Online Program

280146
Pattern, determinants and risk analysis of care seeking for preterm newborns: A study in rural Bangladesh


Wednesday, November 6, 2013

Rashed Shah, MBBS, M.Sc (Int'l Health), Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Luke Mullany, PhD MHS, Bloomberg School of Public Health, Johns Hopkins, Baltimore, MD
Saifuddin Ahmed, MBBS, PhD, Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Dipak Mitra, MBBS, MPH, PhD, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Nazma Begum, M.Sc, Johns Hopkins University, Dhaka, Bangladesh
Abdullah Baqui, MBBS, MPH, DrPH, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Background: More than a quarter of early neonatal mortality in developing countries is attributable to lack of perinatal care seeking. A better understanding of the barriers and challenges to appropriate care-seeking is critical to enhance care-seeking for neonates, particularly for preterm babies who are at higher risks of morbidity and mortality. Method: Prospective data from 30,944 live births, including 6,378 preterm babies, were collected during June 2007 -September 2009. Log binomial regression and multinomial logistic regression model were employed for data analysis. Results: Almost one-fifth (19.8%) preterm newborns sought care from outside home (6.2% from qualified providers and 13.6% from non-qualified providers), while preterm newborns without care seeking were found higher in proportion compared to babies born at term (80.2% vs. 78.7%). Homeopath practitioners were found as the most preferred health care provider (50.0%). Compared to males, female preterm babies were 8% more likely to be at risk for not seeking care (RR: 1.08; [1.05, 1.10]). Birth preparedness (RRR: 1.39 [1.09 – 1.78]) and any ANC visit (RRR: 1.93 [1.50 – 2.49]) increased the likelihood of seeking care from qualified care for preterm born babies. Conclusion: These study findings proposed following programmatic measures to reduce health risks among preterm babies by enhancing care seeking for those in needs: 1) Community level awareness raising campaign on health risks for preterm neonates; 2) Involve non-formal and non-qualified health providers into health education and counselling sessions in the community; 3) Antenatal counselling of pregnant women and families about postnatal care seeking practices.

Learning Areas:

Planning of health education strategies, interventions, and programs
Program planning

Learning Objectives:
Describe the pattern of care seeking for preterm newborns. Discuss the determinants of care seeking for preterm newborns. Analyze comparative risks for care-seeking for preterm babies from qualitative and non-qualitative health providers.

Keyword(s): Care Seeking, Community Health Programs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently a junior Faculty in the department of International Health at Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. I graduated from Dhaka Medical College, Bangladesh in 1992 and thereafter I obtained M.Sc (International Health) from Uppsala University, Sweden in 2001. I conceptualized the hypothesis, identified the research question and conducted the data analysis. Also I wrote the first draft of the manuscript and the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.