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Care-seeking behaviours of mothers and associated factors for possible serious bacterial infection in young infants during COVID-19 pandemic in Ethiopia: mixed-methods formative research.
- Source :
-
BMJ open [BMJ Open] 2023 Jul 05; Vol. 13 (7), pp. e073118. Date of Electronic Publication: 2023 Jul 05. - Publication Year :
- 2023
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Abstract
- Objectives: Implementation research was employed to examine rates and contextual factors associated with mothers' care-seeking for their sick neonates and identify challenges for community-based possible serious bacterial infection (PSBI) services access and implementation during the COVID-19 pandemic.<br />Design: We conducted formative research involving household survey and programmatic qualitative study.<br />Setting: This formative study was conducted in Dembecha and Lume woredas of Amhara and Oromia regions.<br />Participants: Data were captured from 4262 mothers aged 15-49 years who gave live birth 2-14 months before data collection, and interviews with 18 programme managers and 16 service providers in April to May 2021.<br />Analysis: A multilevel regression model was employed to identify predictors of maternal care-seeking for PSBI and thematic qualitative analysis to inform strategy development to strengthen PSBI implementation.<br />Results: Overall, 12% (95% CI 11.0% to 12.9%) and 8% (95% CI 7.9% to 9.6%) of mothers reported any newborn illness and severe neonatal infection (PSBI), respectively. More than half of mothers sought formal medical care, 56% (95% CI 50.7% to 60.8%) for PSBI. Women who received postnatal care within 6 weeks (adjusted OR (AOR) 2.08; 95% CI 1.12 to 3.87) and complete antenatal care (ie, weight measured, blood pressure taken, urine and blood tested) (AOR 2.04; 95% CI 1.12 to 3.75) had higher odds of care-seeking for PSBI. Conversely, fear of COVID-19 (AOR 0.27; 95% CI 0.15 to 0.47) and residing more than 2 hours of walking distance from the health centre (AOR 0.39; 95% CI 0.16 to 0.93) were negatively associated with care-seeking for severe newborn infection. Multiple pre-existing health system bottlenecks were identified from interviews as barriers to PSBI service delivery and exacerbated by the COVID-19 pandemic.<br />Conclusion: We found gaps in and factors associated with care-seeking behaviour of mothers for their sick young infants including fear of COVID-19 and pre-existing health system-level barriers. The findings of the study were used to design and implement strategies to mitigate COVID-19 impacts on management of PSBI.<br />Competing Interests: Competing interests: The authors (GTT, NF, DE, WB and KE) work for JSI Research & Training Institute, a commercial company.<br /> (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)
Details
- Language :
- English
- ISSN :
- 2044-6055
- Volume :
- 13
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- BMJ open
- Publication Type :
- Academic Journal
- Accession number :
- 37407046
- Full Text :
- https://doi.org/10.1136/bmjopen-2023-073118