Factors Associated with Malaria Care-Seeking for Among Children Under 5 Years of Age in Mozambique: A Secondary Analysis of the 2018 Malaria Indicator Survey

2021 ◽  
Author(s):  
Annette Cassy ◽  
Sergio Chicumbe ◽  
Abuchahama Saifodine ◽  
Rose Zulliger
Keyword(s):  
Health Facility ◽  
Secondary Analysis ◽  
Secondary Data ◽  
Wealth Quintile ◽  
Care Seeking ◽  
Older Children ◽  
Factors Associated ◽  
Malaria Indicator Survey ◽  
Weighted Analysis ◽  
Malaria Knowledge

Abstract BackgroundMozambique is ranked fourth in a list of the 29 countries that accounted for 95% of all malaria cases globally in 2019. The aim of this study was to identify factors associated with care-seeking for fever, to determine the association between knowledge about malaria and care-seeking and to describe the main reasons for not seeking care among children under five years of age in Mozambique.MethodsThis is a quantitative, observational study based on a secondary data analysis of the 2018 Malaria Indicatory Survey. This weighted analysis was based on data reported by surveyed mothers or caregivers of children aged 0-59 months who had fever in the two weeks prior to the survey.ResultsCare was reportedly sought for 69.1% [95% CI 63.5-74.2] of children aged 0-59 months old with fever. Care-seeking was significantly higher among younger children, <6 months old (AOR=2.47 [95% CI 1.14-5.31]), 6-11 months old (AOR=1.75 [95% CI 1.01-3.04]) and 12-23 months old (AOR=1.85 [95% CI 1.19-2.89]), as compared with older children (48-59 months old).In adjusted analysis, mothers from the middle (AOR=1.66 [95% CI 0.18-3.37]) and richest (AOR=3.46 [95% CI 1.26-9.49]) wealth quintiles were more likely to report having sought care for their febrile children than mothers from the poorest wealth quintile. Additionally, mothers with secondary or higher education level were more likely to seek care (AOR=2.16 [95% CI 1.19-3.93]) than mothers with no education. There was no association between maternal malaria knowledge or reported exposure to malaria messages and care-seeking behaviors.The main reasons reported for not seeking care included distance to health facility (46.3% of respondents), perception that the fever was not severe (22.4%) and the perception that treatment was not available at the health facility (15%).ConclusionHealth facility access and socioeconomic barriers continue to be important constraints on malaria service utilization in Mozambique.

scholarly journals Effect of bed net colour and shape preferences on bed net usage: a secondary data analysis of the 2017 Malawi Malaria Indicator Survey

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Donnie Mategula ◽  
Latif Ndeketa ◽  
Judy Gichuki ◽  
Boston Zimba ◽  
Wilson Ching’ani ◽  
...  
Keyword(s):  
Universal Access ◽  
Secondary Analysis ◽  
Secondary Data ◽  
Paediatric Population ◽  
User Preferences ◽  
Outcome Variable ◽  
Bed Nets ◽  
Bed Net ◽  
Previous Night ◽  
Malaria Indicator Survey

Abstract Background Malaria remains a significant cause of morbidity and mortality in the paediatric population in Malawi. Insecticide-treated bed nets are a key vector malaria control intervention, however, advancement towards universal access is progressing slowly. Malawi Malaria indicator surveys (MMIS) show diverse user preferences of bed net shape and colour. The objective of this work was to understand if bed net shape and colour preferences affect usage. Methods This is a secondary analysis of data from households that participated in the 2016–2017 MMIS. The main outcome variable was net usage defined, at net level, whether someone slept under a particular net on the night before the survey. The main exposure variables were preference attributes, whether a particular net is of a preferred colour or shape as defined by the household respondent. Both bivariate and multivariate logistic regression analyses were done to determine the association between the exposure and outcome variables. Results A total of 3729 households with 16,755 individuals were included in this analysis. There were a total 7710 bed nets in households that participated in the survey of which 5435 (70.5%) of these nets had someone sleep under them the previous night before the survey. Bed nets that are of a preferred shape have 3.55 times higher odds of being used than those not preferred [AOR 3.55 (95% CI 2.98, 4.23; p value < 0.001)]. Bed nets that are of a preferred colour have 1.61 times higher odds of being used than those that are not of a preferred colour [AOR 1.61 (95% CI 1.41, 1.84; p value < 0.001]. Conclusions The results indicate that if a bed net is of a preferred colour or shape, it is more likely to be used. Bed net purchase by malaria stakeholders need to balance more factors on top of preferences such as price and efficacy.

