Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015

Malaz Elbashir Ahmed; Talal Elfadil Mahdi; Nada Jaffar Osman Ahmed

doi:doi:10.11648/j.sjph.20170502.14

| Peer-Reviewed

Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015

Malaz Elbashir Ahmed, Talal Elfadil Mahdi, Nada Jaffar Osman Ahmed

Published in Science Journal of Public Health (Volume 5, Issue 2)

Received: 17 December 2016 Accepted: 9 January 2017 Published: 9 February 2017

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

In Sudan despite the current implementation of universal health coverage policy, routine monitoring reports highlight that patients frequently bypass Primary Health Care (PHC) facilities in favor of higher-level hospitals, though hospitals are costly and time consuming. The main objective of this study was to study the extent of bypassing the public PHC facilities and factors associated with the decision of caretakers to bypass such facilities seeking care for their under-five year’s children with common illnesses in Sharg-Alneel locality, 2015. The study proposed strategies and interventions to the Sudan government -Federal Ministry of Health (FMoH) - to improve PHC service utilization The study was cross- sectional comparative study, interviewer administered questionnaires and facility assessment checklist was used for data collection. The data was analysed using SPSS. The study interviewed 497 caretakers, 87% of them pursued health care for their children directly from secondary hospitals. The main reasons for bypassing the closest public health facilities were unavailability of doctors, lack of health insurance services and higher cost of services. The proportion of bypassing a PHC facility for child care is significantly associated with child sex, child age, presenting symptoms of diarrhea, fever, difficult breathing and severe vomiting, caretakers’ occupation as well as the economic status. In a resource limited country, health policy to achieve universal health coverage is better to focus on quality of care as well as quantity. Community mobilization and interventions to improve access and utilization of quality PHC services are all recommended. Furthermore, more research on bypassing behaviour is also recommended.

Published in	Science Journal of Public Health (Volume 5, Issue 2)
DOI	10.11648/j.sjph.20170502.14
Page(s)	77-87
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

