埃塞俄比亚的健康中心准备情况及其对患病儿童母亲就医行为的影响。
Health post readiness and its influence on mothers' care-seeking practice for their sick children in Ethiopia.
作者信息
Mekonnen Wassie Negash, Tiruneh Gizachew Tadele, Birhane Adugnaw, Mekonnen Wubegzier
机构信息
School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
JSI Research and Training Institute, Inc., Addis Ababa, Ethiopia.
出版信息
Front Public Health. 2025 Jun 16;13:1569970. doi: 10.3389/fpubh.2025.1569970. eCollection 2025.
INTRODUCTION
Infection accounts for about half of all neonatal deaths and it contributes to 37% of neonatal deaths in Sub-Saharan Africa where there is low health facility readiness and the quality of service given at health facilities is low. In this study, we assessed the influence of health posts' readiness on the care-seeking behavior of mothers of sick young children.
METHOD
This study analyzed data from a community-based implementation survey conducted by JSI in the two districts of Ethiopia from April 2021 to July 2022. In this study, we enrolled 4,262 and 4,081 mothers with children < 15 months at the baseline and end-line surveys, respectively, of which 508 and 359 infants were diagnosed for illness at 66 and 64 health posts at the baseline and end-line surveys. We used the Service Availability and Readiness Assessment tool to compute the facility readiness score. We used independent sample -test and logistic regression to see the contributions of facility readiness for care-seeking practices of mothers. AOR at 95% CI and -value < 0.05 is used to declare a statistically significant association between variables and to control the confounding.
RESULTS
In the end-line survey about 359 sick young infants were identified. And in the baseline survey, 508 young infants were ill. Most of 88.0% sick young infants sought care in the end line compared to 57.3% at the baseline ( < 0.001). The overall summated mean facility readiness score was 69.6%, equivalent to 49.0% of the standardized mean score. This study also highlights rich households (AOR = 2.02; 95% CI: 1.1-3.9), reaching out to health posts (HPs) equipped with materials and supplies (AOR = 1.52; 95% CI: 1.2-1.9), and ANC use (AOR = 2.35; 95%CI: 1.2-4.7) were positively associated with care seeking practice compared to their counterparts.
CONCLUSION
The study reveals a moderate level of health post-readiness that needs improvement. Health posts readiness, ANC use, parity, and wealth status influenced the care-seeking behavior of mothers for their sick children.
引言
感染约占所有新生儿死亡的一半，在撒哈拉以南非洲地区，感染导致37%的新生儿死亡，该地区卫生设施准备不足，且卫生设施提供的服务质量较低。在本研究中，我们评估了卫生站的准备情况对患病幼儿母亲寻求医疗行为的影响。
方法
本研究分析了JSI于2021年4月至2022年7月在埃塞俄比亚两个地区进行的一项基于社区的实施调查的数据。在本研究中，我们在基线调查和终线调查中分别纳入了4262名和4081名15个月以下儿童的母亲，其中在基线调查和终线调查中，分别有508名和359名婴儿在66个和64个卫生站被诊断患病。我们使用服务可用性和准备情况评估工具来计算设施准备得分。我们使用独立样本t检验和逻辑回归来观察设施准备对母亲寻求医疗行为的影响。95%置信区间的调整后比值比（AOR）和P值<0.05用于表明变量之间存在统计学显著关联并控制混杂因素。
结果
在终线调查中，共识别出约359名患病幼儿。在基线调查中，有508名幼儿患病。在终线调查中，88.0%的患病幼儿寻求了医疗服务，而在基线调查中这一比例为57.3%（P<0.001）。设施准备得分的总体汇总平均分为69.6%，相当于标准化平均分的49.0%。本研究还强调，与其他情况相比，富裕家庭（AOR = 2.02；95%置信区间：1.1 - 3.9）、前往配备物资和用品的卫生站（AOR = 1.52；95%置信区间：1.2 - 1.9）以及产前护理的使用（AOR = 2.35；95%置信区间：1.2 - 4.7）与寻求医疗行为呈正相关。
结论
该研究揭示了卫生站准备情况处于中等水平，有待改善。卫生站的准备情况、产前护理的使用、胎次和财富状况影响了母亲为患病子女寻求医疗的行为。
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