Caregivers Of Sick Children Research Articles

‘Let him die in peace’: understanding caregiver’s refusal of medical oxygen treatment for children in Nigeria

IntroductionEfforts to improve oxygen access have focused mainly on the supply side, but it is important to understand demand barriers, such as oxygen refusal among caregivers. We therefore aimed to...

Socio-Economic Factors Associated with Anaemia Management among Children under Five in Kisumu County Hospital, Kenya

Background: High burden of anaemia due to high prevalence and its impacts in children's health especially in growth and development especially, makes anaemia an important public health concern. The difficulty in implementing effective measures for controlling anaemia remains a concern, World Health Organization (WHO) is implementing new strategies for the integrated management of the sick child in the primary care set ups, these includes algorithms based on clinical signs observed by health care workers. We aimed to assess the healthcare-seeking behaviour, economic, and social factors affecting anaemia management among caregivers of sick children who had severe anaemia and are five years and below in Western Kenya. Methods: Descriptive cross-sectional study design was used. Systematic random sampling was used in selection of study subjects. Data on factors associated with anaemia management in Kisumu County hospitals was collected using a structured questionnaire and clinician desk review charts. Association of factors measured using a Chi-Square test of association and odds ratio used for likelihood tests. Results: Results revealed that Anaemia factors, Number of children <5 years of age, and type of food were major determinants for anaemia management. Children fed on non-rich iron foods were less likely to practice good anaemia management as compared to those who eat iron-rich food and prone to increase likelihood of developing anaemia. Conclusions: Anaemia management in Kisumu County Hospital is satisfactory. However, there is a need to address finding gaps and as well conduct further studies on home and hospital management outcomes to inform policy.

Measuring user experience of care among caregivers of sick children: Validation and descriptive analysis in a sample of 75 health facilities in rural Tanzania.

User experience is an important aspect of quality of care that is highly valued by patients. However, there are currently no validated tools for measuring user experience among caregivers of sick children in low- and middle-income countries. We aimed to develop and validate a measure of user experience in this population in primary healthcare facilities in rural Tanzania, where major quality improvement efforts to date have not included a large focus on user experience. We then aimed to describe variation in user experience between and within facilities. Informed by theory and formative qualitative research, we developed questions to measure user experience across three domains: prompt care, respect, and communication. We then conducted interviewer-administered surveys with caregivers of sick children. Using survey data, we conducted psychometric analyses to inform the development of a composite measure of user experience. Finally, we used multilevel models to describe variation in user experience and examine associations with facility, patient, and caregiver characteristics. Surveys were completed by 1085 caregivers across 75 facilities. In exploratory factor analysis, user experience items did not group according to theoretical domains. We therefore assessed items individually and designed a single 8-item additive measure of user experience. Using this composite measure, and adjusting for differences in case mix across facilities, we found that 69% of variation in user experience was within facilities and 31% was between facilities. Smaller facility size and more caregiver education were positively associated with user experience. We found that user experience varied significantly across health facilities in rural Tanzania, highlighting opportunities for improvement. Measurement tools are needed to inform efforts to improve user experience and monitor changes over time. The scale developed in this study could serve as a starting point for the measurement of user experience among caregivers in similar settings.

Utilisation of diagnostics in India: a rapid ethnographic study exploring context and behaviour

ObjectivesTo explore factors that influence behaviour in the utilisation of diagnostics by caregivers of sick children. Utilisation is defined as a caregiver assisting a child to get diagnostic tests done...