PHC, Child Health Services Utilization, Accessibility, Caretaker

References

[1]	FMOH: Promoting access to high quality primary health care services in Sudan (policy brief). Khartoum: Policy and Planning Unit 2011.
[2]	FMOH: Sudan Household Health survey-Round 2. Khartoum: Policy and Planning Unit 2012.
[3]	FMOH: National Acceleration PLAN for Maternal and CHILD Health 2013 –2015. Khartoum: Directorate General for PHC and Preventive Medicine 2013.
[4]	WHO: Reduction of child mortality in the Eastern Mediterranean Region. Geneva: World Health Organization 2012.
[5]	Macinko J, Starfield B, Erinosho T. The impact of primary healthcare on population health in low- and middle-income countries. J Ambul Care Manage. 2009; 32(2):150.
[6]	Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L: Evidence-based, cost-effectiveinterventions: how many newborn babies can we save? Lancet 2005, 365(9463):977-88.
[7]	Rutherford ME, Mulholland K, Hill PC: How access to health care relates to under-five mortality in sub-Saharan Africa: systematic review. Trop Med Int Health 2010, 15(5):508-19.
[8]	Low A, Coeyere D, Shivute N, Brandt LJ: Patient referral patterns in Namibia: identification of potential to improve the efficiency of the health care system. Int J Health Plan M 2001, 16(3):243-57.
[9]	Audo MO, Ferguson A, Njoroge PK: Quality of health care and its effects in the utilization of maternal and child health services in Kenya. East Afr Med J 2006, 82(11).
[10]	Sembuche SH, Ishengoma DS, Seth MD, Francis F, Rutta AS, Kamugisha ML, Lemnge MM: Epidemiology of malaria in an area prepared for clinical trials in Korogwe, north-eastern Tanzania. Malaria Journal 2009, 8:165.
[11]	Kruk ME, Mbaruku G, McCord CW, Moran M, Rockers PC, Galea S: Bypassing PHC facilities for childbirth: a population-based study in rural Tanzania.Health Policy Plan 2009, 24(4):279-88.
[12]	FMOH: Knowledge, Attitudes and Practices (KAP) in the Sudanese communities for their health seeking behavior: Policy and Planning Unit 2011.
[13]	KSMOH: Annual statistical report 2013: health information management system directorate 2013 (unpublished).
[14]	Rutebemberwa E, Kallander K, Tomson G, Peterson S, Pariyo G: Determinants of delay in care seeking for febrile children in eastern Uganda. Trop Med &Int Health 2009, 14(4):472-9.
[15]	Kahabuka et al.: Why caretakers bypass Primary Health Care facilities for child care - a case from rural Tanzania. BMC Health Services Research 2011, 11:315.
[16]	Low A, Coeyere D, Shivute N, Brandt LJ: Patient referral patterns in Namibia: identification of potential to improve the efficiency of the health care system. Int J Health Plan M 2001, 16(3):243-57.
[17]	FMOH: Specifications and standards for the health system in Sudan, Part II: Document of Characterization of services and health units. Khartoum: Policy and Planning Unit 2010.
[18]	Mohamed et al: Scaling up family medicine training in Gezira, Sudan – a 2-year in-service master programme using modern information and communication technology: a survey study, Human Resources for Health 2014, 12:3.
[19]	FMOH, Health Financing System Review Report, May 2014, Public Health Institute, unpublished.
[20]	Free healthcare policy for under-fives and pregnant women in northern Sudan:findings of a review. Khartoum: directorate general of planning and international health 2011.
[21]	Yount KM: Gender bias in the allocation of curative health care in Minia, Egypt. Popul Res Policy Rev 2003; 22:267–95.
[22]	Pauline Rossi, Lea Rouanet. Gender Preferences in Africa: A Comparative Analysis of Fertility Choices. PSE Working Papers n 2014-33. 2015. .
[23]	Milazzo, A. M. Son preference, fertility and family structure. Evidence form reproductive behavior among Nigerian women. World Bank Policy Research Working Paper 2014, No. 6869.
[24]	S. Pokhrel et al: Gender role and child health care utilization in Nepal. Health Policy 2005;74100–109.
[25]	Nuruddin R, Hadden WC, PetersenMR, Lim MK: Does child gender determine household decision for health care in rural Thatta, Pakistan? J Public Health (Oxf) 2009; 31:389–97.
[26]	Das Gupta, Metal. “Why is Son Preference so Persistent in East and South Asia? A Cross Country Study of China, India and the Republic of Korea.” Journal of Developmental Studies, (2003) vol.40 (2).
[27]	Audo MO, Ferguson A, Njoroge PK: Quality of health care and its effects in the utilization of maternal and child health services in Kenya. East Afr Med J 2006, 82(11).
[28]	Tsukahara T., The Choice of Healthcare Providers for Febrile Children after Introducing Non-professional Health Workers in a Malaria Endemic Area in Papua New Guinea. 2015; 3:275.
[29]	Dong et al: Focus on vulnerable populations and promoting equity in health service utilization ––an analysis of visitor characteristics and service utilization of the Chinese community health service. BMC Public Health 2014, 14:503.
[30]	Wu D, Lam TP. Underuse of Primary Care in China: The Scale, Causes, and Solutions. JABFM 2016, Vol. 29 No.
[31]	Sreeramareddy C T, et al: Care seeking behavior for childhood illness- a questionnaire survey in western Nepal. BMC International Health and Human Rights 2006, 6:7.
[32]	MOH, Report of IMCI evaluation in the District of Kirehe in Rwanda - July 2008. Rwanda.
[33]	Lin Y. and Tavrow P: Assessing Health Worker Performance of IMCI in Kenya. Quality Assurance Project Case Study. Published for the U. S. Agency for International Development (USAID) by the Quality Assurance Project (QAP): 2000 Bethesda, Maryland, U.S.A.
[34]	Tulloch J: Integrated approach to child health in developing countries. The Lancet 354 (Suppl. 2): SII16-20.

Cite This Article

Plain Text BibTeX RIS

APA Style

Malaz Elbashir Ahmed, Talal Elfadil Mahdi, Nada Jaffar Osman Ahmed. (2017). Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015. Science Journal of Public Health, 5(2), 77-87. https://doi.org/10.11648/j.sjph.20170502.14

Copy | Download

ACS Style

Malaz Elbashir Ahmed; Talal Elfadil Mahdi; Nada Jaffar Osman Ahmed. Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015. Sci. J. Public Health 2017, 5(2), 77-87. doi: 10.11648/j.sjph.20170502.14

Copy | Download

AMA Style

Malaz Elbashir Ahmed, Talal Elfadil Mahdi, Nada Jaffar Osman Ahmed. Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015. Sci J Public Health. 2017;5(2):77-87. doi: 10.11648/j.sjph.20170502.14

