Original scientific paper
https://doi.org/10.3325/cmj.2013.54.541
Care-seeking and quality of care for outpatient sick children in rural Hebei, China: a cross-sectional study
Yanfeng Zhang
; 1Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
Michelle Helena van Velthoven
; Global eHealth Unit, Department of Primary Care and Public Health Imperial College London, London United Kingdom
Li Chen
; 1Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
Josip Car
; Global eHealth Unit, Department of Primary Care and Public Health Imperial College London, London United Kingdom
Ye Li
; 1Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
Wei Wang
; 1Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
Robert W. Scherpbier
; Section of Health and Nutrition Water, Environment and Sanitation, UNICEF China, Beijing, China
Abstract
Aim To assess the quality of outpatient pediatric care provided
by township and village doctors, prevalence of common
childhood diseases, care-seeking behavior, and coverage
of key interventions in Zhao County in China.
Methods We conducted two cross-sectional surveys: 1)
maternal, newborn, and child health household survey
including1601 caregivers of children younger than two
years; 2) health facility survey on case management of 348
sick children younger than five years by local health workers
and assessment of the availability of drugs and supplies
in health facility.
Results Our household survey showed that the prevalence
of fever, cough, and diarrhea was 16.8%, 9.2%, and 15.6%
respectively. Caregivers of children with fever, cough, and
diarrhea sought care primarily in village clinics and township
hospitals. Only 41.2% of children with suspected pneumonia
received antibiotics, and very few children with diarrhea
received oral rehydration solutions (1.2%) and zinc
(4.4%). Our facility survey indicated that very few sick children
were fully assessed, and only 43.8% were correctly
classified by health workers when compared with the gold
standard. Use of antibiotics for sick children was high and
not according to guidelines.
Conclusion We showed poor quality of services for outpatient
sick children in Zhao County. Since Integrated Management
of Childhood Illness strategy has shown positive
effects on child health in some areas of China, it is advisable
to implement it in other areas as well.
Keywords
Hrčak ID:
117021
URI
Publication date:
15.12.2013.
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