#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Care Seeking for Neonatal Illness in Low- and Middle-Income Countries: A Systematic Review


Background:
Despite recent achievements to reduce child mortality, neonatal deaths continue to remain high, accounting for 41% of all deaths in children under five years of age worldwide, of which over 90% occur in low- and middle-income countries (LMICs). Infections are a leading cause of death and limitations in care seeking for ill neonates contribute to high mortality rates. As estimates for care-seeking behaviors in LMICs have not been studied, this review describes care seeking for neonatal illnesses in LMICs, with particular attention to type of care sought.

Methods and Findings:
We conducted a systematic literature review of studies that reported the proportion of caregivers that sought care for ill or suspected ill neonates in LMICs. The initial search yielded 784 studies, of which 22 studies described relevant data from community household surveys, facility-based surveys, and intervention trials. The majority of studies were from South Asia (n = 17/22), set in rural areas (n = 17/22), and published within the last 4 years (n = 18/22). Of the 9,098 neonates who were ill or suspected to be ill, 4,320 caregivers sought some type of care, including care from a health facility (n = 370) or provider (n = 1,813). Care seeking ranged between 10% and 100% among caregivers with a median of 59%. Care seeking from a health care provider yielded a similar range and median, while care seeking at a health care facility ranged between 1% and 100%, with a median of 20%. Care-seeking estimates were limited by the few studies conducted in urban settings and regions other than South Asia. There was a lack of consistency regarding illness, care-seeking, and care provider definitions.

Conclusions:
There is a paucity of data regarding newborn care-seeking behaviors; in South Asia, care seeking is low for newborn illness, especially in terms of care sought from health care facilities and medically trained providers. There is a need for representative data to describe care-seeking patterns in different geographic regions and better understand mechanisms to enhance care seeking during this vulnerable time period.

: Please see later in the article for the Editors' Summary


Vyšlo v časopise: Care Seeking for Neonatal Illness in Low- and Middle-Income Countries: A Systematic Review. PLoS Med 9(3): e32767. doi:10.1371/journal.pmed.1001183
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1001183

Souhrn

Background:
Despite recent achievements to reduce child mortality, neonatal deaths continue to remain high, accounting for 41% of all deaths in children under five years of age worldwide, of which over 90% occur in low- and middle-income countries (LMICs). Infections are a leading cause of death and limitations in care seeking for ill neonates contribute to high mortality rates. As estimates for care-seeking behaviors in LMICs have not been studied, this review describes care seeking for neonatal illnesses in LMICs, with particular attention to type of care sought.

Methods and Findings:
We conducted a systematic literature review of studies that reported the proportion of caregivers that sought care for ill or suspected ill neonates in LMICs. The initial search yielded 784 studies, of which 22 studies described relevant data from community household surveys, facility-based surveys, and intervention trials. The majority of studies were from South Asia (n = 17/22), set in rural areas (n = 17/22), and published within the last 4 years (n = 18/22). Of the 9,098 neonates who were ill or suspected to be ill, 4,320 caregivers sought some type of care, including care from a health facility (n = 370) or provider (n = 1,813). Care seeking ranged between 10% and 100% among caregivers with a median of 59%. Care seeking from a health care provider yielded a similar range and median, while care seeking at a health care facility ranged between 1% and 100%, with a median of 20%. Care-seeking estimates were limited by the few studies conducted in urban settings and regions other than South Asia. There was a lack of consistency regarding illness, care-seeking, and care provider definitions.

Conclusions:
There is a paucity of data regarding newborn care-seeking behaviors; in South Asia, care seeking is low for newborn illness, especially in terms of care sought from health care facilities and medically trained providers. There is a need for representative data to describe care-seeking patterns in different geographic regions and better understand mechanisms to enhance care seeking during this vulnerable time period.