scholarly journals Prevalence and risk factors of short birth interval in Bangladesh: Evidence from the linked data of population and health facility survey

2021 ◽  
Author(s):  
Mohammad Zahidul Islam ◽  
M Mofizul Islam ◽  
Md Mostafizur Rahman ◽  
Md Nuruzzaman Khan
Keyword(s):  
Health Facility ◽  
Rural Women ◽  
Birth Interval ◽  
Wealth Quintile ◽  
World Health ◽  
Short Intervals ◽  
Live Births ◽  
Factors Associated ◽  
Modern Contraceptives ◽  
Short Birth Interval

Background: The Sustainable Development Goals target significant reductions in maternal and under-five deaths by 2030. The prevalence of these deaths is significantly associated with short birth interval (SBI). Identification of factors associated with SBI is pivotal for intervening with appropriate programmes to reduce these adverse consequences. This study aimed to determine the factors associated with SBI in Bangladesh. Methods: The Bangladesh Demographic and Health Survey 2017/18 and Bangladesh Health Facility Data 2017 were linked and analysed. SBI was defined as an interval between consecutive births of 33 months or less, as recommended by the World Health Organization. We used descriptive statistics to summarise characteristics of respondents and multilevel Poisson regression to assess the predictors of SBI. Results: Around 26% of live births occurred in short intervals, with a further higher prevalence among younger, uneducated, or rural women. The likelihoods of SBI were lower among women aged 20-34 years (PR, 0.14, 95% CI, 0.11-0.17) and more than or equal to 35 years (PR, 0.03, 95% CI, 0.02-0.05) as compared to the women aged 19 years or less. Women from households with the richest wealth quintile experienced lower odds of SBI (PR, 0.61, 95% CI, 0.45-0.85) compared to those from the poorest wealth quintile. The prevalences of SBI were higher among women for whom the children born from the second most pregnancies died (PR, 5.23, 95% CI, 4.18-6.55), those who were living in Chattogram (PR, 1.52, 95% CI, 1.12-2.07) or Sylhet (PR, 2.83, 95% CI, 2.08-3.86) divisions. Availability of modern contraceptives at the nearest healthcare facilities was 66% protective to the occurrence of SBI (PR, 0.34, 95% CI, 0.22-0.78). Also, the prevalence of SBI increased around 85% (PR, 1.85, 95% CI, 1.33-2.18) for every kilometer increase in the distance of nearby health facilities from homes of women. Conclusion: More than a quarter of live births in Bangladesh occurred in short intervals. This relatively high prevalence is a challenge for Bangladesh in reducing pregnancy-related adverse consequences, including maternal and child mortality. Policies and programmes are needed to increase awareness of SBI and associated adverse health outcomes and expand access to modern contraceptives.

scholarly journals Community And Individual Factors Associated With Maternal And Neonatal Care Practices In Low Resource Settings. A Case Of Zimbabwe

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
E. Chiwawa ◽  
M. Mhlanga ◽  
A. Munodawafa ◽  
F. Mukora-Mutseyekwa
Keyword(s):  
Neonatal Mortality ◽  
Health Facility ◽  
Breast Feeding ◽  
Newborn Care ◽  
Neonatal Care ◽  
Care Seeking ◽  
District Health ◽  
Live Births ◽  
Factors Associated ◽  
Care Practices

Neonatal mortality has been increasing in Zimbabwe from 20/1,000 live births between 2000 and 2004 to 29 /1,000 live births between 2010 and 2014.Suboptimal newborn care practices are the predisposing factors to neonatal mortality. In Manicaland Province, care seeking behaviours for fever which is the main symptom of majority of infections in children and knowledge levels of danger signs that should cause the mother to take a child immediately to a health facility remains unacceptably lower than the national averages. A cross sectional descriptive and analytic design was carried out to explore the factors associated with the practice of the recommended newborn care practices by women of child bearing age in Mutare District. Health facilities were purposively sampled and participants were systematically sampled. Structured interviews were used to collect data which was analysed in Epi-Info version 7.2. Descriptive and multivariate analysis was performed on data collected from 349 participants. Practice of the five assessed recommended newborn care practices was high. Exclusive breast feeding (62%), early initiation of Breast feeding (74%), good code care (73%), care seeking for neonatal illness within 24hrs of onset of fever (82%) and keeping baby warm was at 58%. Statistically significant independent factors associated with the recommended newborn care practices were post-natal stay for more than 72 hours at the clinic (AOR=0.56; 95%CI: 0.12-0.87, p=0.000), and delivery at the health facility (AOR=0.43; 95%CI: 0.21-0.77; p=0.000). Cultural practices that impact negatively on neonatal care in Mutare district include; asking for permission to seek treatment for the child when ill, feeding the baby immediately after delivery and applying substances and mixed traditional herbs on the cord stump of the newborn. Improving newborn care outcomes require approaches addressing demand and supply factors to reach communities with correct information on good newborn care.

