Health service use by children in rural Bihar
1Department of Health Services, UCLA School of Public Health, Los Angeles, CA 90095-1772, USA. amardeep@ucla.edu
Insights
Healthcare access for sick children in Bihar, India, depends on child's sex, living standards, and service availability. Understanding these factors is key to improving child survival rates and reducing mortality.
Area of Science:
- Public Health
- Health Services Research
- Pediatric Health
Background:
- Bihar, India, faces significant economic deprivation and poor health indicators, particularly impacting child survival.
- Understanding healthcare utilization is crucial for developing effective policies to reduce childhood mortality.
- Diarrheal and respiratory illnesses are major contributors to child morbidity and mortality in the region.
Purpose of the Study:
- To analyze the determinants of healthcare service utilization for children under three with diarrhea and/or respiratory illness in rural Bihar.
- To apply the Andersen Behavioral Model to identify factors influencing healthcare seeking behavior.
- To inform policy development aimed at enhancing health service utilization among vulnerable child populations.
Main Methods:
- Utilized data from the Second National Family Health Survey (NFHS-2) for rural Bihar.
- Analyzed a sample of 840 children under three experiencing diarrhea and/or respiratory illness.
- Employed regression analysis to identify significant determinants of healthcare utilization.
Main Results:
- A majority (69%) of children with illness utilized healthcare services.
- Significant determinants of healthcare utilization included the child's sex, household standard of living, service availability, and illness severity (need).
- The Andersen Behavioral Model effectively explained variations in healthcare use.
Conclusions:
- Child sex, socioeconomic status, and healthcare system factors significantly influence healthcare utilization for common childhood illnesses in Bihar.
- The NFHS-2 data is a valuable resource for state-level health services research and policy formulation.
- Targeted interventions addressing identified determinants can improve child health outcomes and reduce mortality in underserved regions.
Abstract:
Bihar is one of the most economically deprived states in India. Home to nearly 10 per cent of India's population, it consistently ranks poorly on a variety of development and health-related indicators. In order to improve child survival and decrease childhood mortality, it is important to understand the determinants of healthcare use so that appropriate policies may be developed to maximize health services utilization. This paper undertakes such as analysis. It uses the Andersen Behavioral Model to understand determinants of health services utilization for children suffering from diarrhea and respiratory illness in rural Bihar. Data were abstracted from the Second National Family Health Survey (NFHS-2). Out of 2703 children under 3 years of age in the dataset, 840 had an episode of diarrhea and/or respiratory illness in the preceding 2 weeks. A majority (69 per cent) had utilized healthcare services for their illness. The results indicate that controlling for other factors, sex of the child, household standard of living, service availability and need, are significant determinants of health service utilization. The analysis highlights the usefulness of the NFHS-2 data as a tool to conduct health services research and analyses at the state level, and in developing policies to safeguard and improve the health of vulnerable population groups in India.
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