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

<h4>Background</h4>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 ch...

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Autores principales:	Yemisrach B Okwaraji, Simon Cousens, Yemane Berhane, Kim Mulholland, Karen Edmond
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/754a1e31565a4646841582952c66d2a9
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id	oai:doaj.org-article:754a1e31565a4646841582952c66d2a9
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spelling	oai:doaj.org-article:754a1e31565a4646841582952c66d2a92021-11-18T07:25:22ZEffect of geographical access to health facilities on child mortality in rural Ethiopia: a community based cross sectional study.1932-620310.1371/journal.pone.0033564https://doaj.org/article/754a1e31565a4646841582952c66d2a92012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22428070/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Methods and findings</h4>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 <1.5 hours from the health centre (children with travel time 1.5-<2.5 hrs adjusted relative risk [adjRR] 2.3[0.95-5.6], travel time 2.5-<3.5 hrs adjRR 3.1[1.3-7.4] and travel time 3.5-<6.5 hrs adjRR 2.5[1.1-6.2]).<h4>Conclusion</h4>Distance to a health centre had a marked influence on under five mortality in a poor, rural, remote area of Ethiopia. This study provides important information for policy makers on the likely impact of new health centres and their most effective location in remote areas.Yemisrach B OkwarajiSimon CousensYemane BerhaneKim MulhollandKaren EdmondPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 3, p e33564 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yemisrach B Okwaraji Simon Cousens Yemane Berhane Kim Mulholland Karen Edmond Effect of geographical access to health facilities on child mortality in rural Ethiopia: a community based cross sectional study.
description	<h4>Background</h4>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.<h4>Methods and findings</h4>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 <1.5 hours from the health centre (children with travel time 1.5-<2.5 hrs adjusted relative risk [adjRR] 2.3[0.95-5.6], travel time 2.5-<3.5 hrs adjRR 3.1[1.3-7.4] and travel time 3.5-<6.5 hrs adjRR 2.5[1.1-6.2]).<h4>Conclusion</h4>Distance to a health centre had a marked influence on under five mortality in a poor, rural, remote area of Ethiopia. This study provides important information for policy makers on the likely impact of new health centres and their most effective location in remote areas.
format	article
author	Yemisrach B Okwaraji Simon Cousens Yemane Berhane Kim Mulholland Karen Edmond
author_facet	Yemisrach B Okwaraji Simon Cousens Yemane Berhane Kim Mulholland Karen Edmond
author_sort	Yemisrach B Okwaraji
title	Effect of geographical access to health facilities on child mortality in rural Ethiopia: a community based cross sectional study.
title_short	Effect of geographical access to health facilities on child mortality in rural Ethiopia: a community based cross sectional study.
title_full	Effect of geographical access to health facilities on child mortality in rural Ethiopia: a community based cross sectional study.
title_fullStr	Effect of geographical access to health facilities on child mortality in rural Ethiopia: a community based cross sectional study.
title_full_unstemmed	Effect of geographical access to health facilities on child mortality in rural Ethiopia: a community based cross sectional study.
title_sort	effect of geographical access to health facilities on child mortality in rural ethiopia: a community based cross sectional study.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/754a1e31565a4646841582952c66d2a9
work_keys_str_mv	AT yemisrachbokwaraji effectofgeographicalaccesstohealthfacilitiesonchildmortalityinruralethiopiaacommunitybasedcrosssectionalstudy AT simoncousens effectofgeographicalaccesstohealthfacilitiesonchildmortalityinruralethiopiaacommunitybasedcrosssectionalstudy AT yemaneberhane effectofgeographicalaccesstohealthfacilitiesonchildmortalityinruralethiopiaacommunitybasedcrosssectionalstudy AT kimmulholland effectofgeographicalaccesstohealthfacilitiesonchildmortalityinruralethiopiaacommunitybasedcrosssectionalstudy AT karenedmond effectofgeographicalaccesstohealthfacilitiesonchildmortalityinruralethiopiaacommunitybasedcrosssectionalstudy
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Effect of geographical access to health facilities on child mortality in rural Ethiopia: a community based cross sectional study.

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