Treatment-seeking Behaviour Prior to Under-five Child Deaths in Uganda and Mali

Authors: Mair Thomas*, University of Southampton, Jim Wright, University of Southampton, Merlin Willcox, University of Southampton
Topics: Development, Geographic Information Science and Systems, Africa
Keywords: Child mortality, Healthcare, Utilisation, sub-Saharan Africa, Sustainable Development Goals
Session Type: Poster
Day: 4/4/2019
Start / End Time: 3:05 PM / 4:45 PM
Room: Lincoln 2, Marriott, Exhibition Level
Presentation File: No File Uploaded


Although child mortality is at an all-time low, for low and middle-income countries, especially those in sub-Saharan Africa, it remains a real threat to millions. A multitude of factors can intervene which make reducing mortality difficult, namely utilisation and accessibility to healthcare facilities. Healthcare utilisation has often been observed to decline with distance, but it is unclear if such distance decay depends on the way healthcare utilisation is measured. Despite their best efforts, Uganda and Mali have both struggled to reduce high child mortality rates. The goal of this study was to test whether any observed decline in utilisation of publicly funded healthcare, due to distance, was dependent on how such utilisation was measured. Treatment-seeking prior to the deaths of 386 children under-5 years in case-study areas of Uganda and Mali, previously the focus of a community confidential survey, were examined. In contrast to most surveys, the study included three different measures of healthcare utilisation. Using Geographic Information Systems, distance decay models were developed for each healthcare utilisation measure to analyse the effect of distance. Where distance was not an implicating factor, regression models were used to explore alternative socio-economic explanations. Overall results showed sub-national and cross-country variations. Within each study site different measures of healthcare utilisation showed similar relationships with distance. However, evidence of distance decay existed in only Mali. The socio-economic variables included were insignificant predictors of healthcare utilisation. This study suggests that a single well-designed question on healthcare utilisation may be sufficient to capture distance decay relationships.

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