scholarly journals Rural-Urban Disparities and Factors Associated with Delayed Care Seeking for Fever by Mothers of Under-Five Children, Lgabi LGA, Kaduna Nigeria.

2020 ◽  
Author(s):  
Obafemi Joseph Babalola ◽  
Olufemi Ajumobi ◽  
IkeOluwapo O. Ajayi
Keyword(s):  
P Value ◽  
Care Seeking ◽  
Rural Settlements ◽  
Cross Sectional Survey ◽  
Major Health Problem ◽  
Under Five ◽  
Factors Associated ◽  
Under Five Children ◽  
Fever Treatment ◽  
Malaria Knowledge

Abstract Background Fever in under-five children (U5) is the commonest presenting complaint in general practice and mothers’ recognition is an entry point for fever treatment including malaria. This study describes rural - urban disparity in fever prevalence, mothers’ malaria knowledge, and care seeking for fever in U5 and the associated factors. Methods A cross-sectional survey was conducted among 630 mother-child pairs [rural (300) and urban (330)] selected randomly using a multi-stage sampling from 63 villages in Igabi LGA, Kaduna State, Nigeria. Trained female data collectors administered a pre-tested structured questionnaire to collect information on mother-child demographic profiles, malaria knowledge, fever episodes in birth order last child in two weeks prior to survey, and care - seeking for fever within 48 hours of onset. Care sought for fever > 48 hours of onset was defined as delayed care seeking. Malaria knowledge was categorized into good, average and poor if the final scores is ≥ 75 th , 50 th - 74 th , and < 50 th percentiles, respectively. Frequency, proportions, and odds ratio were calculated. Statistically significant was set at p-value < 0.05. Results The median age (interquartile range) of rural mothers was 30 (IQR, 10) years compared to 27 (IQR, 6) years in urban. Of the 70.0% (441/629) U5 children with fever, 58.5% (258/441) were in rural settlements. A third of the mothers whose child had fever sought care. Mothers in rural settlement were 2.7 (CI: 1.8 – 4.2, p < 0.01) times more likely to delay care seeking for fever, and those with no knowledge of malaria transmission were 70% less likely to seek care (OR: 0.3, CI: 0.2 – 0.7). On the other hand, poor perception of malaria as a major health problem (OR: 2.1, CI: 1.4 – 3.1), and poor knowledge of cause of malaria (OR: 1.7, CI: 1.1 – 2.5) were associated with delayed seeking for fever among urban mothers. Conclusions Disparity existed between fever prevalence in U5 children, care -seeking practices by their mothers, and factors associated with delayed care seeking for fever. Fever treatment for high impact malaria elimination needs a context specific intervention rather than ‘one-size-fits-all’ approach. Also, intensify efforts to educate mothers on malaria.

scholarly journals Factors Associated with the Use of Insecticide-Treated Nets Among Women of Reproductive Age in Mozambique, 2018

2021 ◽  
Author(s):  
Fabiao Mausse Mausse ◽  
Erika Valeska Rossetto ◽  
Cynthia Semá Baltazar ◽  
Baltazar Neves Candrinho ◽  
Rose Zulliger
Keyword(s):  
Rural Areas ◽  
Age Groups ◽  
Secondary Analysis ◽  
Wealth Quintile ◽  
Reproductive Age ◽  
P Value ◽  
Insecticide Treated Nets ◽  
Women Of Reproductive Age ◽  
Factors Associated ◽  
Itn Use

