatal and postnatal care use and improving health care quality and safety in health facilities.

scholarly journals POLYGYNY AND WOMEN'S HEALTH IN RURAL MALI

2013 ◽  
Vol 46 (1) ◽  
pp. 66-89 ◽  
Author(s):  
R. M. BOVE ◽  
EMILY VALA-HAYNES ◽  
CLAUDIA VALEGGIA
Keyword(s):  
Mixed Methods ◽  
Women’S Health ◽  
Women's Health ◽  
Social Power ◽  
Wealth Index ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Theory Approach ◽  
Sub Saharan ◽  
The Impact

SummaryWomen's social networks and social power are increasingly seen as important factors modulating their health in sub-Saharan Africa. Polygyny, a common marital structure in many societies, mediates important intra-household relationships by requiring both competition and co-operation among co-wives. Using mixed methods, semi-structured questionnaires were administered to 298 women aged 15–84 living in the Kolondiéba region of rural Mali in 1999, and supplemented by detailed interviews with 40 women. Three categories of outcome were explored: illness experience, therapeutic itinerary and social support received. Quantitative data were analysed using regression analysis and qualitative data using a grounded theory approach. In quantitative analyses, controlling for age and household wealth index, senior wives were less likely to be escorted to a healer by their husbands during illness than were junior wives or monogamous women. Polygynous women were also less likely to obtain a treatment for which there was a monetary fee. Fewer than one-third of polygynous women reported the assistance of a co-wife during illness in any given task. In qualitative analyses, women further related varied mechanisms through which polygyny impacted their health trajectories. These ranged from strongly supportive relationships, to jealousy because of unequal health or fertility, bias in emotional and material support provided by husbands, and accusations of wrong-doing and witchcraft. This study highlights the need for more prospective mixed methods analyses to further clarify the impact of polygyny on women's health-related experiences and behaviours in sub-Saharan Africa.

scholarly journals The Impact of Household Wealth on Adoption and Compliance to GLOBAL GAP Production Standards: Evidence from Smallholder farmers in Kenya

Agriculture ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 50
Author(s):  
Castro N. Gichuki ◽  
Jiqin Han ◽  
Tim Njagi
Keyword(s):  
Food Safety ◽  
Smallholder Farmers ◽  
Agricultural Practices ◽  
Wealth Index ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Export Market ◽  
Capital Investments ◽  
Cross Sectional ◽  
The Impact

Horticultural production for the export market has been credited for rural community growth and employment in Sub-Saharan Africa. To make the agri-enterprises competitive and profitable, smallholder farmers are now required to invest in food safety and production standards such as GLOBAL Good Agricultural Practices (GLOBAL GAP). Most often, the inability to afford capital has affected compliance with food safety production standards. However, farmers can use household assets to finance the agri enterprise ventures. The purpose of the study is to explore the impact of household wealth on the adoption of food safety certification standards. The study used cross-sectional data collected from 479 smallholder farmers in Kenya. The findings reveal that 49% of the households are categorized as wealthy and 51% as poorly endowed. The empirical findings on the willingness to adopt GLOBAL GAP certification reveal that membership to GLOBAL GAP affiliated farmers groups significantly influence on wealthier farmers to attain GLOBAL GAP certification status. Farmers groups facilitate joint investments that reduce the cost of investing in GLOBAL GAP assets such as grading shed, protective gear, shower rooms, disposal pits, incinerators, hessian coolers, packaging crates, soil testing kits and establishing food traceability systems. In comparison to poor endowed farming households, the well-endowed farmers have a relatively significantly better wealth index, an indication that they can easily raise capital investments to finance GAP certification. Finally, we observe that selling beans to GAP certified buyers significantly enables farmers to comply with the expected certified production standards.

