Health of children less than 5 years old in an upper middle income country: parents' views

Abstract

Health literature in the Caribbean, and in particular Jamaica, has continued to use objective indices such as mortality and morbidity to examine children’s health. The current study uses subjective indices such as parent-reported health conditions and health status to evaluate the health of children instead of traditional objective indices. The study seeks 1) to examine the health and health care-seeking behaviour of the sample from the parents’ viewpoints; and 2) to compute the mean age of the sample with a particular illness and describe whether there is an epidemiological shift in these conditions. Two nationally representative cross-sectional surveys were used for this study (2002 and 2007). The sample for the current study is 3,062 respondents aged less than 5 years. For 2002, the study extracted a sample of 2,448 under 5 year olds from the national survey of 25,018 respondents, and 614 under 5 year olds were extracted from the 2007 survey of 6,728 respondents. Parents-reported information was used to measure issues on children under 5 years old. In 2007, 43.4% of the sample had very good health status; 46.7% good health status; 2.5% poor health and 0.3% very poor health status. Almost 15% of children had illnesses in 2002, and 6% more had illnesses in 2007 over 2002. In 2002, the percentage of the sample with particular chronic illnesses was: diabetes mellitus (0.6%); hypertension (0.3%) and arthritis (0.3%). However, none was recorded in 2007. The mean age of children less than 5 years old with acute health conditions (i.e. diarrhoea, respiratory diseases and influenza) increased over 2002. In 2007, 43.4% of children less than 5 years old had very good health status; 46.7% good health status; 7.1% fair health status; 2.5% poor and 0.3% very poor health status. The association between health status and parent- reported illness was –x2 (df = 4) = 57.494, P< 0.001-with the relationship being a weak one, correlation coefficient=0.297. A cross-tabulation between health status and parent-reported diagnosed illness found that a significant statistical correlation existed between the two variables –x2 (df = 16) = 26.621, P < 0.05, cc = 0.422, – with the association being a moderate one, correlation coefficient = 0.422. A cross tabulation between health status and health care- seeking behaviour found a significant statistical association between the two variables –x2 (df = 4) = 10.513, P < 0.033-with the correlation being a weak one-correlation coefficient = 0.281. Rural children had the least health status. The health disparity that existed between rural and urban less than 5 year olds showed that this will not be removed simply because of the abolition of health care utilization fees.