Effect of geographical access to health facilities on child mortality in rural Ethiopia: a community based cross sectional study

There have been few studies that have examined associations between access to health care and child health outcomes in remote populations most in need of health services. This study assessed the effect of travel time and distance to health facilities on mortality in children under five years in a re...

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Bibliographic Details
Published in:PloS one 2012-03, Vol.7 (3), p.e33564-e33564
Main Authors: Okwaraji, Yemisrach B, Cousens, Simon, Berhane, Yemane, Mulholland, Kim, Edmond, Karen
Format: Article
Language:English
Subjects:
Analysis
Child health
Child Mortality
Child, Preschool
Children
Cross-Sectional Studies
Data processing
Ethiopia - epidemiology
Family Characteristics
Female
Geographic Information Systems
Geography
Health aspects
Health care
Health care access
Health care facilities
Health care services accessibility
Health facilities
Health Facilities - statistics & numerical data
Health Services Accessibility - statistics & numerical data
Households
Humans
Medicine
Mortality
Poisson density functions
Principal Component Analysis
Regression Analysis
Remote sensing
Rural areas
Rural Health - statistics & numerical data
Satellite navigation systems
Statistical analysis
Time Factors
Travel
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Summary:There have been few studies that have examined associations between access to health care and child health outcomes in remote populations most in need of health services. This study assessed the effect of travel time and distance to health facilities on mortality in children under five years in a remote area of rural north-western Ethiopia. This study involved a randomly selected cross sectional survey of 2,058 households. Data were collected during home visits to all resident women of reproductive age (15-49 years). A geographic information system (GIS) was used to map all households and the only health centre in the district. The analysis was restricted to 2,206 rural children who were under the age of five years during the five years before the survey. Data were analysed using random effects Poisson regression. 90.4% (1,996/2,206) of children lived more than 1.5 hours walk from the health centre. Children who lived ≥1.5 hrs from the health centre had a two to three fold greater risk of death than children who lived
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0033564