Back to Search
Start Over
Distance to care, care seeking and child mortality in rural Burkina Faso: findings from a population‐based cross‐sectional survey
- Source :
- Tropical Medicine & International Health
- Publication Year :
- 2018
- Publisher :
- John Wiley and Sons Inc., 2018.
-
Abstract
- Objective Although distance has been identified as an important barrier to care, evidence for an effect of distance to care on child mortality is inconsistent. We investigated the association of distance to care with self‐reported care seeking behaviours, neonatal and post‐neonatal under‐five child mortality in rural areas of Burkina Faso. Methods We performed a cross‐sectional survey in 14 rural areas from November 2014 to March 2015. About 100 000 women were interviewed on their pregnancy history and about 5000 mothers were interviewed on their care seeking behaviours. Euclidean distances to the closest facility were calculated. Mixed‐effects logistic and Poisson regressions were used respectively to compute odds ratios for care seeking behaviours and rate ratios for child mortality during the 5 years prior to the survey. Results Thirty per cent of the children lived more than 7 km from a facility. After controlling for confounding factors, there was a strong evidence of a decreasing trend in care seeking with increasing distance to care (P ≤ 0.005). There was evidence for an increasing trend in early neonatal mortality with increasing distance to care (P = 0.028), but not for late neonatal mortality (P = 0.479) and post‐neonatal under‐five child mortality (P = 0.488). In their first week of life, neonates living 7 km or more from a facility had an 18% higher mortality rate than neonates living within 2 km of a facility (RR = 1.18; 95%CI 1.00, 1.39; P = 0.056). In the late neonatal period, despite the lack of evidence for an association of mortality with distance, it is noteworthy that rate ratios were consistent with a trend and similar to or larger than estimates in early neonatal mortality. In this period, neonates living 7 km or more from a facility had an 18% higher mortality rate than neonates living within 2 km of a facility (RR = 1.18; 95%CI 0.92, 1.52; P = 0.202). Thus, the lack of evidence may reflect lower power due to fewer deaths rather than a weaker association. Conclusion While better geographic access to care is strongly associated with increased care seeking in rural Burkina Faso, the impact on child mortality appears to be marginal. This suggests that, in addition to improving access to services, attention needs to be paid to quality of those services.
- Subjects :
- Adult
Rural Population
neonatal mortality
mortalité néonatale
Health Services Accessibility
under‐five child mortality
Pregnancy
Burkina Faso
Infant Mortality
Humans
Maternal Health Services
Child
mortalité des moins de 5 ans
Maternal Welfare
Travel
Infant, Newborn
Infant
Prenatal Care
distance to care
care seeking
recherche de soins
Cross-Sectional Studies
Transportation of Patients
Socioeconomic Factors
Child, Preschool
Child Mortality
Original Article
Female
distance aux soins
Original Research Papers
Subjects
Details
- Language :
- English
- ISSN :
- 13653156 and 13602276
- Volume :
- 24
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Tropical Medicine & International Health
- Accession number :
- edsair.pmid..........040ff428ade5c8a3610cb16d94072fad