Matlab Health Research Centre, ICDDR,B, GPO Box 128, Dhaka 1000 Bangladesh.
BMC Pediatr. 2011 Oct 14;11:88. doi: 10.1186/1471-2431-11-88.
Poor neonatal health is a major contributor to under-five mortality in developing countries. A major constraint to effective neonatal survival programme has been the lack of population level data in developing countries. This study investigated the consultation patterns of caregivers during neonatal fatal illness episodes in the rural Matlab sub-district of eastern Bangladesh.
Neonatal deaths were identified through a population-based demographic surveillance system in Matlab ICDDR,B maternal and child health (MCH) project area and an adjoining government service area. Trained project staff administered a structured questionnaire on care seeking to mothers at home who had experienced a neonatal death. Univariate, bivariate and binary multivariate logistic regressions were performed to describe care seeking during the fatal illness episode.
Of the 365 deaths recorded during 2003 and 2004, 84% died in the early (0-7 days) neonatal period, with the remaining deaths occurring over the subsequent 8 to 28 days. The first resort of care by parents was a qualified doctor or paramedic in 37% of cases, followed by traditional and unqualified health care providers in 25%, while 38% sought no care. Thus, almost two thirds (63%) of neonates who died received only traditional and unqualified care or no care at all during their final illness episode. About 22% sought care from more than one provider, including 6% from 3 or more providers. Such plurality in care seeking was more likely among male infants, in the late neonatal period, and in the MCH project area.
The high proportion of neonatal deaths that had received traditional care or no medical care in a rural area of Bangladesh highlights the need to develop community awareness about prompt medical care seeking for neonatal illnesses and to improve access to effective health care. Integration of traditional care providers into mainstream health programs should also be considered.
在发展中国家，新生儿健康状况不佳是导致五岁以下儿童死亡的主要原因。发展中国家缺乏人口水平数据，这是有效新生儿生存方案的主要制约因素。本研究调查了孟加拉国东部 Matlab 分区农村地区新生儿致命疾病发作期间照顾者的咨询模式。
通过 Matlab ICDDR,B 母婴健康（MCH）项目区和毗邻政府服务区的基于人群的人口监测系统确定新生儿死亡。受过培训的项目工作人员向在家中经历新生儿死亡的母亲进行了关于寻求护理的结构化问卷调查。进行了单变量、双变量和二元多变量逻辑回归，以描述在致命疾病发作期间的护理寻求情况。
在 2003 年和 2004 年记录的 365 例死亡中，84%的死亡发生在早期（0-7 天）新生儿期，其余死亡发生在随后的 8 至 28 天。父母的第一求助对象是合格的医生或护士，占 37%，其次是传统和不合格的医疗保健提供者，占 25%，而 38%的人没有寻求护理。因此，几乎三分之二（63%）的死亡新生儿在其最后一次疾病发作期间仅接受传统和不合格的护理或根本没有护理。约 22%的人寻求了不止一个提供者的护理，包括 6%的人寻求了 3 个或更多提供者的护理。在孟加拉国农村地区，这种寻求护理的多样性在男婴、晚期新生儿期和 MCH 项目区更为常见。
在孟加拉国农村地区，接受传统护理或根本没有医疗护理的新生儿死亡比例很高，这突出表明需要提高社区对及时寻求新生儿疾病医疗护理的认识，并改善获得有效医疗保健的机会。还应考虑将传统护理提供者纳入主流卫生方案。