: Please see later in the article for the Editors' Summary


Zdroje

1. BlackRECousensSJohnsonHLLawnJERudanI 2010 Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet 375 1969 1987

2. World Health Organization 2006 Neonatal and perinatal mortality: country, regional and global estimates Geneva World Health Organization

3. BlackRECousensSJohnsonHLLawnJERudanI 2010 Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet 375 1969 1987

4. Young Infants Clinical Signs Study Group 2006 Clinical signs that predict severe illness in children under age 2 months: a multicentre study. Lancet 371 135 142

5. US National Library of Medicine. PubMed Available: http://www.ncbi.nlm.nih.gov/pubmed. Accessed 21 October 2011

6. Embase Available: http://www.embase.com/. Accessed 21 October 2011

7. Cochrane Library Available: http://www.cochrane.org/. Accessed 21 October 2011

8. Global Health Available: http://www.globalhealth.org/. Accessed 21 October 2011

9. African Index Medicus Available: http://indexmedicus.afro.who.int/. Accessed 29 September 2011

10. African Trials Register Available: http://www.mrc.ac.za/ATR/. Accessed 29 September 2011

11. Africa-Wide Information Available: http://www.ebscohost.com/academic/africa-wide-information. Accessed 29 September 2011

12. LILACS. “Literature on the Health Sciences in Latin America and the Caribbean.” Available: http://bases.bireme.br/cgi-bin/wxislind.exe/iah/online/?IsisScript=iah/iah.xis&base=LILACS&lang=i&form=F. Accessed 29 September 2011

13. Eldis Available: http://www.eldis.org/. Accessed 27 October 2011

14. USAID. “Data Online for Population, Health and Nutrition (Dolphn).” Available: http://dolphn.aimglobalhealth.org/. Accessed 21 October 2011

15. Johns Hopkins University. “Reproductive Health Gateway.” Available: http://www.k4health.org/resources/rhgateway/. Accessed 21 October 2011

16. USAID. “Basic Support for Institutionalizing Child Survival (Basics).” Available: http://www.basics.org/. Accessed 23 October 2011

17. Save the Children. “Saving Newborn Lives.” Available: http://www.savethechildren.org/site/apps/nlnet/content2.aspx?c=8rKLIXMGIpI4E&b=6239395&ct=9163913. Accessed 25 October 2011

18. Demographic Health Surveys STATcompiler Available: http://www.statcompiler.com/. Accessed 21 October 2011

19. Service Provision Assessments Available: http://www.measuredhs.com/aboutsurveys/spa/start.cfm. Accessed 21 October 2011

20. PROSPERO Available: http://www.crd.york.ac.uk/PROSPERO/full_doc.asp?ID=CRD42011001669. Accessed 5 January 2012

21. GoodmanLA 1961 Snowball sampling. Ann Math Statist 32 148 170

22. World Health Organization. “Health Statistics and Health Information Systems: Definition of Region Groupings.” Available: http://www.who.int/healthinfo/global_burden_disease/definition_regions/en/index.html. Accessed 30 September 2011

23. AwasthiSSrivastavaNMAgarwalGGPantSAhluwaliaTP 2009 Effect of behaviour change communication on qualified medical care-seeking for sick neonates among urban poor in Lucknow, Northern India: A before and after intervention study. Trop Med Int Health 14 1199 1209

24. WalkerNFischer-WalkerCBryceJBahlRCousensS 2010 Standards for cherg reviews of intervention effects on child survival. Int J Epidemiol 39 Suppl 1 i21 31

25. TripathyPNairNBarnettSMahapatraRBorghiJ 2010 Effect of a participatory intervention with women's groups on birth outcomes and maternal depression in Jharkhand and Orissa, India: a cluster-randomised controlled trial. Lancet 375 1182 1192

26. ManandharDSOsrinDShresthaBPMeskoNMorrisonJ 2004 Effect of a participatory intervention with women's groups on birth outcomes in Nepal: cluster-randomised controlled trial. Lancet 364 970 979

27. AzadKBarnettSBanerjeeBShahaSKhanK 2010 Effect of scaling up women's groups on birth outcomes in three rural districts in Bangladesh: A cluster-randomised controlled trial. Lancet 375 1193 1202

28. KumarVMohantySKumarAMisraRPSantoshamM 2008 Effect of community-based behaviour change management on neonatal mortality in Shivgarh, Uttar Pradesh, India: a cluster-randomised controlled trial. Lancet 372 1151 1162

29. DarmstadtGLChoiYArifeenSEBariSRahmanSM 2010 Evaluation of a cluster-randomized controlled trial of a package of community-based maternal and newborn interventions in Mirzapur, Bangladesh. PLoS One 5 e9696 doi:10.1371/journal.pone.0009696

