Unit for Health Promotion Research, University of Southern Denmark, 6700 Esbjerg, Denmark.
Global Health Section, Department of Public Health, University of Copenhagen, 1050 Copenhagen, Denmark.
Int J Environ Res Public Health. 2021 Jan 4;18(1):308. doi: 10.3390/ijerph18010308.
Child survival and wellbeing remain a global health challenge despite vast development within the area and a significant decline in mortality rates of children under five years of age. This study investigates the perceived causes of ill health and childhood mortality in the context of five villages located in the Tonkolili district of Sierra Leone. Mixed method methodology was applied in this study consisting of both quantitative and qualitative data contribution. The quantitative part consisted of a household survey on child health, where 341 households, equivalent to 50.6% of the total number of households in the five villages, participated with a response rate of 100%. The qualitative part consisted of six semi structured interviews-one with a health care worker and five with mothers from each village. The main perceived reason for child morbidity was inadequate care of children related to personal hygiene of the child, hygiene and safety in the environment, in-sufficient nutrition, inadequate supervision and poor healthcare seeking behavior. Additionally, reasons given for disease included supernatural forces such as witchcraft. In relation to the survey, the perceived causes of child mortality for ill children in the villages were mainly malaria (33.6%), diarrhea (11.6%), pneumonia (8.6%), and unknown (26%). The observed symptoms of illness among children were fever (43.7%), cough and difficulty breathing (10.7%), frequent watery stool (10.3%) and no symptoms (20.3%). The perception of ill health in children was mainly associated with the parent's ability to cater for the child's physical needs, but also associated with external factors such as witchcraft and "God's will". In addition, biomedical causes for disease and supernatural causes for disease were seen to coexist.
尽管在该领域取得了巨大发展，五岁以下儿童死亡率也显著下降，但儿童生存和福祉仍然是全球卫生挑战。本研究调查了塞拉利昂通科利利区五个村庄背景下人们对儿童健康不良和儿童死亡的看法。本研究采用了混合方法学，包括定量和定性数据贡献。定量部分包括一项儿童健康家庭调查，共有 341 户家庭（相当于五个村庄总家庭数的 50.6%）参与了调查，回应率为 100%。定性部分包括六次半结构式访谈，一次是与一名保健工作者，五次是与每个村庄的五位母亲进行的访谈。儿童发病的主要原因是对儿童照顾不足，包括儿童个人卫生、环境卫生和安全、营养不足、监督不力和不良的医疗保健行为。此外，疾病的原因还包括巫术等超自然力量。就调查而言，村庄中患病儿童死亡的主要原因是疟疾（33.6%）、腹泻（11.6%）、肺炎（8.6%）和未知（26%）。观察到儿童患病的症状是发烧（43.7%）、咳嗽和呼吸困难（10.7%）、频繁水样腹泻（10.3%）和无症状（20.3%）。儿童健康不良的感知主要与父母满足孩子身体需求的能力有关，但也与巫术和“上帝的旨意”等外部因素有关。此外，还存在生物医学病因和超自然病因并存的情况。
