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首页> 外文期刊>Journal of Global Health >Determinants and patterns of care-seeking for childhood illness in rural Pune District, India
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Determinants and patterns of care-seeking for childhood illness in rural Pune District, India

机译：印度浦尾区儿童疾病的决定因素和追求挑战模式

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Background An estimated 1.2 million children under five years of age die each year in India, with pneumonia and diarrhea among the leading caus- es. Increasing care-seeking is important to reduce mortality and morbidity from these causes. This paper explores the determinants and patterns of care-seeking for childhood illness in rural Pune district, India. Methods Mothers having at least one child <5 years from the study area of the Vadu Health and Demographic Surveillance System were enrolled in a prospective cohort study. Household sociodemographic information was collected through a baseline questionnaire administered at enrollment. Participants were visited up to six times between July 2015 and February 2016 to collect information on recent childhood acute illness and associ- ated care-seeking behavior. Multivariate logistic regression explored the associations between care-seeking and child, participant, and household characteristics. Results We enrolled 743 mothers with 1066 eligible children, completing 2585 follow-up interviews (90% completion). Overall acute illness prev- alence in children was 26% with care sought from a health facility during 71% of episodes. Multivariable logistic regression showed care-seeking was associated with the number of reported symptoms (Odds ratio (OR) = 2.4, 95% confidence interval (CI) = 1.5-3.9) and household insurance cover- age (OR = 2.2, 95% CI = 1.1-4.3). We observed an interaction between the associations of illness severity and maternal employment on care-seeking. Somewhat-to-very severe illness was associated with increased care-seeking among both employed (OR = 5.0, 95% CI = 2.2-11.1) and currently unem- ployed mothers (OR = 7.0, 95% CI = 3.9-12.6). Maternal employment was associated with reduced care-seeking for non-severe illness (OR = 0.3, 95% CI = 0.1-0.7), but not associated with care-seeking for somewhat-to-very severe illness. Child sex was not associated with care-seeking. Conclusions This study demonstrates the importance of illness character- istics in determining facility-based care-seeking while also suggesting that maternal employment resulted in decreased care-seeking among non-se- vere illness episodes. The nature of the association between maternal em- ployment and care-seeking is unclear and should be explored through ad- ditional studies. Similarly, the absence of male bias in care-seeking should be examined to assess for potential bias at other stages in the management of childhood illness.
机译：背景，在印度每年5岁以下的估计120万名儿童在印度死亡，肺炎和腹泻是领先的原因。越来越苛刻的追求对于减少这些原因的死亡率和发病率是重要的。本文探讨了印度浦尾区农村疾病的决定因素和幼儿疾病模式。方法有至少一个孩子的母亲从Vadu健康和人口监测系统的研究领域开始的<5年的母亲在预期的队列研究中注册了。通过在注册时管理的基线调查问卷收集家庭社会渗目信息。参与者在2015年7月至2016年7月至2016年2月期间访问了六次，以收集有关近期儿童急性疾病的信息和关心的追求行为。多变量逻辑回归探索了课程和儿童，参与者和家庭特征之间的协会。结果我们注册了743名母亲的母亲1066名符合条件的儿童，完成了2585份后续访谈（90％完成）。在71％的发作期间，儿童的总体急性疾病预期为26％，在卫生设施中寻求。多变量的逻辑回归显示仔细寻求症状与报告症状的数量有关（差距（或）= 2.4,95％置信区间（CI）= 1.5-3.9）和家庭保险息（或= 2.2,95％CI） = 1.1-4.3）。我们观察到疾病严重程度和母亲就业协会与仔细的互动。有些令人严重的疾病与雇用（或= 5.0,95％CI = 2.2-11.1）和目前未缺乏的母亲（或= 7.0,95％CI = 3.9-12.6）相关的疾病有关母体就业与针对非严重疾病的追求减少（或= 0.3,95％CI = 0.1-0.7）有关，但与仔细疾病无关，不关联。儿童性没有与追求有关。结论本研究表明，疾病特征在确定基于设施的追求中的重要性，同时也表明母亲就业导致非疾病发作中的追求下降。孕产妇的关联性质和追求追求之间的性质尚不清楚，并应通过附加研究进行探索。同样，应检查缺乏持牧场的偏见，以评估其他阶段的潜在偏见在儿童疾病的管理中。

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