Determinants of Perceived Morbidity and Use of Health Services by Children Less Than 15 Years Old in Rural Bangladesh
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This study examined the association of a number of social and economic and other factors with perceived morbidity and use of health services by children in rural Bangladesh, using the data of a health and socioeconomic survey conducted in Matlab, Bangladesh in 1996. One of the factors of interest was women’s social position measured with indicators such as their education, domestic autonomy, social networks and social prestige. Other factors of interest were economic in nature and included the availability of high-quality primary health care (PHC) facilities in one part of the study area. A total of 52% of the 3,793 children below 15 had an episode of an acute illness in the month preceding the interview. The medical care sought for acute illnesses was grouped into four categories: medical doctors, paramedics, traditional and untrained village doctors (including drug sellers) and homeopaths. A total of 55% of the children who were sick in the past month consulted any type of health provider. Logistic regression was used to estimate the effects of the various independent variables on the two dependent variables: perceived morbidity of under-15 children and health service use for under-15 sick children. The results revealed that age of the child was the most important factor influencing perceived morbidity while social and economic variables were in general not related to perceived morbidity. Prolonged and severe illnesses and illnesses of young and male children were more likely to be treated by health providers, particularly by physicians. While women’s education and social network influenced visits to any health providers socioeconomic indicators influenced visits to physicians. Availability of PHC facilities in one part of the study area also led to more use of modern medical care. The findings highlight that improvement of women’s education and of social and economic status in general, in combination with more availability of high-quality PHC will in Bangladesh lead to better health care of children.
KeywordsBangladesh Children Perceived morbidity Episodes of acute illness Health seeking behaviour Maternal education Domestic autonomy Social network Prestige
This study used the data of the 1996 Matlab Health and Socioeconomic Survey sponsored by the US National Institute of Aging (NIA) with additional support from the US National Institute of Child Health and Human Development and The Mellon Foundation. The survey was jointly carried out by investigators from RAND Corporation, the University of Colorado, Harvard University, University of Pennsylvania, the Brown University and ICDDR,B: Centre for Health and Population Research. This research is supported by ICDDR,B. ICDDR,B gratefully acknowledges these donors who provide unrestricted support to the Centre’s research efforts: Australian International Development Agency (AusAID), Government of Bangladesh, Canadian International Development Agency (CIDA), The Kingdom of Saudi Arabia (KSA), Government of the Netherlands, Government of Sri Lanka, Swedish International Development Cooperative Agency (SIDA), Swiss Development Cooperation (SDC) and Department for International Development, UK (DFID). We thank Dr. Peter Kim Streatfield and anonymous reviewers for comments and suggestions on an earlier version of the paper.
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