30. McPhersonRAKhadkaNMooreJMSharmaM 2006 Are birth-preparedness programmes effective? results from a field trial in Siraha District, Nepal. J Health Popul Nutr 24 479 488

31. ManjiK 2009 Situation analysis of newborn health in Tanzania: current situation, existing plans and strategic next steps for newborn health Dar es Salaam Ministry of Health and Social Welfare, Save the Children

32. UNICEF 2009 State of the world's children, special edition: celebrating 20 years of the Convention on the Rights of the Child New York, New York United Nations Children's Fund

33. LawnJEKerberKEnweronu-LaryeaCCousensS 2010 3.6 million neonatal deaths–what is progressing and what is not? Semin Perinatol 34 371 386

34. WeberMWCarlinJBGatchalianSLehmannDMuheL 2003 Predictors of neonatal sepsis in developing countries. Pediatr Infect Dis J 22 711 717

35. HillZManuATawiah-AgyemangCGyanTTurnerK 2008 how did formative research inform the development of a home-based neonatal care intervention in rural Ghana? J Perinatol 28 S38; S45 S38; S45

36. ChoiYEl ArifeenSMannanIRahmanSMBariS 2010 Can mothers recognize neonatal illness correctly? comparison of maternal report and assessment by community health workers in rural Bangladesh. Trop Med Int Health 15 743 753

37. BangATBangRAReddyMHBaituleSBDeshmukhMD 2005 Simple clinical criteria to identify sepsis or pneumonia in neonates in the community needing treatment or referral. Pediatr Infect Dis J 24 335 341

38. SyedUKhadkaNKhanAWallS 2008 Care-seeking practices in South Asia: using formative research to design program interventions to save newborn lives. J Perinatol 28 Suppl 2 S9 13

39. KhadduriRMarshDRRasmussenBBariANazirR 2008 Household knowledge and practices of newborn and maternal health in Haripur District, Pakistan. J Perinatol 28 182 187

40. LeeACLawnJECousensSKumarVOsrinD 2009 Linking families and facilities for care at birth: what works to avert intrapartum-related deaths? Int J Gynecol Obstet 107 Suppl 1 S65 85, S86–68

41. ThaddeusSMaineD 1994 Too far to walk: maternal mortality in context. Soc Sci Med 38 1091 1110

42. BhuttaZAMemonZASoofiSSalatMSCousensS 2008 implementing community-based perinatal care: results from a pilot study in rural Pakistan. Bull World Health Organ 86 452 459

43. BaquiAHEl-ArifeenSDarmstadtGLAhmedSWilliamsEK 2008 Effect of community-based newborn-care intervention package implemented through two service-delivery strategies in Sylhet District, Bangladesh: a cluster-randomised controlled trial. Lancet 371 1936 1944

44. BariSMannanIRahmanMADarmstadtGLSerajilMH 2006 Trends in use of referral hospital services for care of sick newborns in a community-based intervention in Tangail District, Bangladesh. J Health Popul Nutr 24 519 529

45. EnglishMNgamaMMwalekwaLPeshuN 2004 Signs of illness in Kenyan infants aged less than 60 days. Bull World Health Organ 82 323 329

46. BamjiMSMurthyPVKumarKVBhargaviDDangoriaD 2000 Health and nutrition problems and health care seeking practices of rural women and children-lessons for health and nutrition entrepreneur's training. Indian Pediatr 37 807 808

47. HildenwallHNantandaRTumwineJKPetzoldMPariyoG 2009 Care-seeking in the development of severe community acquired pneumonia in Ugandan children. Ann Trop Paediatr 29 281 289

48. SodemannMJakobsenMSMolbakKAlvarengaICJrAabyP 1997 High mortality despite good care-seeking behaviour: a community study of childhood deaths in Guinea-Bissau. Bull World Health Organ 75 205 212

49. MustafaHSMalikEMTuokHTMohamedAAJullaAI 2009 Malaria preventive measures, health care seeking behaviour and malaria burden in different epidemiological settings in Sudan. Trop Med Int Health 14 1488 1495

50. WangWBJiangQWChenYXuB 2007 Pathways from first health care seeking to diagnosis: obstacles to tuberculosis care in rural China. Int J Tuberc Lung Dis 11 386 391