Abstract Background: In 2018 there were approximately 228 million diagnosed cases of malaria and 405,000 deaths. The use of insecticide-treated nets (ITNs) is one of the main malaria prevention interventions. Despite widescale distribution resulting in improved ITN access, use remains an important challenge. This study determined factors associated with the use of ITNs among women of reproductive age in Mozambique in 2018.Methods: A secondary analysis of data from the 2018 Malaria Indicator Survey (MIS) was implemented. Women of reproductive age (15-49 years) from households with at least one ITN were included in the analysis. Appropriately weighted descriptive analysis of sociodemographic characteristics and univariate and multivariate logistic regression were performed to identify factors associated with ITN use. The highest frequency categories were used as reference variables for the variables age, province, type of place of residence and wealth quintile and the lowest frequency category was used for education level. Variables that had p-value <0.05 were considered statistically significant.Results: Of 6,184 total women of reproductive age in the MIS, 5,587 women (90%) were in households with at least one ITN, of whom 88% (4,908/5,587) reported prior night use of ITNs. Most women were in the 15-19 age group of whom 81% (975/1,206) reported ITN use. The odds of ITN use were significantly higher in all other age groups compared to these women aged 15-19 years. The odds of ITN use were significantly lower in lower prevalence provinces in southern Mozambique. In adjusted analysis, there was no significant association between the odds of ITN use and malaria knowledge, exposure to malaria messages, literacy, or other sociodemographic variables.Conclusions:. Young women and those in southern Mozambique are demographic groups that would benefit from targeted communication interventions, along with those in rural areas where the burden of malaria is higher.

scholarly journals Factors associated with health facility utilization during childbirth among 15 to 49-year-old women in Uganda: evidence from the Uganda demographic health survey 2016

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Quraish Sserwanja ◽  
David Mukunya ◽  
Milton W. Musaba ◽  
Joseph Kawuki ◽  
Freddy Eric Kitutu
Keyword(s):  
Mass Media ◽  
Health Facility ◽  
Health Survey ◽  
Low Income ◽  
Tertiary Education ◽  
Wealth Quintile ◽  
Northern Region ◽  
Health Facilities ◽  
Low Income Countries ◽  
Factors Associated

Abstract Background Almost all maternal deaths and related morbidities occur in low-income countries. Childbirth supervised by a skilled provider in a health facility is a key intervention to prevent maternal and perinatal morbidity and mortality. Our study aimed to establish the factors associated with health facility utilization during childbirth in Uganda. Methods We used the Uganda Demographic and Health Survey 2016 data of 10,152 women aged 15 to 49 years. The study focused on their most recent live birth in 5 years preceding the survey. We applied multistage stratified sampling to select study participants and we conducted multivariable logistic regression to establish the factors associated with health facility utilization during childbirth, using SPSS (version 25). Results The proportion of women who gave birth at a health facility was 76.6% (7780/10,152: (95% confidence interval, CI, 75.8–77.5). The odds of women aged 15–19 years giving birth at health facilities were twice as those of women aged 40 to 49 years (adjusted odds ratio, AOR = 2.29; 95% CI: 1.71–3.07). Residing in urban areas and attending antenatal care (ANC) were associated with health facility use. The odds of women in the northern region of Uganda using health facilities were three times of those of women in the central region (AOR = 3.13; 95% CI: 2.15–4.56). Women with tertiary education (AOR = 4.96; 95% CI: 2.71–9.11) and those in the richest wealth quintile (AOR = 4.55; 95% CI: 3.27–6.32) had higher odds of using a health facility during child birth as compared to those with no education and those in the poorest wealth quintile, respectively. Muslims, Baganda, women exposed to mass media and having no problem with distance to health facility had higher odds of utilizing health facilities during childbirth as compared to Catholic, non Baganda, women not exposed to mass media and those having challenges with distance to access healthcare. Conclusion Health facility utilization during childbirth was high and it was associated with decreasing age, increasing level of education and wealth index, urban residence, Northern region of Uganda, ANC attendance, exposure to mass media, tribe, religion and distance to the nearby health facility. We recommend that interventions to promote health facility childbirths in Uganda target the poor, less educated, and older women especially those residing in rural areas with less exposure to mass media.

scholarly journals Utilization of insecticide-treated bed nets and care-seeking for fever and its associated socio-demographic and geographical factors among under-five children in different regions: evidence from the Myanmar Demographic and Health Survey, 2015–2016

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Kyi Thar Min ◽  
Thae Maung Maung ◽  
Myo Minn Oo ◽  
Tin Oo ◽  
Zaw Lin ◽  
...  
Keyword(s):  
Health Survey ◽  
Associated Factors ◽  
Wealth Quintile ◽  
Demographic And Health Survey ◽  
Care Seeking ◽  
Under Five ◽  
Factors Associated ◽  
Under Five Children ◽  
Hilly Region ◽  
Care Seeking Behaviour

