29 个中低收入国家五岁以下儿童急性呼吸道感染就医行为的个人和社区层面预测因素：多层面分析

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health Pub Date : 2024-09-27 DOI:10.1016/j.puhe.2024.08.028

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引用次数: 0

摘要

本研究旨在确定在中低收入国家（LMICs）中，母亲为有急性呼吸道感染（ARI）症状的 5 岁以下儿童寻求医疗保健行为的个人和社区层面的决定因素。研究采用多层次逻辑回归模型来检验个人和社区因素与急性呼吸道感染就医行为之间的关系。结果在低收入和中等收入国家，5 岁以下儿童因急性呼吸道感染就医行为的总体流行率为 58.83%（95% CI：58.08, 59.57）。调查结果显示，受过初等或高等教育（AOR = 1.20；95% CI：1.08, 1.33）、居住在富裕家庭（AOR = 1.32；95% CI：1.18, 1.48）、接受产前检查（AOR = 1.53；95% CI：1.31, 1.79）和在医疗机构分娩（AOR = 1.28；95% CI：1.16, 1.41）的母亲更有可能因急性呼吸道感染就医。较高的社区孕产妇教育水平（AOR = 1.44；95% CI：1.24，1.68）与急性呼吸道感染就医呈正相关，而较高的社区贫困水平（AOR = 0.83；95% CI：0.72，0.96）与急性呼吸道感染就医呈负相关、产前护理）以及社区贫困和文化水平。未来的干预措施在制定改善低收入与中等收入国家儿童健康状况的策略时应考虑这些可改变的风险因素。

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Individual- and community-level predictors of healthcare-seeking behaviour for acute respiratory tract infections among children under five in 29 low- and middle-income countries: a multilevel analysis

Objectives

This study aimed to identify the individual- and community-level determinants of mothers’ healthcare-seeking behaviour for children under the age of 5 years with acute respiratory infection (ARI) symptoms in low-and middle-income countries (LMICs).

Study design

Nationally representative Demographic and Health Survey datasets from 29 LMICs were used.

Methods

The study included 16,893 children aged under 5 years with ARI symptoms in the 2 weeks prior to the survey. A multilevel logistic regression model was used to examine associations between individual- and community-level factors with health-seeking behaviour for ARIs. The adjusted odds ratio (AOR) along with 95% confidence intervals (CIs) were reported as a measure of association.

Results

The overall prevalence of healthcare-seeking behaviour for ARIs among children under 5 years in LMICs was 58.83% (95% CI: 58.08, 59.57). Findings showed that mothers with primary or higher education (AOR = 1.20; 95% CI: 1.08, 1.33), and those residing in rich households (AOR = 1.32; 95% CI: 1.18, 1.48), attending antenatal care (ANC) visits (AOR = 1.53; 95% CI: 1.31, 1.79) and delivering at a healthcare facility (AOR = 1.28; 95% CI: 1.16, 1.41) were more likely to seek healthcare for ARIs. A higher level of community maternal education (AOR = 1.44; 95% CI: 1.24, 1.68) was positively associated with seeking healthcare for ARIs, while a higher level of community poverty (AOR = 0.83; 95% CI: 0.72, 0.96) was negatively associated with healthcare seeking for ARIs.

Conclusions

This study revealed that mothers’ healthcare-seeking behaviour for ARIs was closely linked to modifiable risk factors, including maternal education, household wealth, use of maternal health services (e.g., ANC), as well as community poverty and literacy levels. Future interventions should consider these modifiable risk factors when developing strategies to improve child health outcomes in LMICs.

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来源期刊

Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

0.00%

发文量

280

审稿时长

37 days

期刊介绍： Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.