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El conocer a un médico está asociado con una reducción en la mortalidad de los niños enfermos ingresados en una sala pediátrica en Guinea‐Bissau, África Occidental
Author(s) -
Sodemann M.,
Biai S.,
Jakobsen M. S.,
Aaby P.
Publication year - 2006
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2006.01744.x
Subject(s) - medicine , psychological intervention , public health , family medicine , socioeconomic status , developing country , child mortality , pediatrics , health care , population , nursing , environmental health , economics , economic growth
Summary Background To examine equity in access to public health services in Guinea‐Bissau. Methods The study was conducted in 2000–2001 at the emergency clinic of the only paediatric ward in Bissau. Mothers of all children from the study area were interviewed about previous care seeking and relations with anybody working in the health sector. All management actions in the emergency clinic were registered. In‐hospital and subsequent community mortality was ascertained through community surveillance. The measured outcome was mortality risk within 30 days of first consultation. Results We followed 1572 children with a first consultation. Of these, 8.2% died within 30 days. Acquaintance with a physician reduced 30‐day mortality risk by 48% (95% CI: 18–66). The effect was strongest among post‐neonatal children (54%; 95% CI: 18–74). Mortality within 30 days of consultation was also independently predicted by consultation after 7 pm , nurse team on duty, day of week and young mother. In a multivariate model, socioeconomic status and school education were not associated with 30‐day mortality when acquaintance with a medical doctor was taken into account. Conclusion Favouritism may be a significant factor for quality of care and child mortality in developing countries. Interventions to improve hospital and health worker performance should be given high priority.