Copy | Download

@article{10.11648/j.sjph.20170502.14,
  author = {Malaz Elbashir Ahmed and Talal Elfadil Mahdi and Nada Jaffar Osman Ahmed},
  title = {Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015},
  journal = {Science Journal of Public Health},
  volume = {5},
  number = {2},
  pages = {77-87},
  doi = {10.11648/j.sjph.20170502.14},
  url = {https://doi.org/10.11648/j.sjph.20170502.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20170502.14},
  abstract = {In Sudan despite the current implementation of universal health coverage policy, routine monitoring reports highlight that patients frequently bypass Primary Health Care (PHC) facilities in favor of higher-level hospitals, though hospitals are costly and time consuming. The main objective of this study was to study the extent of bypassing the public PHC facilities and factors associated with the decision of caretakers to bypass such facilities seeking care for their under-five year’s children with common illnesses in Sharg-Alneel locality, 2015. The study proposed strategies and interventions to the Sudan government -Federal Ministry of Health (FMoH) - to improve PHC service utilization The study was cross- sectional comparative study, interviewer administered questionnaires and facility assessment checklist was used for data collection. The data was analysed using SPSS. The study interviewed 497 caretakers, 87% of them pursued health care for their children directly from secondary hospitals. The main reasons for bypassing the closest public health facilities were unavailability of doctors, lack of health insurance services and higher cost of services. The proportion of bypassing a PHC facility for child care is significantly associated with child sex, child age, presenting symptoms of diarrhea, fever, difficult breathing and severe vomiting, caretakers’ occupation as well as the economic status. In a resource limited country, health policy to achieve universal health coverage is better to focus on quality of care as well as quantity. Community mobilization and interventions to improve access and utilization of quality PHC services are all recommended. Furthermore, more research on bypassing behaviour is also recommended.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015
AU  - Malaz Elbashir Ahmed
AU  - Talal Elfadil Mahdi
AU  - Nada Jaffar Osman Ahmed
Y1  - 2017/02/09
PY  - 2017
N1  - https://doi.org/10.11648/j.sjph.20170502.14
DO  - 10.11648/j.sjph.20170502.14
T2  - Science Journal of Public Health
JF  - Science Journal of Public Health
JO  - Science Journal of Public Health
SP  - 77
EP  - 87
PB  - Science Publishing Group
SN  - 2328-7950
UR  - https://doi.org/10.11648/j.sjph.20170502.14
AB  - In Sudan despite the current implementation of universal health coverage policy, routine monitoring reports highlight that patients frequently bypass Primary Health Care (PHC) facilities in favor of higher-level hospitals, though hospitals are costly and time consuming. The main objective of this study was to study the extent of bypassing the public PHC facilities and factors associated with the decision of caretakers to bypass such facilities seeking care for their under-five year’s children with common illnesses in Sharg-Alneel locality, 2015. The study proposed strategies and interventions to the Sudan government -Federal Ministry of Health (FMoH) - to improve PHC service utilization The study was cross- sectional comparative study, interviewer administered questionnaires and facility assessment checklist was used for data collection. The data was analysed using SPSS. The study interviewed 497 caretakers, 87% of them pursued health care for their children directly from secondary hospitals. The main reasons for bypassing the closest public health facilities were unavailability of doctors, lack of health insurance services and higher cost of services. The proportion of bypassing a PHC facility for child care is significantly associated with child sex, child age, presenting symptoms of diarrhea, fever, difficult breathing and severe vomiting, caretakers’ occupation as well as the economic status. In a resource limited country, health policy to achieve universal health coverage is better to focus on quality of care as well as quantity. Community mobilization and interventions to improve access and utilization of quality PHC services are all recommended. Furthermore, more research on bypassing behaviour is also recommended.
VL  - 5
IS  - 2
ER  -

Copy | Download

Author Information

Malaz Elbashir Ahmed

Community Medicine, Federal Ministry of Health, Directorate General of Human Resources for Health Development, HRH Policy and Planning Director, Khartoum, Sudan
Talal Elfadil Mahdi

Community Medicine, Director General of the National Health Insurance Fund, Khartoum, Sudan
Nada Jaffar Osman Ahmed

Community Medicine, Federal Ministry of Health, Directorate General of Primary Health Care, Maternal and Child Health Director, Khartoum, Sudan

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Malaz Elbashir Ahmed, Talal Elfadil Mahdi, Nada Jaffar Osman Ahmed. (2017). Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015. Science Journal of Public Health, 5(2), 77-87. https://doi.org/10.11648/j.sjph.20170502.14

