An epidemiological approach to the study of users and nonusers of child health services

A case-comparison study was carried out in 1972 to determine the characteristics of users and nonusers of child health services. A sample of 529 mothers with children under five years of age (eligible children) residing in one poor barrio in Cali, Colombia was selected. The characteristics of mothers and their eligible children were described in relation to their use or nonuse of health services and a set of indicators was develop which differentiated the nonuser group from the user group. A two-stage sampling technique was used. First, blocks in the barrio were sampled, and second, an equal number of mothers with eligible children who used and who did not use services in the year prior to the study were selected for interview. Nonusers were matched with users on distance from home to local health center. The set of indicators which best discriminated the groups was: the number of eligible children, age of mother, access to free medical care, the action proneness score (attitudes), and knowledge of health, illness, and services. The study method permitted identification of the target population for services, determination of current patterns of use, and quantification of morbidity and immunization levels.