Risk factors for childhood illness and death in rural Uttar Pradesh, India: perspectives from the community, community health workers and facility staff

Abstract Background Uttar Pradesh (UP), India continues to have a high burden of mortality among young children despite recent improvement. Therefore, it is vital to understand the risk factors associated with under-five (U5) deaths and episodes of severe illness in order to deliver programs targete...

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Autores principales:	Kanchan Srivastava, Ranjana Yadav, Lorine Pelly, Elisabeth Hamilton, Gaurav Kapoor, Aman Mohan Mishra, Parwez Anis, Maryanne Crockett
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Child morbidity and mortality Risk factors Perceived risk Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/172d416951834a33b02855ccb49e1852
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spelling	oai:doaj.org-article:172d416951834a33b02855ccb49e18522021-11-08T10:43:26ZRisk factors for childhood illness and death in rural Uttar Pradesh, India: perspectives from the community, community health workers and facility staff10.1186/s12889-021-12047-21471-2458https://doaj.org/article/172d416951834a33b02855ccb49e18522021-11-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12047-2https://doaj.org/toc/1471-2458Abstract Background Uttar Pradesh (UP), India continues to have a high burden of mortality among young children despite recent improvement. Therefore, it is vital to understand the risk factors associated with under-five (U5) deaths and episodes of severe illness in order to deliver programs targeted at decreasing mortality among U5 children in UP. However, in rural UP, almost every child has one or more commonly described risk factors, such as low socioeconomic status or undernutrition. Determining how risk factors for childhood illness and death are understood by community members, community health workers and facility staff in rural UP is important so that programs can identify the most vulnerable children. Methods This qualitative study was completed in three districts of UP that were part of a larger child health program. Twelve semi-structured interviews and 21 focus group discussions with 182 participants were conducted with community members (mothers and heads of households with U5 children), community health workers (CHWs; Accredited Social Health Activists and Auxiliary Nurse Midwives) and facility staff (medical officers and staff nurses). All interactions were recorded, transcribed and translated into English, coded and clustered by theme for analysis. The data presented are thematic areas that emerged around perceived risk factors for childhood illness and death. Results There were key differences among the three groups regarding the explanatory perspectives for identified risk factors. Some perspectives were completely divergent, such as why the location of the housing was a risk factor, whereas others were convergent, including the impact of seasonality and certain occupational factors. The classic explanatory risk factors for childhood illness and death identified in household surveys were often perceived as key risk factors by facility staff but not community members. However, overlapping views were frequently expressed by two of the groups with the CHWs bridging the perspectives of the community members and facility staff. Conclusion The bridging views of the CHWs can be leveraged to identify and focus their activities on the most vulnerable children in the communities they serve, link them to facilities when they become ill and drive innovations in program delivery throughout the community-facility continuum.Kanchan SrivastavaRanjana YadavLorine PellyElisabeth HamiltonGaurav KapoorAman Mohan MishraParwez AnisMaryanne CrockettBMCarticleChild morbidity and mortalityRisk factorsPerceived riskPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Child morbidity and mortality Risk factors Perceived risk Public aspects of medicine RA1-1270
spellingShingle	Child morbidity and mortality Risk factors Perceived risk Public aspects of medicine RA1-1270 Kanchan Srivastava Ranjana Yadav Lorine Pelly Elisabeth Hamilton Gaurav Kapoor Aman Mohan Mishra Parwez Anis Maryanne Crockett Risk factors for childhood illness and death in rural Uttar Pradesh, India: perspectives from the community, community health workers and facility staff
description	Abstract Background Uttar Pradesh (UP), India continues to have a high burden of mortality among young children despite recent improvement. Therefore, it is vital to understand the risk factors associated with under-five (U5) deaths and episodes of severe illness in order to deliver programs targeted at decreasing mortality among U5 children in UP. However, in rural UP, almost every child has one or more commonly described risk factors, such as low socioeconomic status or undernutrition. Determining how risk factors for childhood illness and death are understood by community members, community health workers and facility staff in rural UP is important so that programs can identify the most vulnerable children. Methods This qualitative study was completed in three districts of UP that were part of a larger child health program. Twelve semi-structured interviews and 21 focus group discussions with 182 participants were conducted with community members (mothers and heads of households with U5 children), community health workers (CHWs; Accredited Social Health Activists and Auxiliary Nurse Midwives) and facility staff (medical officers and staff nurses). All interactions were recorded, transcribed and translated into English, coded and clustered by theme for analysis. The data presented are thematic areas that emerged around perceived risk factors for childhood illness and death. Results There were key differences among the three groups regarding the explanatory perspectives for identified risk factors. Some perspectives were completely divergent, such as why the location of the housing was a risk factor, whereas others were convergent, including the impact of seasonality and certain occupational factors. The classic explanatory risk factors for childhood illness and death identified in household surveys were often perceived as key risk factors by facility staff but not community members. However, overlapping views were frequently expressed by two of the groups with the CHWs bridging the perspectives of the community members and facility staff. Conclusion The bridging views of the CHWs can be leveraged to identify and focus their activities on the most vulnerable children in the communities they serve, link them to facilities when they become ill and drive innovations in program delivery throughout the community-facility continuum.
format	article
author	Kanchan Srivastava Ranjana Yadav Lorine Pelly Elisabeth Hamilton Gaurav Kapoor Aman Mohan Mishra Parwez Anis Maryanne Crockett
author_facet	Kanchan Srivastava Ranjana Yadav Lorine Pelly Elisabeth Hamilton Gaurav Kapoor Aman Mohan Mishra Parwez Anis Maryanne Crockett
author_sort	Kanchan Srivastava
title	Risk factors for childhood illness and death in rural Uttar Pradesh, India: perspectives from the community, community health workers and facility staff
title_short	Risk factors for childhood illness and death in rural Uttar Pradesh, India: perspectives from the community, community health workers and facility staff
title_full	Risk factors for childhood illness and death in rural Uttar Pradesh, India: perspectives from the community, community health workers and facility staff
title_fullStr	Risk factors for childhood illness and death in rural Uttar Pradesh, India: perspectives from the community, community health workers and facility staff
title_full_unstemmed	Risk factors for childhood illness and death in rural Uttar Pradesh, India: perspectives from the community, community health workers and facility staff
title_sort	risk factors for childhood illness and death in rural uttar pradesh, india: perspectives from the community, community health workers and facility staff
publisher	BMC
publishDate	2021
url	https://doaj.org/article/172d416951834a33b02855ccb49e1852
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Risk factors for childhood illness and death in rural Uttar Pradesh, India: perspectives from the community, community health workers and facility staff

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