Muro Florida, Meta Judith, Renju Jenny, Mushi Adiel, Mbakilwa Hilda, Olomi Raimos, Reyburn Hugh, Hildenwall Helena
Kilimanjaro Christian Medical University College, P.O.Box 2240, Moshi, Tanzania.
Kilimanjaro Christian Medical Centre, P.O.Box 3010, Moshi, Tanzania.
BMC Int Health Hum Rights. 2017 Sep 22;17(1):27. doi: 10.1186/s12914-017-0135-1.
Pneumonia is among the leading causes of avoidable deaths for young children globally. The main burden of mortality falls on children from poor and rural families who are less likely to obtain the treatment they need, highlighting inequities in access to effective care and treatment. Caretakers' illness perceptions and care-seeking practices are of major importance for children with pneumonia to receive adequate care. This study qualitatively explores the caretaker concepts of childhood pneumonia in relation to treatment seeking behaviour and health worker management in Moshi urban district, Tanzania.
In May - July 2013 data was gathered through different qualitative data collection techniques including five focus group discussions (FGDs) with mothers of children under-five years of age. The FGDs involved free listing of pneumonia symptoms and video presentations of children with respiratory symptoms done, these were triangulated with ten case narratives with mothers of children admitted with pneumonia and eleven in-depth interviews with hospital health workers. Transcripts were coded and analysed using qualitative content analysis.
Mothers demonstrated good awareness of common childhood illnesses including pneumonia, which was often associated with symptoms such as cough, flu, chest tightness, fever, and difficulty in breathing. Mothers had mixed views on causative factors and treatments options but generally preferred modern medicine for persisting and severe symptoms. However, all respondent reported access to health facilities as a barrier to care, associated with transport, personal safety and economic constraints.
Local illness concepts and traditional treatment options did not constitute barriers to care for pneumonia symptoms. Poor access to health facilities was the main barrier. Decentralisation of care through community health workers may improve access to care but needs to be combined with strengthened referral systems and accessible hospital care for those in need.
肺炎是全球幼儿可避免死亡的主要原因之一。死亡的主要负担落在贫困和农村家庭的儿童身上，他们获得所需治疗的可能性较小，这凸显了在获得有效护理和治疗方面的不平等。照顾者对疾病的认知和寻求护理的行为对于患肺炎的儿童获得充分护理至关重要。本研究定性探讨了坦桑尼亚莫希市区照顾者对儿童肺炎的认知与寻求治疗行为以及卫生工作者管理之间的关系。
2013年5月至7月，通过不同的定性数据收集技术收集数据，包括与五岁以下儿童的母亲进行五次焦点小组讨论（FGD）。焦点小组讨论包括自由列出肺炎症状以及播放有呼吸道症状儿童的视频，这些与十份患肺炎儿童母亲的病例叙述以及对医院卫生工作者的十一次深入访谈进行了三角互证。使用定性内容分析法对转录本进行编码和分析。
母亲们对包括肺炎在内的常见儿童疾病表现出良好的认知，肺炎通常与咳嗽、流感、胸闷、发烧和呼吸困难等症状相关。母亲们对病因和治疗选择看法不一，但一般在症状持续和严重时更倾向于现代医学。然而，所有受访者都报告说，获得卫生设施是护理的障碍，这与交通、人身安全和经济限制有关。
当地的疾病认知和传统治疗选择并非肺炎症状护理的障碍。获得卫生设施的机会差是主要障碍。通过社区卫生工作者进行护理的分散化可能会改善获得护理的机会，但需要与加强转诊系统以及为有需要的人提供可及的医院护理相结合。
