Sociology Discipline, Social Science School, Khulna University, Khulna, Bangladesh.
PLoS One. 2022 Sep 12;17(9):e0274449. doi: 10.1371/journal.pone.0274449. eCollection 2022.
Although Bangladesh has made significant progress in reducing child mortality, proper utilization of health services for under-five children among mothers remains one of the major challenges. Hence, this study was designed to investigate the factors influencing health service utilization among mothers for under-five children in the Khulna district of Bangladesh. Administering a semi-structured interview schedule, data were collected from 364 randomly selected mothers from the study area between June and August 2021. At first, Pearson's Chi-square test was conducted to measure the association between outcome and predictor variables. Multivariable logistic regression model was used to identify the factors associated with utilization of health services. Overall, about 59 percent of the mother received health services from unqualified doctors during their children's illness and the rest of them (41.5%) seek care from the qualified doctors. Results of regression analysis revealed that long duration of illness (AOR = 2.338; CI: 1.175-4.649; p = 0.015), the severity of illness (AOR = 6.402; CI: 3.275-12.513; p<0.001), and higher cost of treatment (AOR = 7.371; CI: 3.297-16.480; p<0.001) were the significant predictors of utilization of health services from the qualified doctors for under-five children. Thus, the study suggests that to reduce under-five child mortality by ensuring proper utilization of health services, it is necessary to raise awareness among mothers, improve transport facilities, establish need-based health care centers, and lower treatment costs.
尽管孟加拉国在降低儿童死亡率方面取得了重大进展，但母亲对 5 岁以下儿童的适当卫生服务利用仍然是主要挑战之一。因此，本研究旨在调查影响孟加拉国库尔纳地区母亲为 5 岁以下儿童利用卫生服务的因素。在 2021 年 6 月至 8 月期间，通过半结构式访谈表从研究地区随机抽取了 364 名母亲收集数据。首先，进行 Pearson's Chi-square 检验以衡量结果与预测变量之间的关联。使用多变量逻辑回归模型确定与卫生服务利用相关的因素。总体而言，约有 59%的母亲在孩子生病期间接受了不合格医生的治疗，其余 41.5%的母亲则寻求合格医生的治疗。回归分析的结果表明，疾病持续时间长（AOR = 2.338；CI：1.175-4.649；p = 0.015）、疾病严重程度（AOR = 6.402；CI：3.275-12.513；p<0.001）和治疗费用较高（AOR = 7.371；CI：3.297-16.480；p<0.001）是母亲选择合格医生为 5 岁以下儿童提供治疗的重要预测因素。因此，该研究表明，为了通过确保适当利用卫生服务来降低 5 岁以下儿童死亡率，有必要提高母亲的意识，改善交通设施，建立基于需求的医疗中心，并降低治疗费用。
