Abstract
Child health care factors such as medical treatment of sick children have direct and indirect effect on childhood mortality. Through international cooperation, a number of countries including Kenya have gathered information on provision of child health services at facility level from periodic Service Provision Assessment (SPA) surveys. Kenya has also gathered information on medical treatment of sick children at household level from periodic Demographic and Health Surveys (DHS). However, establishing how health care information in the SPA surveys relates to childhood mortality and also how these factors relate to medical treatment of sick children in the DHS has been constrained by differences in sample designs of the surveys. This study deployed a fstrategy of constructing community level variables derived from the SPA survey data and incorporated them into DHS data which served as the main data source. The SPA and DHS sampling designs for Kenya allow computation of stable estimates of regional demographic and health service indicators at provincial level. This study analyzed information gathered from 690 health facilities in 2010 SPA and 6079 births born less than 60 months from 2008/09 DHS. The study found that access to child health services, waiting time before service in facility and time to the nearest referral facility were significant facilitating factors for medical treatment of sick children. The study also established that waiting time before service in facility was the only access to health care factor which had a significant effect on childhood mortality when HIV prevalence was excluded in the analysis. However, the significance of waiting time before service diminished with inclusion of HIV prevalence. Further research is required to refine definition and measurement for child health care variable on female autonomy.
Highlights
Access to child health care is an important component of quality health service provision
Due to sample design issues limiting combined use of Kenya Demographic and Health Survey (KDHS) and Kenya Service Provision Assessment (KSPA) surveys’ data which are collected after every five years, establishing how access to child health care factors including medical treatment of sick children relates with childhood mortality in Kenya has remained as a major challenge
At national level 2010 KSPA Report contained the following relevant key highlights that: 1) basic child health services were available in 68 percent of the facilities; 2) all first-line medicines to treat diarrhea, malaria and emergency conditions defined in Integrated Management of Childhood Illnesses (IMCI) strategy were available in 66 percent of facilities offering outpatient care for sick children; 3) reasons given by mothers as to why they failed to seek health care from the nearest facility included waiting time before being attended to and shortage of prescribed medicines [3]
Summary
Access to child health care is an important component of quality health service provision. Due to sample design issues limiting combined use of KDHS and Kenya Service Provision Assessment (KSPA) surveys’ data which are collected after every five years, establishing how access to child health care factors including medical treatment of sick children relates with childhood mortality in Kenya has remained as a major challenge. At national level 2010 KSPA Report contained the following relevant key highlights that: 1) basic child health services were available in 68 percent of the facilities; 2) all first-line medicines to treat diarrhea, malaria and emergency conditions defined in IMCI strategy were available in 66 percent of facilities offering outpatient care for sick children; 3) reasons given by mothers as to why they failed to seek health care from the nearest facility included waiting time before being attended to and shortage of prescribed medicines [3]. Some of the studies undertaken using Kenyan data concluded as follows: 1) that heath care delivery system pose recurrent barriers to the accessing of health care for the under-five and by implication frustrate efforts towards childhood mortality reduction [10]; and, 2) efforts of unmeasured environmental and community factors such as availability of hospitals and economic resources are likely to be important for child mortality [11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