Evaluating the Performance of Five Asset-based Wealth Indices in Predicting Socioeconomic Position in Rural Bangladesh

Field Methods ◽  
2021 ◽  
pp. 1525822X2110206
Author(s):  
Katherine Woolard ◽  
Shirajum Munira ◽  
Khaleda Jesmin ◽  
Daniel Hruschka
Keyword(s):  
Socioeconomic Position ◽  
Wealth Index ◽  
Well Being ◽  
Household Wealth ◽  
General Measure ◽  
Social Scientists ◽  
Rural Bangladesh ◽  
Explained Variation ◽  
Highly Correlated ◽  
Probability Index

Social scientists have developed numerous asset-based wealth indices to assess and target socioeconomic inequalities globally. However, there are no systematic studies of the relative performance of these different measures as proxies for socioeconomic position. In this study, we compare how five asset-based wealth indices—the International Wealth Index (IWI), the Standard of Living portion of the Multi-Dimensional Poverty Index (MPI-SL), the Poverty Probability Index (PPI), the Absolute Wealth Estimate (AWE), and the DHS Wealth Index (DHS)—predict benchmarks of socioeconomic position across 11 communities in rural Bangladesh. All indices were highly correlated. The IWI best explained variation in individual and community ranking of economic well-being, while the PPI best explained variation both between and within communities for total household wealth and a general measure of subjective social status.

scholarly journals Inequalities in Infant Immunization Coverage in Bangladesh

2008 ◽  
Vol 1 ◽  
pp. HSI.S927 ◽  
Author(s):  
Amal K. Halder ◽  
M. Kabir
Keyword(s):  
Immunization Coverage ◽  
Indirect Costs ◽  
Principal Component ◽  
Wealth Index ◽  
Household Wealth ◽  
Wealth Status ◽  
Proxy Variable ◽  
Household Level ◽  
Immunization Status ◽  
The Impact

Background Although, health status of Bangladeshis has improved, levels of child mortality in Bangladesh remain unacceptably high. This paper reviews household wealth inequalities in immunization coverage in Bangladesh. The objective of the study is to examine how household wealth status and socio-demographic characteristics relate to immunization status of children. Methods Using data from the 2004 Bangladesh Demographic and Health Survey (BDHS), this paper investigated the inequalities and implications of infant immunization coverage in Bangladesh. To prepare the proxy variable of household wealth status we applied principal component analysis (PCA) technique based on variables such as assets, utilities and services available at household level. And then scores of the proxy variable was transferred into quintiles. Results The difference in immunization status between the richest and the poorest quintiles was significant (crude OR 5.2, p < 0.001). The addition of education to the multivariate model lowered the impact of wealth index by almost half. Increasing education levels were positively associated with achieving full vaccination status. Sex of children and age of mothers were not associated with the child's immunization status. Conclusions Despite free immunizations, use is not uniform throughout the population. Access to wealth and education may contribute to disparities in achieving full immunization. Minimizing indirect costs of immunizations may reduce disparities. Health education needs to be intensified for parents with minimal education.

scholarly journals An Integrated Enhanced Infant and Young Child Feeding (IYCF) and Micronutrient Powder Intervention Improved Select IYCF Practices Among Caregivers of Children Aged 12–23 Months in Eastern Uganda

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Nicole D Ford ◽  
Laird J Ruth ◽  
Sarah Ngalombi ◽  
Abdelrahman Lubowa ◽  
Siti Halati ◽  
...  
Keyword(s):  
Young Child ◽  
Complementary Feeding ◽  
Household Wealth ◽  
Bottle Feeding ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Micronutrient Powder ◽  
Infant And Young Child ◽  
The Impact ◽  
Eastern Uganda