Copy | Download

ACS Style

Malaz Elbashir Ahmed; Talal Elfadil Mahdi; Nada Jaffar Osman Ahmed. Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015. Sci. J. Public Health 2017, 5(2), 77-87. doi: 10.11648/j.sjph.20170502.14

Copy | Download

AMA Style

Malaz Elbashir Ahmed, Talal Elfadil Mahdi, Nada Jaffar Osman Ahmed. Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015. Sci J Public Health. 2017;5(2):77-87. doi: 10.11648/j.sjph.20170502.14

Copy | Download

@article{10.11648/j.sjph.20170502.14,
  author = {Malaz Elbashir Ahmed and Talal Elfadil Mahdi and Nada Jaffar Osman Ahmed},
  title = {Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015},
  journal = {Science Journal of Public Health},
  volume = {5},
  number = {2},
  pages = {77-87},
  doi = {10.11648/j.sjph.20170502.14},
  url = {https://doi.org/10.11648/j.sjph.20170502.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20170502.14},
  abstract = {In Sudan despite the current implementation of universal health coverage policy, routine monitoring reports highlight that patients frequently bypass Primary Health Care (PHC) facilities in favor of higher-level hospitals, though hospitals are costly and time consuming. The main objective of this study was to study the extent of bypassing the public PHC facilities and factors associated with the decision of caretakers to bypass such facilities seeking care for their under-five year’s children with common illnesses in Sharg-Alneel locality, 2015. The study proposed strategies and interventions to the Sudan government -Federal Ministry of Health (FMoH) - to improve PHC service utilization The study was cross- sectional comparative study, interviewer administered questionnaires and facility assessment checklist was used for data collection. The data was analysed using SPSS. The study interviewed 497 caretakers, 87% of them pursued health care for their children directly from secondary hospitals. The main reasons for bypassing the closest public health facilities were unavailability of doctors, lack of health insurance services and higher cost of services. The proportion of bypassing a PHC facility for child care is significantly associated with child sex, child age, presenting symptoms of diarrhea, fever, difficult breathing and severe vomiting, caretakers’ occupation as well as the economic status. In a resource limited country, health policy to achieve universal health coverage is better to focus on quality of care as well as quantity. Community mobilization and interventions to improve access and utilization of quality PHC services are all recommended. Furthermore, more research on bypassing behaviour is also recommended.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015
AU  - Malaz Elbashir Ahmed
AU  - Talal Elfadil Mahdi
AU  - Nada Jaffar Osman Ahmed
Y1  - 2017/02/09
PY  - 2017
N1  - https://doi.org/10.11648/j.sjph.20170502.14
DO  - 10.11648/j.sjph.20170502.14
T2  - Science Journal of Public Health
JF  - Science Journal of Public Health
JO  - Science Journal of Public Health
SP  - 77
EP  - 87
PB  - Science Publishing Group
SN  - 2328-7950
UR  - https://doi.org/10.11648/j.sjph.20170502.14
AB  - In Sudan despite the current implementation of universal health coverage policy, routine monitoring reports highlight that patients frequently bypass Primary Health Care (PHC) facilities in favor of higher-level hospitals, though hospitals are costly and time consuming. The main objective of this study was to study the extent of bypassing the public PHC facilities and factors associated with the decision of caretakers to bypass such facilities seeking care for their under-five year’s children with common illnesses in Sharg-Alneel locality, 2015. The study proposed strategies and interventions to the Sudan government -Federal Ministry of Health (FMoH) - to improve PHC service utilization The study was cross- sectional comparative study, interviewer administered questionnaires and facility assessment checklist was used for data collection. The data was analysed using SPSS. The study interviewed 497 caretakers, 87% of them pursued health care for their children directly from secondary hospitals. The main reasons for bypassing the closest public health facilities were unavailability of doctors, lack of health insurance services and higher cost of services. The proportion of bypassing a PHC facility for child care is significantly associated with child sex, child age, presenting symptoms of diarrhea, fever, difficult breathing and severe vomiting, caretakers’ occupation as well as the economic status. In a resource limited country, health policy to achieve universal health coverage is better to focus on quality of care as well as quantity. Community mobilization and interventions to improve access and utilization of quality PHC services are all recommended. Furthermore, more research on bypassing behaviour is also recommended.
VL  - 5
IS  - 2
ER  -

Copy | Download