PMID- 21447057
OWN - NLM
STAT- MEDLINE
DCOM- 20110711
LR  - 20220409
IS  - 1365-3156 (Electronic)
IS  - 1360-2276 (Linking)
VI  - 16
IP  - 6
DP  - 2011 Jun
TI  - Impact of implementation of free high-quality health care on health facility 
      attendance by sick children in rural western Kenya.
PG  - 711-20
LID - 10.1111/j.1365-3156.2011.02752.x [doi]
AB  - OBJECTIVES: To explore whether implementation of free high-quality care as part 
      of research programmes resulted in greater health facility attendance by sick 
      children. METHODS: As part of the Intermittent Preventive Treatment for Malaria 
      in Infants (IPTi), begun in 2004, and population-based infectious disease 
      surveillance (PBIDS), begun in 2005 in Asembo, rural western Kenya, free 
      high-quality care was offered to infants and persons of all ages, respectively, 
      at one Asembo facility, Lwak Hospital. We compared rates of sick-child visits by 
      children <10 years to all seven Asembo clinics before and after implementation of 
      free high-quality care in 10 intervention villages closest to Lwak Hospital and 8 
      nearby comparison villages not participating in the studies. Incidence rates and 
      rate ratios for sick-child visits were compared between intervention and 
      comparison villages by time period using Poisson regression. RESULTS: After IPTi 
      began, the rate of sick-child visits for infants, the study's target group, in 
      intervention villages increased by 191% (95% CI 75-384) more than in comparison 
      villages, but did not increase significantly more in older children. After PBIDS 
      began, the rate of sick-child visits in intervention villages increased by 267% 
      (95% CI 76-661) more than that in comparison villages for all children <10 years. 
      The greatest increases in visit rates in intervention villages occurred 3-6 
      months after the intervention started. Visits for cough showed greater increases 
      than visits for fever or diarrhoea. CONCLUSIONS: Implementation of free 
      high-quality care increased healthcare use by sick children. Cost and quality of 
      care are potentially modifiable barriers to improving access to care in rural 
      Africa.
CI  - (c) 2011 Blackwell Publishing Ltd.
FAU - Burgert, Clara R
AU  - Burgert CR
AD  - Rollins School of Public Health, Emory University, Atlanta, GA, USA.
FAU - Bigogo, Godfrey
AU  - Bigogo G
FAU - Adazu, Kubaje
AU  - Adazu K
FAU - Odhiambo, Frank
AU  - Odhiambo F
FAU - Buehler, James
AU  - Buehler J
FAU - Breiman, Robert F
AU  - Breiman RF
FAU - Laserson, Kayla
AU  - Laserson K
FAU - Hamel, Mary J
AU  - Hamel MJ
FAU - Feikin, Daniel R
AU  - Feikin DR
LA  - eng
PT  - Journal Article
DEP - 20110329
PL  - England
TA  - Trop Med Int Health
JT  - Tropical medicine & international health : TM & IH
JID - 9610576
SB  - IM
MH  - Age Distribution
MH  - Child
MH  - Child Health Services/economics/standards/*statistics & numerical data
MH  - Child Mortality/trends
MH  - Child, Preschool
MH  - Fees and Charges
MH  - Female
MH  - Health Services Accessibility
MH  - Health Services Research/methods
MH  - Humans
MH  - Infant
MH  - Infant Mortality/trends
MH  - Infant, Newborn
MH  - Kenya/epidemiology
MH  - Male
MH  - *Quality of Health Care
MH  - Rural Health Services/economics/standards/*statistics & numerical data
MH  - Seasons
EDAT- 2011/03/31 06:00
MHDA- 2011/07/12 06:00
CRDT- 2011/03/31 06:00
PHST- 2011/03/31 06:00 [entrez]
PHST- 2011/03/31 06:00 [pubmed]
PHST- 2011/07/12 06:00 [medline]
AID - 10.1111/j.1365-3156.2011.02752.x [doi]
PST - ppublish
SO  - Trop Med Int Health. 2011 Jun;16(6):711-20. doi: 
      10.1111/j.1365-3156.2011.02752.x. Epub 2011 Mar 29.