ABSTRACT Background There is little evidence of the impact of integrated programs distributing nutrition supplements with behavior change on infant and young child feeding (IYCF) practices. Objective We evaluated the impact of an integrated IYCF/micronutrient powder intervention on IYCF practices among caregivers of children aged 12–23 mo in eastern Uganda. Methods We used pre-post data from 2 population-based, cross-sectional surveys representative of children aged 12–23 mo in Amuria (intervention) and Soroti (nonintervention) districts (n = 2816). Caregivers were interviewed in June/July at baseline in 2015 and 12 mo after implementation in 2016. We used generalized linear mixed models with cluster as a random effect to calculate the average intervention effect on receiving IYCF counseling, ever breastfed, current breastfeeding, bottle feeding, introducing complementary feeding at age 6 mo, continued breastfeeding at ages 1 and 2 y, minimum meal frequency (MMF), minimum dietary diversity, minimum acceptable diet (MAD), and consumption of food groups the day preceding the survey. Results Controlling for child age and sex, household wealth and food security, and caregiver schooling, the intervention was positively associated with having received IYCF counseling by village health team [adjusted prevalence difference-in-difference (APDiD): +51.6%; 95% CI: 44.0%, 59.2%]; timely introduction of complementary feeding (APDiD: +21.7%; 95% CI: 13.4%, 30.1%); having consumed organs or meats (APDiD: +9.0%; 95% CI: 1.4%, 16.6%) or vitamin A–rich fruits or vegetables (APDiD: +17.5%; 95% CI: 4.5%, 30.5%); and MMF (APDiD: +18.6%; 95% CI: 11.2%, 25.9%). The intervention was negatively associated with having consumed grains, roots, or tubers (APDiD: −4.4%; 95% CI: −7.0%, −1.7%) and legumes, nuts, or seeds (APDiD: −15.6%; 95% CI: −26.2%, −5.0%). Prevalences of some IYCF practices were low in Amuria at endline including MAD (19.1%; 95% CI :16.3%, 21.9%). Conclusions The intervention had a positive impact on several IYCF practices; however, endline prevalence of some indicators suggests a continued need to improve complementary feeding practices.

The Role of Household Wealth in Combining Child School and Child Labor: Evidence from MICS Balochistan (Pakistan)

2021 ◽  
Vol 3 (2) ◽  
pp. 188-199
Author(s):  
Tabish Nawab ◽  
Beyza Nur Aktaş ◽  
Tusawar Iftikhar Ahmad ◽  
Ruqayya Ibraheem
Keyword(s):  
Child Labor ◽  
Wealth Index ◽  
Well Being ◽  
Household Wealth ◽  
Positive Influence ◽  
Vital Role ◽  
Wealth Status ◽  
Positive Effects ◽  
The Impact

The issue of combining school & work has taken considerable focus in the past years from policymakers, advocates and researchers. In the literature, the role of household wealth, combining school & work is still an unresolved issue. The researchers have contradicting views about the impact of household wealth on combining child school & work. Child labor and low schooling attendance are found pervasive issues worldwide, particularly in developing countries. This study aims to explore the impact of household wealth on combining child school & work, particularly focusing on the wealth index of the household. For this purpose, microdata having 18471 observations from Multiple Indicator Cluster Survey Balochistan (2010) has been utilized. The binary logistic model has been applied for the children (5-15 years) activity whether they are combining school & work or not. The main finding of this paper is the wealth status of households which has a statistically significant and positive influence on combining child school & work. Both mother and father's education is positively associated with combining school & work. In addition, mother and father being alive played a vital role in their children’s combined activities of schooling & work rather than doing nothing because the expectations of child schooling are high in parent's lives. Furthermore, gender, age of the child, and area of residence are positive effects combining school & work. The children from urban zones are more likely to be involved in combining school & work. The policy of this paper suggests that education is the key to break child labor in society by providing education facilities for both girls and boys equally. In addition to policy recommendations, there should be crucial steps to provide a better economic environment for the well-being of the masses to enhance their economic condition especially in rural and deprived areas of Balochistan, and the applicability of child labor laws needs to be focused on.Keywords:

