Where do mothers take their children for pneumonia care? Findings from three Indian states.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2019
Historique:
received: 14 12 2018
accepted: 11 03 2019
entrez: 16 4 2019
pubmed: 16 4 2019
medline: 19 12 2019
Statut: epublish

Résumé

Childhood pneumonia accounts for 17% of IMR in India, posing a major health burden. With cultural beliefs influencing care seeking behaviour and disparities existing in health infrastructure across the country, an understanding of the underlying issues merits exploration. Study assessed prevalence of probable pneumonia and examined care seeking behaviour of mothers in three states, Madhya Pradesh (MP), Uttar Pradesh (UP) and Tamil Nadu (TN). This mixed methods study involved a household survey and qualitative interviews with mothers in three districts from each state. Households with children aged 2-59 months were screened to identify those with probable pneumonia; sub-sample of mothers participated in qualitative interviews. Care seeking behaviour was explored in the context of recognition of symptoms, nature of first care provided, time when care was sought outside the home and choice of health provider. Overall 17,442 children from 13,544 households were screened, of which 729 (MP), 752 (UP) and 713 (TN) children respectively, were identified with probable pneumonia; 72 mothers participated in the qualitative interviews. Three months period prevalence was estimated in study districts at 22.2%-MP 13.3%-UP and 8.4%-TN. Most mothers in MP and UP were not perceptive to severity of illness; type of care sought was often inappropriate, delayed, with home remedies and visits to unqualified care providers being their first response. In contrast, in TN, use of home remedies was minimal, going to untrained care providers, non-existent and more than 90% mothers sought appropriate care. Private doctors were the preferred choice among all mothers but utilization of government care was highest in TN (20%). Community health workers were underutilized, with less than 10% mothers consulting them. Need for educating mothers about appropriate care seeking and development of good health infrastructure as essential to attainment of better child health indices are advocated.

Identifiants

pubmed: 30986210
doi: 10.1371/journal.pone.0214331
pii: PONE-D-18-35714
pmc: PMC6464169
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0214331

Déclaration de conflit d'intérêts

The authors have declared that no competing interest exists.

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Auteurs

Rani Mohanraj (R)

Samarth, Chennai, Tamilnadu, India.

Shuba Kumar (S)

Samarth, Chennai, Tamilnadu, India.

Sylvia Jayakumar (S)

Statshub, Chennai, Tamilnadu, India.

Monica Agarwal (M)

Department of Community Medicine and Public Health, King George's Medical University, Lucknow, Uttar Pradesh, India.

Bhavna Dhingra (B)

Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.

Visalakshi Jeyaseelan (V)

Department of Biostatistics, Christian Medical College, Vellore, Tamilnadu, India.

Saradha Suresh (S)

Samarth, Chennai, Tamilnadu, India.

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