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ABSTRACT: Background
We conducted a social and verbal autopsy study to determine cultural-, social- and health system-related factors that were associated with the delay in formal care seeking in Sylhet district, Bangladesh.Methods
Verbal and social autopsy interviews were conducted with mothers who experienced a neonatal death between October 2007 and May 2011. We fitted a semi-parametric regression model of the cumulative incidence of seeking formal care first, accounting for competing events of death or seeking informal care first.Results
Three hundred and thirty-one neonatal deaths were included in the analysis and of these, 91(27.5%) sought formal care first; 26 (7.9%) sought informal care first; 59 (17.8%) sought informal care only, and 155 (46.8%) did not seek any type of care. There was lower cumulative incidence of seeking formal care first for preterm neonates (sub-hazard ratio SHR 0.61, P?=?0.025), and those who delivered at home (SHR 0.52, P?=?0.010); and higher cumulative incidence for those who reported less than normal activity (SHR 1.95, P?=?0.048). The main barriers to seeking formal care reported by 165 mothers included cost (n?=?98, 59.4%), believing the neonate was going to die anyway (n?=?29, 17.7%), and believing traditional care was more appropriate (n?=?26, 15.8%).Conclusions
The majority of neonates died before formal care could be sought, but formal care was more likely to be sought than informal care. There were economic and social belief barriers to care-seeking. There is a need for programs that educate caregivers about well-recognized danger signs requiring timely care-seeking, particularly for preterm neonates and those who deliver at home.
SUBMITTER: Nonyane BA
PROVIDER: S-EPMC4920004 | biostudies-literature | 2016 Jun
REPOSITORIES: biostudies-literature
Nonyane Bareng As BA Kazmi Narjis N Koffi Alain K AK Begum Nazma N Ahmed Salahuddin S Baqui Abdullah H AH Kalter Henry D HD
Journal of global health 20160601 1
<h4>Background</h4>We conducted a social and verbal autopsy study to determine cultural-, social- and health system-related factors that were associated with the delay in formal care seeking in Sylhet district, Bangladesh.<h4>Methods</h4>Verbal and social autopsy interviews were conducted with mothers who experienced a neonatal death between October 2007 and May 2011. We fitted a semi-parametric regression model of the cumulative incidence of seeking formal care first, accounting for competing e ...[more]