51. BaquiAHRahmanMZamanKEl ArifeenSChowdhuryHR 2007 A population-based study of hospital admission incidence rate and bacterial aetiology of acute lower respiratory infections in children aged less than five years in Bangladesh. J Health Popul Nutr 25 179 188

52. ShresthaBPBhandariBManandharDSOsrinDCostelloA 2011 community interventions to reduce child mortality in Dhanusha, Nepal: study protocol for a cluster randomized controlled trial. Trials 12 136

53. LewyckaSMwansamboCKazembePPhiriTMgangaA 2010 A cluster randomised controlled trial of the community effectiveness of two interventions in Rural Malawi to improve health care and to reduce maternal, newborn and infant mortality. Trials 11 88

54. TripathyPNairNMahapatraRRathSGopeRK 2011 Community mobilisation with women's groups facilitated by accredited social health activists (Ashas) to improve maternal and newborn health in underserved areas of Jharkhand and Orissa: study protocol for a cluster-randomised controlled trial. Trials 12 182

55. AhmedSSobhanFIslamABarkateK 2001 Neonatal morbidity and care-seeking behaviour in rural Bangladesh. J Trop Pediatr 47 98 105

56. BhandariNBahlRTanejaSMartinesJBhanMK 2002 Pathways to infant mortality in urban slums of Delhi, India: implications for improving the quality of community- and hospital-based programmes. J Health Popul Nutr 20 148 155

57. MohanPIyengarSDAgarwalKMartinesJCSenK 2008 Care-seeking practices in rural Rajasthan: barriers and facilitating factors. J Perinatol 28 Suppl 2 S31 37

58. BaquiAHArifeenSEDarmstadtGLAhmedSSerajiHR 2008 differentials in neonatal mortality in two adjacent rural areas of Bangladesh: lessons for neonatal health interventions. Glob Public Health 3 366 382

59. DongreARDeshmukhPRGargBS 2008 perceptions and health care seeking about newborn danger signs among mothers in rural Wardha. Indian J Pediatr 75 325 329

60. DongreARDeshmukhPRGargBS 2009 Awareness and health care seeking for newborn danger signs among mothers in peri-urban Wardha. Indian J Pediatr 76 691 693

61. WillisJRKumarVMohantySSinghPSinghV 2009 gender differences in perception and care-seeking for illness of newborns in Rural Uttar Pradesh, India. J Health Popul Nutr 27 62 71

62. ChowdhuryHRThompsonSCAliMAlamNYunusM 2011 Care seeking for fatal illness episodes in neonates: a population-based study in rural Bangladesh. BMC Pediatr 11 88

63. BazzanoANKirkwoodBRTawiah-AgyemangCOwusu-AgyeiSAdongoPB 2008 Beyond symptom recognition: care-seeking for ill newborns in rural Ghana. Trop Med Int Health 13 123 128

64. WaiswaPKallanderKPetersonSTomsonGPariyoGW 2010 Using the three delays model to understand why newborn babies die in Eastern Uganda. Trop Med Int Health 15 964 972

65. DongreARDeshmukhPRGargBS 2009 A community based approach to improve health care seeking for newborn danger signs in rural Wardha, India. Indian J Pediatr 76 45 50

66. AwasthiSVermaTAgarwalM 2006 Danger signs of neonatal illnesses: perceptions of caregivers and health workers in northern India. Bull World Health Organ 84 819 826

67. AwasthiSSrivastavaNMPantS 2008 symptom-specific care-seeking behavior for sick neonates among urban poor in Lucknow, Northern India. J Perinatol 28 Suppl 2 S69 75

68. OgunlesiTAOgunlesiFB 2011 Family socio-demographic factors and maternal obstetric factors influencing appropriate health-care seeking behaviours for newborn jaundice in Sagamu, Nigeria. Matern Child Health J

Štítky
Interné lekárstvo

Článok vyšiel v časopise

PLOS Medicine


2012 Číslo 3
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Kurzy

Zvýšte si kvalifikáciu online z pohodlia domova

Získaná hemofilie - Povědomí o nemoci a její diagnostika
nový kurz

Eozinofilní granulomatóza s polyangiitidou
Autori: doc. MUDr. Martina Doubková, Ph.D.

Všetky kurzy
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#