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Effect of Geographical Access to Health Facilities on Child Mortality in Rural Ethiopia: A Community Based Cross Sectional Study

BACKGROUND: There have been few studies that have examined associations between access to health care and child health outcomes in remote populations most in need of health services. This study assessed the effect of travel time and distance to health facilities on mortality in children under five y...

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Autores principales: Okwaraji, Yemisrach B., Cousens, Simon, Berhane, Yemane, Mulholland, Kim, Edmond, Karen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3299799/
https://www.ncbi.nlm.nih.gov/pubmed/22428070
http://dx.doi.org/10.1371/journal.pone.0033564
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author Okwaraji, Yemisrach B.
Cousens, Simon
Berhane, Yemane
Mulholland, Kim
Edmond, Karen
author_facet Okwaraji, Yemisrach B.
Cousens, Simon
Berhane, Yemane
Mulholland, Kim
Edmond, Karen
author_sort Okwaraji, Yemisrach B.
collection PubMed
description BACKGROUND: There have been few studies that have examined associations between access to health care and child health outcomes in remote populations most in need of health services. This study assessed the effect of travel time and distance to health facilities on mortality in children under five years in a remote area of rural north-western Ethiopia. METHODS AND FINDINGS: This study involved a randomly selected cross sectional survey of 2,058 households. Data were collected during home visits to all resident women of reproductive age (15–49 years). A geographic information system (GIS) was used to map all households and the only health centre in the district. The analysis was restricted to 2,206 rural children who were under the age of five years during the five years before the survey. Data were analysed using random effects Poisson regression. 90.4% (1,996/2,206) of children lived more than 1.5 hours walk from the health centre. Children who lived ≥1.5 hrs from the health centre had a two to three fold greater risk of death than children who lived <1.5 hours from the health centre (children with travel time 1.5–<2.5 hrs adjusted relative risk [adjRR] 2.3[0.95–5.6], travel time 2.5–<3.5 hrs adjRR 3.1[1.3–7.4] and travel time 3.5–<6.5 hrs adjRR 2.5[1.1–6.2]). CONCLUSION: Distance to a health centre had a marked influence on under five mortality in a poor, rural, remote area of Ethiopia. This study provides important information for policy makers on the likely impact of new health centres and their most effective location in remote areas.
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spelling pubmed-32997992012-03-16 Effect of Geographical Access to Health Facilities on Child Mortality in Rural Ethiopia: A Community Based Cross Sectional Study Okwaraji, Yemisrach B. Cousens, Simon Berhane, Yemane Mulholland, Kim Edmond, Karen PLoS One Research Article BACKGROUND: There have been few studies that have examined associations between access to health care and child health outcomes in remote populations most in need of health services. This study assessed the effect of travel time and distance to health facilities on mortality in children under five years in a remote area of rural north-western Ethiopia. METHODS AND FINDINGS: This study involved a randomly selected cross sectional survey of 2,058 households. Data were collected during home visits to all resident women of reproductive age (15–49 years). A geographic information system (GIS) was used to map all households and the only health centre in the district. The analysis was restricted to 2,206 rural children who were under the age of five years during the five years before the survey. Data were analysed using random effects Poisson regression. 90.4% (1,996/2,206) of children lived more than 1.5 hours walk from the health centre. Children who lived ≥1.5 hrs from the health centre had a two to three fold greater risk of death than children who lived <1.5 hours from the health centre (children with travel time 1.5–<2.5 hrs adjusted relative risk [adjRR] 2.3[0.95–5.6], travel time 2.5–<3.5 hrs adjRR 3.1[1.3–7.4] and travel time 3.5–<6.5 hrs adjRR 2.5[1.1–6.2]). CONCLUSION: Distance to a health centre had a marked influence on under five mortality in a poor, rural, remote area of Ethiopia. This study provides important information for policy makers on the likely impact of new health centres and their most effective location in remote areas. Public Library of Science 2012-03-12 /pmc/articles/PMC3299799/ /pubmed/22428070 http://dx.doi.org/10.1371/journal.pone.0033564 Text en Okwaraji et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Okwaraji, Yemisrach B.
Cousens, Simon
Berhane, Yemane
Mulholland, Kim
Edmond, Karen
Effect of Geographical Access to Health Facilities on Child Mortality in Rural Ethiopia: A Community Based Cross Sectional Study
title Effect of Geographical Access to Health Facilities on Child Mortality in Rural Ethiopia: A Community Based Cross Sectional Study
title_full Effect of Geographical Access to Health Facilities on Child Mortality in Rural Ethiopia: A Community Based Cross Sectional Study
title_fullStr Effect of Geographical Access to Health Facilities on Child Mortality in Rural Ethiopia: A Community Based Cross Sectional Study
title_full_unstemmed Effect of Geographical Access to Health Facilities on Child Mortality in Rural Ethiopia: A Community Based Cross Sectional Study
title_short Effect of Geographical Access to Health Facilities on Child Mortality in Rural Ethiopia: A Community Based Cross Sectional Study
title_sort effect of geographical access to health facilities on child mortality in rural ethiopia: a community based cross sectional study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3299799/
https://www.ncbi.nlm.nih.gov/pubmed/22428070
http://dx.doi.org/10.1371/journal.pone.0033564
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