Sex and socioeconomic differentials in child health in rural Bangladesh: findings from a baseline survey for evaluating Integrated Management of Childhood Illness.

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dc.contributor.authorEl Arifeen, Shamsen_US
dc.contributor.authorBaqui, Abdullah Hen_US
dc.contributor.authorVictora, Cesar Gen_US
dc.contributor.authorBlack, Robert Een_US
dc.contributor.authorBryce, Jenniferen_US
dc.contributor.authorHoque, D M Een_US
dc.contributor.authorChowdhury, E Ken_US
dc.contributor.authorBegum, Nen_US
dc.contributor.authorAkter, Ten_US
dc.contributor.authorSiddik, Aen_US
dc.date.accessioned2008-03-22en_US
dc.date.accessioned2009-05-27T03:49:44Z
dc.date.available2008-03-22en_US
dc.date.available2009-05-27T03:49:44Z
dc.date.issued2008-03-22en_US
dc.descriptionJournal of Health, Population, and Nutrition.en_US
dc.description.abstractThis paper reports on a population-based sample survey of 2,289 children aged less than five years (under-five children) conducted in 2000 as a baseline for the Bangladesh component of the Multi-country Evaluation (MCE) of the Integrated Management of Childhood Illness strategy. Of interest were rates and differentials by sex and socioeconomic status for three aspects of child health in rural Bangladesh: morbidity and hospitalizations, including severity of illness; care-seeking for childhood illness; and home-care for illness. The survey was carried out among a population of about 380,000 in Matlab upazila (subdistrict). Generic MCE Household Survey tools were adapted, translated, and pretested. Trained interviewers conducted the survey in the study areas. In total, 2,289 under-five children were included in the survey. Results showed a very high prevalence of illness among Bangladeshi children, with over two-thirds reported to have had at least one illness during the two weeks preceding the survey. Most sick children in this population had multiple symptoms, suggesting that the use of the IMCI clinical guidelines will lead to improved quality of care. Contrary to expectations, there were no significant differences in the prevalence of illness either by sex or by socioeconomic status. About one-third of the children with a reported illness did not receive any care outside the home. Of those for whom outside care was sought, 42% were taken to a village doctor. Only 8% were taken to an appropriate provider, i.e. a health facility, a hospital, a doctor, a paramedic, or a community-based health worker. Poorer children than less-poor children were less likely to be taken to an appropriate healthcare provider. The findings indicated that children with severe illness in the least poor households were three times more likely to seek care from a trained provider than children in the poorest households. Any evidence of gender inequities in child healthcare, either in terms of prevalence of illness or care-seeking patterns, was not found. Care-seeking patterns were associated with the perceived severity of illness, the presence of danger signs, and the duration and number of symptoms. The results highlight the challenges that will need to be addressed as IMCI is implemented in health facilities and extended to address key family and community practices, including extremely low rates of use of the formal health sector for the management of sick children. Child health planners and researchers must find ways to address the apparent population preference for untrained and traditional providers which is determined by various factors, including the actual and perceived quality of care, and the differentials in care-seeking practices that discriminate against the poorest households.en_US
dc.description.affiliationICDDR,B, GPO Box 128, Dhaka 1000, Bangladesh. shams@icddrb.orgen_US
dc.identifier.citationEl Arifeen S, Baqui AH, Victora CG, Black RE, Bryce J, Hoque DM, Chowdhury EK, Begum N, Akter T, Siddik A. Sex and socioeconomic differentials in child health in rural Bangladesh: findings from a baseline survey for evaluating Integrated Management of Childhood Illness. Journal of Health, Population, and Nutrition. 2008 Mar; 26(1): 22-35en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/661
dc.language.isoengen_US
dc.source.urihttps://www.icddrb.org/pub/publication.jsp?classificationID=30&typeClassificationID=2en_US
dc.source.urihttps://www.icddrb.org/publication.cfm?classificationID=30&pubID=9251en_US
dc.subject.meshBangladeshen_US
dc.subject.meshChild Health Services --standardsen_US
dc.subject.meshChild Welfareen_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshFemaleen_US
dc.subject.meshHealth Care Surveys --statistics & numerical dataen_US
dc.subject.meshHealth Services Researchen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshInfant, Newbornen_US
dc.subject.meshMaleen_US
dc.subject.meshPovertyen_US
dc.subject.meshQuality of Health Careen_US
dc.subject.meshRural Populationen_US
dc.subject.meshSentinel Surveillanceen_US
dc.subject.meshSeverity of Illness Indexen_US
dc.subject.meshSex Factorsen_US
dc.subject.meshSocioeconomic Factorsen_US
dc.titleSex and socioeconomic differentials in child health in rural Bangladesh: findings from a baseline survey for evaluating Integrated Management of Childhood Illness.en_US
dc.typeJournal Articleen_US
dc.typeResearch Support, Non-U.S. Gov'ten_US
dc.typeResearch Support, U.S. Gov't, Non-P.H.S.en_US
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