PDF(Pubmed)
Abstract：
Globally, 4.9 million under-five deaths occurred before celebrating their fifth birthday. Four in five under-five deaths were recorded in sub-Saharan Africa and Southern Asia. Childhood diarrhea is one of the leading causes of death and is accountable for killing around 443,832 children every year. Despite healthcare utilization for childhood diarrhea has a significant effect on the reduction of childhood mortality and morbidity, most children die due to delays in seeking healthcare. Therefore, this study aimed to assess healthcare utilization for childhood diarrhea in the top high under-five mortality countries. This study used secondary data from 2013/14 to 2019 demographic and health surveys of 4 top high under-five mortality countries. A total weighted sample of 7254 mothers of under-five children was included. A multilevel binary logistic regression was employed to identify the associated factors of healthcare utilization for childhood diarrhea. The statistical significance was declared at a p-value less than 0.05 with a 95% confidence interval. The overall magnitude of healthcare utilization for childhood diarrhea in the top high under-five mortality countries was 58.40% (95% CI 57.26%, 59.53%). Partner/husband educational status, household wealth index, media exposure, information about oral rehydration, and place of delivery were the positive while the number of living children were the negative predictors of healthcare utilization for childhood diarrhea in top high under-five mortality countries. Besides, living in different countries compared to Guinea was also an associated factor for healthcare utilization for childhood diarrhea. More than four in ten children didn\'t receive health care for childhood diarrhea in top high under-five mortality countries. Thus, to increase healthcare utilization for childhood diarrhea, health managers and policymakers should develop strategies to improve the household wealth status for those with poor household wealth index. The decision-makers and program planners should also work on media exposure and increase access to education. Further research including the perceived severity of illness and ORS knowledge-related factors of healthcare utilization for childhood diarrhea should also be considered by other researchers.
摘要：
全球范围内,在庆祝五岁生日之前，有490万五岁以下儿童死亡。在撒哈拉以南非洲和南亚，五分之四的五岁以下儿童死亡。儿童腹泻是导致死亡的主要原因之一，每年造成约443,832名儿童死亡。尽管儿童腹泻的医疗保健利用对降低儿童死亡率和发病率有显著影响，大多数儿童死于寻求医疗保健的延误。因此,本研究旨在评估5岁以下儿童死亡率最高的国家对儿童腹泻的医疗保健利用情况.这项研究使用了2013/14年至2019年人口和健康调查的次要数据，调查了4个五岁以下死亡率最高的国家。包括7254名五岁以下儿童的母亲的加权样本。采用多水平二元逻辑回归来确定儿童腹泻医疗保健利用的相关因素。在小于0.05的p值以95%置信区间声明统计显著性。在五岁以下儿童死亡率最高的国家中，儿童腹泻的医疗保健利用率总体为58.40%(95%CI57.26%，59.53%）。伴侣/丈夫的教育状况，家庭财富指数，媒体曝光,关于口服补液的信息，在5岁以下儿童死亡率最高的国家,分娩地点和分娩地点均为阳性,而存活儿童数量是儿童腹泻医疗服务利用的阴性预测因素.此外,与几内亚相比,生活在不同国家也是儿童腹泻医疗保健利用的相关因素.在五岁以下死亡率最高的国家，十分之四以上的儿童没有接受儿童腹泻的医疗保健。因此，为了增加儿童腹泻的医疗保健利用率，卫生管理人员和政策制定者应制定战略，以改善家庭财富指数较差的家庭财富状况。决策者和计划规划者还应致力于媒体曝光并增加受教育的机会。其他研究人员也应考虑进一步的研究，包括对疾病的严重程度和对儿童腹泻的医疗保健利用的ORS知识相关因素。
