TY - JOUR
T1 - Determinants and pattern of care seeking for preterm newborns in a rural Bangladeshi cohort
AU - on behalf of the ProjAHNMo Study Group in Bangladesh
AU - Shah, Rashed
AU - Mullany, Luke C.
AU - Darmstadt, Gary L.
AU - Talukder, Radwanur Rahman
AU - Rahman, Syed Moshfiqur
AU - Mannan, Ishtiaq
AU - El Arifeen, Shams
AU - Baqui, Abdullah H.
N1 - Funding Information:
The study was conducted by the Projahnmo study group in Bangladesh. Projahnmo is a partnership of the ICDDR,B; the Bangladesh government’s Ministry of Health and Family Welfare; Bangladeshi nongovernmental organizations, including Shimantik, Save the Children-US, Dhaka Shishu Hospital and the Institute of Child and Mother Health; and the Johns Hopkins Bloomberg School of Public Health. We thank the members of the Projahnmo study team, including Projahnmo field and data management staff who worked tirelessly, and our colleagues at the Bangladesh Ministry of Health and Family Welfare at the sub-district, district and national levels for their valuable support. We are also thankful to many individuals in Sylhet for their generous support and timely effort to conduct this study successfully. Funding for the Projahnmo Project was provided by the United States Agency for International Development, Office of Health, Infectious Diseases, and Nutrition, Global Health Bureau and the Dhaka Mission through the Global Research Activity Cooperative Agreement (GHS-A-00-03-00019-00), and the Saving Newborn Lives initiative of Save the Children through a grant from the Bill and Melinda Gates Foundation. Rashed Shah was supported through a Fogarty Training Grant (Grant # D43TW7587) during the period of data analyses and manuscript writing.
Publisher Copyright:
© 2014 Shah et al.
PY - 2014/9/22
Y1 - 2014/9/22
N2 - Background: Despite the increased burden of preterm birth and its complications, the dearth of care seeking data for preterm newborns remains a significant knowledge gap. Among preterm babies in rural Bangladesh, we examined: 1) determinants and patterns of care seeking, and 2) risk analysis for care-seeking from qualified and unqualified providers. Method: Trained community health workers collected data prospectively from 27,460 mother-liveborn baby pairs, including 6,090 preterm babies, between June 2007 and September 2009. Statistical analyses included binomial and multinomial logistic regressions. Results: Only one-fifth (19.7%) of preterm newborns were taken to seek either preventive or curative health care. Among care-seeker preterm newborns, preferred providers included homeopathic practitioners (50.0%), and less than a third (30.9%) sought care from qualified providers. Care-seeking from either unqualified or qualified providers was significantly lower for female preterm babies, compared to male babies [Relative Risk Ratio (RRR) for unqualified care: 0.68; 95% Confidence Interval (CI): 0.58, 0.80; RRR for qualified care: 0.52; 95% CI: 0.41, 0.66]. Among preterm babies, care-seeking was significantly higher among caregivers who recognized symptoms of illness [RR: 2.14; 95% CI: 1.93, 2.38] or signs of local infection (RR: 2.53; 95% CI: 2.23, 2.87), had a history of child death [RR: 1.21; 95% CI: 1.07, 1.37], any antenatal care (ANC) visit [RR: 1.41; 95% CI: 1.25, 1.59]. Birth preparedness (RRR: 1.24; 95% CI: 1.09, 1.68) and any ANC visit (RRR: 1.73; 95% CI: 1.50, 2.49) were also associated with increased likelihood of care seeking for preterm babies from qualified providers. Conclusion: To improve care seeking practices for preterm babies and referral of sick newborns to qualified providers/facilities, we recommend: 1) involving community-preferred health care providers in community-based health education and awareness raising programs; 2) integrating postnatal care seeking messages into antenatal counselling; and 3) further research on care seeking practices for preterm babies.
AB - Background: Despite the increased burden of preterm birth and its complications, the dearth of care seeking data for preterm newborns remains a significant knowledge gap. Among preterm babies in rural Bangladesh, we examined: 1) determinants and patterns of care seeking, and 2) risk analysis for care-seeking from qualified and unqualified providers. Method: Trained community health workers collected data prospectively from 27,460 mother-liveborn baby pairs, including 6,090 preterm babies, between June 2007 and September 2009. Statistical analyses included binomial and multinomial logistic regressions. Results: Only one-fifth (19.7%) of preterm newborns were taken to seek either preventive or curative health care. Among care-seeker preterm newborns, preferred providers included homeopathic practitioners (50.0%), and less than a third (30.9%) sought care from qualified providers. Care-seeking from either unqualified or qualified providers was significantly lower for female preterm babies, compared to male babies [Relative Risk Ratio (RRR) for unqualified care: 0.68; 95% Confidence Interval (CI): 0.58, 0.80; RRR for qualified care: 0.52; 95% CI: 0.41, 0.66]. Among preterm babies, care-seeking was significantly higher among caregivers who recognized symptoms of illness [RR: 2.14; 95% CI: 1.93, 2.38] or signs of local infection (RR: 2.53; 95% CI: 2.23, 2.87), had a history of child death [RR: 1.21; 95% CI: 1.07, 1.37], any antenatal care (ANC) visit [RR: 1.41; 95% CI: 1.25, 1.59]. Birth preparedness (RRR: 1.24; 95% CI: 1.09, 1.68) and any ANC visit (RRR: 1.73; 95% CI: 1.50, 2.49) were also associated with increased likelihood of care seeking for preterm babies from qualified providers. Conclusion: To improve care seeking practices for preterm babies and referral of sick newborns to qualified providers/facilities, we recommend: 1) involving community-preferred health care providers in community-based health education and awareness raising programs; 2) integrating postnatal care seeking messages into antenatal counselling; and 3) further research on care seeking practices for preterm babies.
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U2 - 10.1186/1472-6963-14-417
DO - 10.1186/1472-6963-14-417
M3 - Article
C2 - 25242278
AN - SCOPUS:84928822110
SN - 1472-6963
VL - 14
JO - BMC health services research
JF - BMC health services research
IS - 1
M1 - 417
ER -