ASSOCIATION OF SOCIO-DEMOGRAPHIC FACTORS WITH DIARRHEA IN CHILDREN LESS THAN FIVE YEARS: A SECONDARY ANALYSIS OF MULTIPLE INDICATOR CLUSTER SURVEY SINDH 2014

1970 ◽  
Vol 7 (2) ◽  
pp. 85-89
Author(s):  
Muhammad Irfan ◽  
Syed Mustansir Hussain Zaidi ◽  
Hira Fatima Waseem
Keyword(s):  
Rural Areas ◽  
Demographic Factors ◽  
Wealth Index ◽  
Household Wealth ◽  
Cluster Survey ◽  
Multiple Indicator Cluster Survey ◽  
Increased Risk ◽  
Multiple Indicator ◽  
Mother Education ◽  
Socio Demographic Factors

Background: Diarrhea founds to be the major cause of morbidity and mortality in children less than five years. Various factors are associated with diarrhea but socio-demographic factors are the main key elements, which associated with diarrhea. Methods: This study was examined association of socio-demographic factors with diarrhea in children less than five years of age of Sindh, Pakistan, using data from the Multiple Indicator Cluster Survey (MICS) conducted from January 2014 to August 2014. Data were collected for 18,108 children in whom 16,449 children had complete data of demographic variables being included in the analysis. Bivariate analysis was done using Pearson's Chi square test and multivariate analysis being done using binary logistic regression. Results: We found increased risk of diarrhea among children lives in rural areas while household wealth index quintile was also associated with diarrhea. Children in the poor, middle and fourth wealth index quintiles being at increased risk of diarrhea compared to children in the richest wealth index quintile. The highest risk of diarrhea was found for the child having mother with no education as well as children aged 12-23 months. Conclusion: Age of child, mother education and wealth index found significant with diarrhea while Male children, child aged 12-23 months, child with no mother education, child from rural areas and child from poor households found with high risk of diarrhea.

scholarly journals Perceptions and Care Seeking Behavior of Obstetric Complication in Thailand

2013 ◽  
Vol 10 (2) ◽  
pp. 63-70 ◽  
Author(s):  
SK Sharma ◽  
P Vong-Ek
Keyword(s):  
Maternal Health ◽  
Health Personnel ◽  
Hard Work ◽  
Obstetric Complication ◽  
Traditional Practices ◽  
Care Seeking ◽  
Appropriate Care ◽  
Care Seeking Behavior ◽  
Seeking Behavior ◽  
Poor Nutrition

Background Importance of maternal health has been recognized over the last decade, however information about the perception of illness and healthcare behavior of obstetric complication is lacking. Objective This study assesses women’s knowledge, perception, and experience of obstetric complication and care-seeking behavior and explores the factors associated with the morbidity and the constraints hindering them from seeking timely care. Methods Twenty one in-depth interviews on the perceptions, experience and care seeking behavior related to pregnancy and delivery of Women at Kanchanaburi Demographic Surveillance site of Thailand were conducted. A structured guideline was first prepared in English and translated into Thai language. An interpreter was hired to interview women at the Thai-Myanmar border to translate Thai into local language. A moderator note-taker, and interpreter were present throughout the interview period and tape recorded the conversation. Results In-depth interview revealed that even though quality maternal health care was accessible to most of the women, obstetric complication was prevalent and they were not seeking appropriate care specifically in highland. Too early and too late marriage, frequent child bearing, poverty, hard work, poor nutrition and traditional practices were the reasons for complications. Poor transportation, lack of health insurance, inadequate training of health personnel, poor health facilities and the perception that the complications are normal for pregnant women were the main reasons for not seeking appropriate care. Conclusions Perceived reasons for complications among women living in Kanchanaburi, Thailand were early marriage, frequent childbearing, hard work, poor nutrition and traditional practices. The constraints hindering them from seeking care for the complications were perceived to be the lack of access to health personnel, health facilities, and proper transportation. These issues seemed to be related to poverty. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 63-70 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7347

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