Adekanmbi, Victor, Adedokun, Sulaimon, Taylor-Phillips, Sian, Uthman, Olalekan A. and Clarke, Aileen (2017) Predictors of differences in health services utilization for children in Nigerian communities. Preventive Medicine, 96 . pp. 67-72. doi:10.1016/j.ypmed.2016.12.035 ISSN 0091-7435.

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Abstract

Health service utilization is an important component of child health promotion. Evidence shows that two-thirds of child deaths in low and middle income countries could be prevented if current interventions were adequately utilized. Aim of this study was to identify determinants of variation in health services utilization for children in communities in Nigeria. Multivariable negative binomial regression model attempting to explain observed variability in health services usage in Nigerian communities was applied to the 2013 Nigeria Demographic and Health Survey data. We included the index of maternal deprivation, gender of child, community environmental factor index, and maternal health seeking behavior, multiple childhood deprivation index and ethnicity diversity index as the independent variables. The outcome variable was under-fives’ hospital attendance rates for acute illness. Of the 7, 577 children from 896 communities in Nigeria that were sick 1, 936 (25.6%) were taken to the health care facilities for treatment. The final model revealed that both multiple childhood deprivation (incidence rate ratio [IRR] = 1.23, 95% confidence interval [CI] 1.12 to 1.35) and children living in communities with a high ethnic diversity were associated with higher rate of health service use. Maternal health seeking behaviour was associated with a significantly lower rate of health care service use. There are significant variations in health services utilization for sick children across Nigeria communities which appear to be more strongly determined by childhood deprivation factors and maternal health seeking behaviour than by health system functions.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Dean's Office & Professional Support Services Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Medical care -- Utilization -- Nigera, Child health services -- Nigeria, Children -- Mortality -- Nigeria, Children -- Nigeria, Children -- Nutrition -- Nigeria, Child development -- Nigeria
Journal or Publication Title:	Preventive Medicine
Publisher:	Academic Press
ISSN:	0091-7435
Official Date:	March 2017
Dates:	Date Event March 2017 Published 28 December 2016 Available 21 December 2016 Accepted 25 July 2016 Submitted
Volume:	96
Page Range:	pp. 67-72
DOI:	10.1016/j.ypmed.2016.12.035
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Date of first compliant deposit:	3 January 2017
Date of first compliant Open Access:	28 December 2017
Funder:	Wellcome Trust (London, England), Styrelsen för Internationellt Utvecklingssamarbete, Sida), Carnegie Corporation of New York
Grant number:	087547/Z/08/Z, B 8606.R02, 54100029

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