Health Care Seeking Behavior among Caregivers of Sick Children Who Had Severe Malarial Anaemia

Aims: The western region in Kenya is holoendemic to malaria and experience stable P. falciparum malaria transmission. The use of health care options has a direct influence on the outcome of severe malaria. As such, the current study will assess the health care seeking behavior among caregivers of sick children who had severe malarial anaemia (SMA) in western Kenya.
 Study Design: Cross section study.
 Place and Duration of Study: The study was conducted at Jaramogi Odinga Oginga Teaching and Referral Hospital (JOOTRH) between September 2014 to July 2015.
 Methodology: It was open to all children ≤10 years (n=271) admitted and diagnosed with SMA (hemoglobin <5.0 g/dl and any density of P. falciparum. Caregivers were interviewed on the health care options before seeking care at a heath facility, when the child started to get sick, if they took child to another health centre/dispensary/private hospital before coming to JOOTRH 
 Results: Majority of the caregivers interviewed, 80.07% (217) had attained Primary education. Majority of the caregivers were in the age category of 19-24 75(27.67%) years and 25-29 years 75 (27.67%). 74.90% (203) of their children were below five years and 25.09% (68) were above 5 years. 61.62% (167. Majority of the caregivers gave some remainder drugs before presenting to a heath facility 32.5% (88). A good number bought drugs at drug stores/pharmacies 27.7% (75). None visited a traditional healer. A minority used herbs 10% (27). There were no statistically significant differences between most of the pre-hospitalization measures taken s with regard to patient’s gender and age, and caretaker’s level of education. Caregivers who chose to give herbs to their sick children took longer in deciding to take their children to hospital. This was however statistically significant between those who used herbs and those who bought drugs only (median 4 days vs. 3 days, respectively, p = 0.0063). There was no significant difference in the delay of child admission at JOOTRH between caregivers who had had primary education only and those with a minimum of secondary education (p = 0.9842).
 Conclusion: Self-medication is a common practice before seeking care at a heath facility. There is need for community awareness for correct and comprehensive information about drawbacks associated with self-medication practices. Since safety continues to be a major issue with the use of herbal remedies, it becomes imperative, therefore, that relevant regulatory authorities put in place to ensure that all herbal medicines are safe and of suitable quality.

The determinants and outcomes of good provider communication: a cross-sectional study in seven African countries

ObjectivesTo determine the extent of provider communication, predictors of good communication and the association between provider communication and patient outcomes, such as patient satisfaction, in seven sub-Saharan African countries.DesignCross-sectional, multicountry...

A study of knowledge, attitude and practice regarding administration of pediatric dosage forms and allied health literacy of caregivers for children.

Context:Caregivers of sick children have to be careful with medicine dosing and giving medicines to a reluctant child can be challenging.Aim:To assess the knowledge, attitude, and practices of caregivers regarding pediatric medicine administration and health literacy allied to this task.Settings and Design:This cross-sectional study was carried out on outpatient and inpatient basis in the pediatrics department of a teaching hospital over 6 months.Subjects and Methods:Data regarding sociodemographic profile of patient and caregiver, idea regarding pediatric dosage forms, dosing of medicines, and medication errors during administration were recorded from 377 caregivers. Reconstitution of dry powder and measurement of 5 mL liquid medicine using measuring cup of the medicine phial was demonstrated by the caregivers.Statistical Analysis:Association assessed by point biserial correlation and Spearman's rank correlation.Results:Majority of the primary caregivers surveyed were young, educated, homemaker mothers. Liquid medicines were used maximally (88.9%). Majority (87.3%) of the caregivers used standardized dosing instruments to measure liquids and reconstitution (85.9%), and teaspoon measurement task (91%) was performed satisfactorily by most. Some potentially wrong practices (e.g., adding medicine to milk, redilution of reconstituted medicine, and storing beyond the recommended period) were recorded. Medication errors were reported by 44.5% caregivers, significantly more in the outpatient setting. Although the statistical correlation was weak, the chance of medication error was less, and the precision of measurement was better with increasing education of the caregiver.Conclusions:Physicians need to be aware of the limitations of knowledge and the possibility of wrong administration practices among caregivers of children. Remedial measures in this regard can reduce the risk of medication errors.

Acceptance of a malaria vaccine by caregivers of sick children in Kenya.

