Health Communication and Capacity Collaborative Project, Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA.
National Malaria Control Programme, Ministry of Health, Capitol By-Pass, PO Box 10-9009, 1000, Monrovia 10, Liberia.
Malar J. 2018 Mar 7;17(1):105. doi: 10.1186/s12936-018-2249-x.
BACKGROUND: In 2010, malaria was responsible for an estimated 41% of deaths among children under the age of five years in Liberia. The same year, the Rebuilding Basic Health Services Project launched "Healthy Baby, Happy Mother," a social and behavior change communication campaign. The campaign encouraged caregivers to take children under the age of five years to a health facility as soon as children developed fever. This study investigated correlates of two case management outcomes: care-seeking for children under five with fever during the past two weeks and administration of an artemisinin-based combination therapy (ACT) the same or next day as fever onset. METHODS: Data from a 2014 cross-sectional household survey from four counties was used to investigate correlates of two case management outcomes. Using multilevel analysis, the association between these outcomes and a caregiver's recall of the campaign, her sociodemographic characteristics, and unmeasured characteristics of the community she lived in was investigated. RESULTS: Caregivers living in Grand Kru County were less likely (OR = 0.21, 95% CI 0.073, 0.632) to take a child to a health facility than those in Bong County. Caregiver recall of the campaign was positively associated with the odds that a child received an ACT promptly (OR 3.62, 95% CI 1.398-9.372), but not with the odds of a caregiver taking a child in their care to a health facility. While unmeasured community-level factors accounted for 19.0% of the variation in the odds that a caregiver's child was brought to a health facility, they did not play a role in the odds of prompt ACT treatment. CONCLUSIONS: Recalling the "Healthy Mother, Happy Baby" campaign was positively associated with the odds that children received ACT promptly, even in the absence of other malaria prevention and treatment messaging. While caregiver exposure was not associated with care-seeking during the two weeks before interview, prompt care-seeking likely preceded prompt receipt of ACT since most ACT came from health facilities. Unmeasured community-level factors, such as distance from the health facility, may play a role in determining the odds that a caregiver takes a child to a health facility.
背景：2010 年，利比里亚 5 岁以下儿童死亡人数中约有 41%是由疟疾导致的。同年，重建基本卫生服务项目发起了“健康宝宝，快乐妈妈”社会和行为改变传播活动。该活动鼓励照顾者一旦孩子发烧，就带 5 岁以下的孩子去医疗机构。本研究调查了两个病例管理结果的相关因素：在过去两周内，五岁以下儿童发烧时寻求医疗照顾的情况，以及发烧当天或次日使用青蒿素为基础的联合治疗（ACT）的情况。
方法：本研究使用了 2014 年来自四个县的一项横断面家庭调查的数据，以调查两个病例管理结果的相关因素。使用多水平分析，调查了这些结果与照顾者对该活动的记忆、她的社会人口统计学特征以及她所在社区未测量特征之间的关联。
结果：与 Bong 县的照顾者相比，居住在大克鲁县的照顾者带孩子去医疗机构的可能性较小（OR=0.21，95%CI 0.073，0.632）。照顾者对该活动的记忆与孩子及时接受 ACT 的可能性呈正相关（OR 3.62，95%CI 1.398-9.372），但与照顾者带孩子去医疗机构的可能性无关。虽然未测量的社区层面因素占照顾者带孩子去医疗机构的可能性变化的 19.0%，但它们在孩子及时接受 ACT 治疗的可能性方面没有作用。
结论：回忆“健康妈妈，快乐宝宝”活动与儿童及时接受 ACT 的可能性呈正相关，即使在没有其他疟疾预防和治疗信息的情况下也是如此。虽然照顾者的接触与访谈前两周的就诊情况无关，但及时就诊可能先于及时接受 ACT，因为大多数 ACT 来自医疗机构。未测量的社区层面因素，如与医疗机构的距离，可能在决定照顾者带孩子去医疗机构的可能性方面发挥作用。
BMC Public Health. 2015-9-23
Glob Health Sci Pract. 2022-4-28
Bull World Health Organ. 2021-11-1
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