Determinants of care seeking for children with pneumonia and diarrhea in guatemala: Implications for intervention strategies

N. Bruce, D. Pope, B. Arana, C. Shiels, C. Romero, R. Klein and D. Stanistreet

American Journal of Public Health, 2014, vol. 104, issue 4, 647-657

Abstract: Objectives. We identified barriers to care seeking for pneumonia and diarrhea among rural Guatemalan children. Methods. A population-based survey was conducted twice from 2008 to 2009 among 1605 households with children younger than 5 years. A 14-day calendar recorded episodes of carer-reported pneumonia (n = 364) and diarrhea (n = 481), and formal (health services, public, private) and informal (neighbors, traditional, local shops, pharmacies) care seeking. Results. Formal care was sought for nearly half of severe pneumonias but only for 27% within 2 days of onset, with 31% and 18%, respectively, for severe diarrhea. In multivariable analysis, factors independently associated with formal care seeking were knowing the Community Emergency Plan, mother's perception of illness severity, recognition of World Health Organization danger signs, distance from the health center, and having someone to care for family in an emergency. Conclusions. Proximal factors associated with recognizing need for care were important in determining formal care, and were strongly linked to social determinants. In addition to specific action by the health system with an enhanced community health worker role, a systems approach can help ensure barriers are addressed among poorer and more remote homes.

Keywords: adult; article; attitude to health; diarrhea; female; Guatemala; health care delivery; human; infant; information processing; interview; male; patient attitude; pneumonia; preschool child; rural population; severity of illness index; socioeconomics; statistics, Adult; Child, Preschool; Data Collection; Diarrhea; Female; Guatemala; Health Knowledge, Attitudes, Practice; Health Services Accessibility; Humans; Infant; Interviews as Topic; Male; Patient Acceptance of Health Care; Pneumonia; Rural Population; Severity of Illness Index; Socioeconomic Factors (search for similar items in EconPapers)
Date: 2014
References: Add references at CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
http://hdl.handle.net/10.2105/AJPH.2013.301658

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2013.301658_2

DOI: 10.2105/AJPH.2013.301658

Access Statistics for this article

American Journal of Public Health is currently edited by Alfredo Morabia

More articles in American Journal of Public Health from American Public Health Association
Bibliographic data for series maintained by Christopher F Baum ().