TY - JOUR
T1 - Local barriers and solutions to improve care-seeking for childhood pneumonia, diarrhoea and malaria in Kenya, Nigeria and Niger
T2 - A qualitative study
AU - Bedford, K. Juliet A.
AU - Sharkey, Alyssa B.
N1 - Funding Information:
The authors wish to acknowledge UNICEF colleagues for their inputs in this study. From UNICEF Headquarters in New York: Mark Young, Thomas O'Connell, Nicholas Oliphant, Deolinda Martins, Natalia Winder Rossi, and Peter Leth. We also acknowledge the involvement of UNICEF country officers, particularly Ketema Bizuneh, Peter Okoth and Josephine Odanga in Kenya; Naawa Sipilanyambe, Emanuelle Gemade and Noma Owens-Ibie in Nigeria; and Khaled Bensaid, Adama Ouédraogo, Ousmane Niang and Rocio Berzal in Niger. Particular thanks are extended to the research assistants who supported fieldwork, Irene Namai and Miriahm Mwaniki in Kenya; Dorcas Kadangs and Onikepe Owolabi in Nigeria; and Rahila Aboubakar, Kadidiatou Hassane Moumoni and Yacouba Mahamane Kakale in Niger. Thanks also to Olivia Tulloch who undertook the secondary analysis for Anthrologica and to Cynthia Joerger and Carolyn Weidemann at the US Fund for UNICEF for grant support. This study was made possible by grants from the Bill and Melinda Gates Foundation and the Rockefeller Foundation. We are extremely grateful to the mothers, families and health workers who participated in this study and willingly shared their experiences and insight.
PY - 2014/6/27
Y1 - 2014/6/27
N2 - We present qualitative research findings on care-seeking and treatment uptake for pneumonia, diarrhoea and malaria among children under 5 in Kenya, Nigeria and Niger. The study aimed to determine the barriers caregivers face in accessing treatment for these conditions; to identify local solutions that facilitate more timely access to treatment; and to present these findings as a platform from which to develop context-specific strategies to improve care-seeking for childhood illness. Kenya, Nigeria and Niger are three high burden countries with low rates of related treatment coverage, particularly in underserved areas. Data were collected in Homa Bay County in Nyanza Province, Kenya; in Kebbi and Cross River States, Nigeria; and in the Maradi and Tillabéri regions of Niger. Primary caregivers of children under 5 who did not regularly engage with health services or present their child at a health facility during illness episodes were purposively selected for interview. Data underwent rigorous thematic analysis. We organise the identified barriers and related solutions by theme: financial barriers; distance/location of health facilities; socio-cultural barriers and gender dynamics; knowledge and information barriers; and health facility deterrents. The relative importance of each differed by locality. Participant suggested solutions ranged from community-level actions to facility-level and more policy-oriented actions, plus actions to change underlying problems such as social perceptions and practices and gender dynamics. We discuss the feasibility and implications of these suggested solutions. Given the high burden of childhood morbidity and mortality due to pneumonia, diarrhoea and malaria in Kenya, Nigeria and Niger, this study provides important insights relating to demand-side barriers and locally proposed solutions. Significant advancements are possible when communities participate in both problem identification and resolution, and are engaged as important partners in improving child health and survival.
AB - We present qualitative research findings on care-seeking and treatment uptake for pneumonia, diarrhoea and malaria among children under 5 in Kenya, Nigeria and Niger. The study aimed to determine the barriers caregivers face in accessing treatment for these conditions; to identify local solutions that facilitate more timely access to treatment; and to present these findings as a platform from which to develop context-specific strategies to improve care-seeking for childhood illness. Kenya, Nigeria and Niger are three high burden countries with low rates of related treatment coverage, particularly in underserved areas. Data were collected in Homa Bay County in Nyanza Province, Kenya; in Kebbi and Cross River States, Nigeria; and in the Maradi and Tillabéri regions of Niger. Primary caregivers of children under 5 who did not regularly engage with health services or present their child at a health facility during illness episodes were purposively selected for interview. Data underwent rigorous thematic analysis. We organise the identified barriers and related solutions by theme: financial barriers; distance/location of health facilities; socio-cultural barriers and gender dynamics; knowledge and information barriers; and health facility deterrents. The relative importance of each differed by locality. Participant suggested solutions ranged from community-level actions to facility-level and more policy-oriented actions, plus actions to change underlying problems such as social perceptions and practices and gender dynamics. We discuss the feasibility and implications of these suggested solutions. Given the high burden of childhood morbidity and mortality due to pneumonia, diarrhoea and malaria in Kenya, Nigeria and Niger, this study provides important insights relating to demand-side barriers and locally proposed solutions. Significant advancements are possible when communities participate in both problem identification and resolution, and are engaged as important partners in improving child health and survival.
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U2 - 10.1371/journal.pone.0100038
DO - 10.1371/journal.pone.0100038
M3 - Article
C2 - 24971642
AN - SCOPUS:84903514659
SN - 1932-6203
VL - 9
JO - PloS one
JF - PloS one
IS - 6
M1 - e100038
ER -