BackgroundSeveral malaria vaccines are currently in clinical trials and are expected to provide an improved strategy for malaria control. Prior to introduction of a new vaccine, policymakers must consider the socio cultural environment of the region to ensure widespread community approval. This study investigated the acceptance of a malaria vaccine by child caregivers and analysed factors that influence these.MethodsInterviews from a standard questionnaire were conducted with 2,003 caregivers at 695 randomly selected health facilities across Kenya during the Kenya Service Provision Assessment Survey 2010. Multinomial regression of quantitative data was conducted using STATA to analyse determinants of caregivers accepting malaria vaccination of their child.ResultsMothers represented 90% of caregivers interviewed who brought their child to the health facility, and 77% of caregivers were 20-34 years old. Overall, 88% of respondents indicated that they would accept a malaria vaccine, both for a child in their community and their own child. Approval for a vaccine was highest in malaria-endemic Nyanza Province at 98.9%, and lowest in the seasonal transmission area of North Eastern Province at 23%. Although 94% of respondents who had attended at least some school reported they would accept the vaccine for a child, only 56% of those who had never attended school would do so. The likelihood of accepting one’s own child to be immunized was correlated with province, satisfaction with health care services in the facility attended, age of the caregiver, and level of education.ConclusionsResults from this study indicate a need for targeted messages and education on a malaria vaccine, particularly for residents of regions where acceptance is low, older caregivers, and those with low literacy and school-attendance levels. This study provides critical evidence to inform policy for a new malaria vaccine that will support its timely and comprehensive uptake in Kenya.

YouTube and Pediatric Surgery. What Is the Danger for Parents?

Internet became one of the most important sources of public health informations especially for relatives and/or caregivers of sick children. Use of YouTube as a source of information in pediatric surgery has not been evaluated. In this study, we want to evaluate the use of YouTube as a source of information about one of the most frequent surgical urgency in pediatric patients, the acute appendicitis, to evaluate the risks for patients and parents.

Ownership and use of mobile phones among health workers, caregivers of sick children and adult patients in Kenya: cross-sectional national survey

BackgroundThe rapid growth in mobile phone penetration and use of Short Message Service (SMS) has been seen as a potential solution to improve medical and public health practice in Africa. Several studies have shown effectiveness of SMS interventions to improve health workers’ practices, patients’ adherence to medications and availability of health facility commodities. To inform policy makers about the feasibility of facility-based SMS interventions, the coverage data on mobile phone ownership and SMS use among health workers and patients are needed.MethodsIn 2012, a national, cross-sectional, cluster sample survey was undertaken at 172 public health facilities in Kenya. Outpatient health workers and caregivers of sick children and adult patients were interviewed. The main outcomes were personal ownership of mobile phones and use of SMS among phone owners. The predictors analysis examined factors influencing phone ownership and SMS use.ResultsThe analysis included 219 health workers and 1,177 patients’ respondents (767 caregivers and 410 adult patients). All health workers possessed personal mobile phones and 98.6% used SMS. Among patients’ respondents, 61.2% owned phones and 71.4% of phone owners used SMS. The phone ownership and SMS use was similar between caregivers of sick children and adult patients. The respondents who were male, more educated, literate and living in urban area were significantly more likely to own the phone and use SMS. The youngest respondents were less likely to own phones, however when the phones were owned, younger age groups were more likely to use SMS. Respondents living in wealthier areas were more likely to own phones; however when phones are owned no significant association between the poverty and SMS use was observed.ConclusionsMobile phone ownership and SMS use is ubiquitous among Kenyan health workers in the public sector. Among patients they serve the coverage in phone ownership and SMS use is lower and disparities exist with respect to gender, age, education, literacy, urbanization and poverty. Some of the disparities on SMS use can be addressed through the modalities of mHealth interventions and enhanced implementation processes while further growth in mobile phone penetration is needed to reduce the ownership gap.