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Risk factors for deaths in children under 5 years old in Bagamoyo district, Tanzania
F D Mtango1, D Neuvians, C V Broome
1Institute for Primary Health Care, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania.
Insights
Child mortality in Tanzania is linked to factors like water source and cooking location. Many families don't use government healthcare due to beliefs in traditional medicine or drug unavailability.
Area of Science:
- Child Health
- Epidemiology
- Public Health
Background:
- Under-five mortality remains a significant public health challenge in many developing regions.
- Understanding factors influencing child deaths and healthcare utilization is crucial for targeted interventions.
Purpose of the Study:
- To investigate factors associated with mortality in children under five years old.
- To identify reasons for non-utilization of the government healthcare system in Bagamoyo District, Tanzania.
Main Methods:
- Population-based case-control study involving 610 deceased children (cases) and 1,160 healthy children (controls).
- Data collected through verbal autopsy for cause of death and surveys on healthcare utilization and associated factors.
- Multivariate analysis employed to identify independent risk factors.
Main Results:
- Pneumonia accounted for 25% of deaths; 39% of acute respiratory deaths were in infants under six months.
- Key risk factors for death included unsafe water sources, child eating with others, and sleeping in the cooking area.
- Only 45% of families utilized government healthcare; primary reasons for non-utilization were preference for traditional medicine (41%) and lack of available drugs (38%).
Conclusions:
- Maternal decision-making autonomy and proximity to healthcare facilities influenced government healthcare utilization.
- Addressing barriers such as perceived efficacy of traditional medicine and drug availability is essential to improve child survival rates.
Abstract:
We conducted a population based case control study of deaths in children < 5 years old from Bagamoyo District, Tanzania, to evaluate factors associated with death, and factors associated with not utilizing Government health care system. Six hundred and ten children who died between 1 July, 1986 and 30 June 1987 were enrolled as cases; 1,160 healthy control children were selected by multistage random cluster sampling. Twenty-five percent of deaths were ascribed to pneumonia based on "verbal autopsy"; 39% of acute respiratory deaths occurred in children < 6 months of age. In a multivariate analysis, significant independent associations were found with mother as sole decision maker for treatment (O.R = 0.13; 95% C:I. 0.07, 0.22); use of water from village well, pond, or river vs. tap water (O.R. = 11.86; 95% C.I., 5.46, 25.72); the child eating with others (O.R. = 9.42; 95% C.I. 5.68, 15.62) and the child sleeping in the room where cooking is done (O.R. = 2.78; 95% C.I. 1.79, 4.33). Overall only 45% of families utilized Government health care (village health worker, dispensary or health centre) during their child's terminal illness. Families utilizing Government health care were significantly more likely to say that the mother alone could make treatment decision (O.R. = 2.49, 95% C.I. 1.39, 4.46), and to be closer to a dispensary. The main reasons for not utilizing Government health care were 'traditional medicine is better' (41%) and 'no drugs available' (38%).