Abstract Background Malaria is one of the top-five contributors to under-5 deaths in Myanmar. Use of insecticide-treated nets (ITN) and receiving early appropriate care in case of fever are the core interventions to prevent malaria and its complications and thereby deaths. This study aimed to assess among the under-five children, (a) utilization of ITNs and its associated factors, (b) care-seeking behaviour among their caregivers and its associated factors and uptake of malaria testing among those with fever in the last 2 weeks. Methods This was a cross sectional study using secondary analysis of Myanmar Demographic and Health Survey (MDHS) conducted in 2015–2016. Multivariable logistic regression was used to explore the factors associated with non-utilization of ITNs and not seeking care for fever. Effect sizes have been presented using odds ratios with 95% confidence intervals. Data analysis was done using svyset command in STATA to account for the multi-stage sampling design of the survey. Results Of 4597 alive under-five children, 80.5% did not sleep under an ITN last night. The factors significantly associated with non-utilization of ITNs were residing in malaria elimination regions (aOR = 2.0, 1.3–3.2), urban residence (aOR = 1.8, 1.2–2.9), staying in delta region (aOR = 8.7, 4.7–12.2), hilly region (aOR = 3.0, 2.0–4.6, and having highest wealth quintile (aOR = 1.8, 1.1–3.0). Around 16% had fever in the last 2 weeks, of whom 66.7% sought care for fever and 3% got tested for malaria. Nearly half (50.9%) of the caregivers sought care from a government health facility, followed by private hospital/doctor (27.8%), shop (8.0%), village health worker (4.4%) and pharmacy (3.1%). The factors associated with not seeking care for fever were residing in specific geographical locations (hilly, delta and central plains compared to coastal region) and having lowest wealth quintile (aOR = 2.3, 1.1–5.7). Conclusions This study highlighted that ownership and utilization of ITNs was very poor among under-5children. Care-seeking behaviour of the caregivers of under-5 children in case of fever was dismal with two-thirds not seeking care. The programme should seriously consider addressing these barriers if Myanmar is to achieve zero malaria deaths by 2030.

scholarly journals Factors associated with changes in adequate antenatal care visits among pregnant women aged 15-49 years in Tanzania from 2004 to 2016.

2020 ◽  
Author(s):  
ELIZABETH KASAGAMA ◽  
Jim Todd ◽  
Jenny Renju
Keyword(s):  
Population Structure ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Decomposition Analysis ◽  
Secondary Data ◽  
Wealth Quintile ◽  
First Trimester ◽  
World Health ◽  
Continuous Variables ◽  
Factors Associated

Abstract Background: Antenatal care (ANC) is crucial for the health of the mother and the unborn child as it delivers highly–effective health interventions that can prevent maternal and newborn deaths and morbidity. In 2002, the World Health Organization (WHO) recommended a minimum of four ANC visits for a pregnant woman with a positive pregnancy during the entire gestational period. Tanzania has sub-optimal adequate (four or more) ANC visits and the trend has been fluctuating over time. An understanding on the factors that have been contributing to the fluctuating trend over years is crucial in increasing the proportions of pregnant women attaining adequate ANC visits in Tanzania.Methods: The study used secondary data from Tanzania Demographic Health Survey (TDHS) from 2004 to 2016. The study included 17976 women aged 15-49 years. Data were analyzed using stata version 13. Categorical and continuous variables were summarized using descriptive statistics and using the weighted proportions. A Poisson regression analysis was done to determine factors associated with adequate antenatal. A multivariable Poisson decomposition analysis was done to determine factors associated with changes in adequate ANC visits among pregnant women in Tanzania from 2004 to 2016.Results: The overall proportion of women who had adequate ANC visits in 2004/05, 2010 and 2015/16 was 62%, 43% and 51% respectively. The identified determinants of adequate ANC visits were: early ANC initiation, zones, having more than one child, being aged 20 years and above, wanting pregnancy later, belonging to a richer and richest wealth quintile, having secondary and higher education, reporting distance to health facility not a big problem and watching TV at least once per week. Comparing 2004/05 and 2010 surveys, changes in the population structure contributed 4.2% of changes in adequate antenatal care visits while changes in coefficients contributed 95.8% of the changes. Also, comparing 2015/16 to 2010 surveys, changes in population structure and coefficients contributed 66.2% and 33.8% respectively. Conclusion: Early ANC initiation has greatly contributed to increased proportion of pregnant women who attain four or more ANC visits overtime. More effort should focus on pregnant women to initiate ANC in the first trimester in order to increase proportion of women with adequate ANC visit.

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