Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, South Korea.
College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Int J Equity Health. 2017 Apr 21;16(1):67. doi: 10.1186/s12939-017-0561-7.
Globally, 5.9 million children under the age of five died in 2015. More than half and almost one-third of those deaths occurred in sub-Saharan Africa and South Asia, respectively. Diarrhea and Pneumonia, which were the major causes of the problem, accounted for more than two million deaths of the world's youngest children every year. Like other developing countries, child health services utilization is low in Ethiopia. The aim of this study was to identify the determinant factors for the inequalities in medical treatment seeking behavior for common childhood illnesses in Ethiopia.
Data were obtained from the Ethiopian Demographic and Health Survey (EDHS) 2011. All children who had diarrhea, cough, and fever in the 2 weeks preceding the survey were included. A total of 1620 children with diarrhea, 2082 with fever, and 2134 with cough were included in the analyses. Multivariate logistic regression with a 95% confidence interval, adjusted odds-ratio, and a P < 0.05 were used to determine the independent effect of each variable.
Household wealth-status, maternal and paternal education, and religion were found to be associated with the inequality in the use of child health services. Respondents from households with the richest, richer, and middle wealth status had higher odds of seeking medical treatment for childhood diarrhea, cough, and fever than that of the poorest ones. Maternal and paternal educational status was also associated with medical treatment seeking behavior for childhood diarrhea and fever, respectively.
Household wealth and educational status of parents were possible determinant factors for the inequalities observed in health care seeking behavior. Policy interventions aimed at improving the appropriate medical treatment seeking behavior for common childhood illnesses are desirable. Practical economic policies aimed at moving those in the lower wealth quintile are essential to bridge the gap between the rich and the poor. Studies comprising qualitative and quantitative methods are recommended to further explore other determinants of health care utilization.
2015 年，全球有 590 万名 5 岁以下儿童死亡。其中，超过一半和近三分之一的儿童分别在撒哈拉以南非洲和南亚地区死亡。腹泻和肺炎是导致这一问题的主要原因，每年导致全世界最年幼的儿童死亡超过 200 万人。与其他发展中国家一样，埃塞俄比亚的儿童卫生服务利用率较低。本研究旨在确定埃塞俄比亚儿童常见疾病治疗寻求行为不平等的决定因素。
数据来自 2011 年埃塞俄比亚人口与健康调查（EDHS）。所有在调查前两周内患有腹泻、咳嗽和发热的儿童均被纳入研究。共有 1620 名腹泻儿童、2082 名发热儿童和 2134 名咳嗽儿童纳入分析。采用具有 95%置信区间、调整后优势比和 P<0.05 的多变量逻辑回归，以确定每个变量的独立影响。
家庭财富状况、父母教育程度和宗教与儿童卫生服务利用不平等有关。来自最富有、较富有和中等财富家庭的受访者比最贫穷家庭更有可能为儿童腹泻、咳嗽和发热寻求医疗治疗。父母的教育程度也与儿童腹泻和发热的治疗寻求行为有关。
家庭财富和父母的教育程度是观察到的卫生保健寻求行为不平等的可能决定因素。需要采取政策干预措施，以改善对常见儿童疾病的适当医疗治疗寻求行为。制定旨在提高较低财富阶层的实际经济政策对于缩小贫富差距至关重要。建议开展定性和定量相结合的研究，以进一步探讨卫生保健利用的其他决定因素。
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