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      DETERMINANTES SOCIODEMOGRÁFICOS DE APLICACIÓN DE PRÁCTICAS CLAVE AIEPI PARA PREVENIR ENFERMEDADES. ÁREA RURAL, CARTAGENA, COLOMBIA Translated title: SOCIODEMOGRAPHIC DETERMINANTS OF IMPLEMENTATION OF IMCI KEY PRACTICES TO PREVENT DISEASES. RURAL AREA, CARTAGENA, COLOMBIA Translated title: DETERMINANTES SOCIODEMOGRÁFICOS DA IMPLEMENTAÇÃO DE AS PRÁTICAS AIEPI RECOMENDADAS PARA IMPEDIR QUE A CHAVE DE DOENÇAS. ÁREA RURAL, CARTAGENA, COLÔMBIA

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          Abstract

          Objetivo: Determinar las variables sociodemográficas asociadas a la aplicación de las prácticas clave de AIEPI para la prevención de enfermedades en familias de niños menores de 5 años del área rural de Cartagena. Métodos: Estudio analítico, de corte transversal, que incluyó una población de referencia de 3618 familias de niños menores de 5 años, habitantes en 15 corregimientos del distrito. Fueron seleccionados 9 corregimientos y se estimó una muestra de 570 familias, aplicando un muestreo probabilístico aleatorio estratificado. Para el análisis de los datos se utilizó el programa estadístico SPSS versión 20. Resultados: La edad promedio del cuidador fue de 29,6 años (DE= 9,6 años) y la de los niños de 2,3 años (DE= 1,6 años). Tener pareja está asociado a una mejor aplicación de la práctica 8, (OR=2 (IC 95% 1,2-4,2)), un mayor nivel educativo es predictor de mejor aplicación de la práctica 5, (OR=2,7 (IC 95% 1,3-5,4)) 7, (OR=0,4 (IC 95% 0,2-0,9)) 9, (OR=1,5 (IC 95% 1,1-2,1)) 10 (OR=1,7 (IC 95% 1,2-2,5)) y tener afiliación en salud a un régimen contributivo favorece la aplicación de la práctica 9 (OR=1,7 (IC 95% 1,1-2,6)) y 10 (OR=1,9 (IC 95% 1,1-3,3)). Conclusiones: Aspectos como un mejor nivel educativo y afiliación en salud a un régimen contributivo son determinantes para una mayor aplicación de prácticas en el hogar, que buscan prevenir enfermedades entre los niños de las comunidades más vulnerables de la ciudad.

          Translated abstract

          Objective: To determine the socio-demographic variables associated with the implementation of IMCI key practices for disease prevention in families of children under 5 years of age in rural areas of Cartagena. Methods: An analytical, cross sectional study, that included a reference population of 3,618 families with children under 5 years of age, living in 15 municipalities of the district. Nine districts were selected and a sample of 570 families was estimated applying stratified random probability sampling. Data analysis was performed using the statistical software SPSS version 20. Results: The average age of caregivers was 29.6 years (SD = 9.6 years) and that of children was 2.3 years (SD = 1.6 years). Having a partner is associated with better implementation of practice 8 (OR = 2 (95% CI 1.2 to 4.2)); a higher educational level is a predictor of better implementation of practice 5, (OR = 2.7 (95% CI 1.3 to 5.4)) 7 (OR = 0.4 (95% CI 0.2-0.9)) 9 (OR = 1.5 (95% CI 1, 1 to 2.1)) and 10 (OR = 1.7 (95% CI 1.2-2.5)); and having health affiliation to a contributory health care system favors the application of practice 9 (OR = 1.7 (95% CI 1.1-2.6)) and 10 (OR = 1.9 (95% CI 1.1 to 3.3)). Conclusions: Aspects such as a better educational level and affiliation to a contributory health care system are determinants for greater application of practices at home that seek to prevent illnesses among children of the most vulnerable communities of the city.

          Translated abstract

          Objetivo: Determinar as variáveis sócio demográficas associadas à aplicação das práticas chave de AIEPI para a prevenção de doenças em famílias de crianças menores do que 5 anos de idade da área rural de Cartagena. Metodologia: Estudo analítico, de corte transversal, que incluiu uma população de referência de 3618 famílias de crianças menos de 5 anos. Para a análise dos dados foi utilizado o programa estadístico SPSS versão 2,0. Resultados: A idade promedio do cuidador foi de 29,6 anos (DE=9,6 anos) e das crianças de 2,3 anos (DE=1,6 anos). Ter parceiro está associado a uma melhor aplicação da prática 8 (OR=2,7) (IC 95 % 1,2-4,2), um maior nível educativo é preditor de melhor aplicação da prática 5, (OR=2,7 (IC 95% 1,3-5,4)) 7, (OR=0,4 (IC 95% 0,2-0,9)) 9, (OR=1,5 (IC 95% 1,1-2,1)) 10 (OR=1,7 (IC 95% 1,2-2,5)) e ter plano de saúde favorece à aplicação da prática 9 (OR=1,7 (IC 95% 1,1-2,6)) y 10 (OR=1,9 (IC 95% 1,1-3,3)). Conclusão: Aspectos tais como um melhor nível educacional e a filiação em saúde a um regime contributivo, são determinantes para uma maior aplicação de práticas em casa, que visam prevenir doenças entre crianças em comunidades mais vulneráveis da cidade.

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          Sex and Socioeconomic Differentials in Child Health in Rural Bangladesh: Findings from a Baseline Survey for Evaluating Integrated Management of Childhood Illness

          This paper reports on a population-based sample survey of 2,289 children aged less than five years (under-five children) conducted in 2000 as a baseline for the Bangladesh component of the Multi-country Evaluation (MCE) of the Integrated Management of Childhood Illness strategy. Of interest were rates and differentials by sex and socioeconomic status for three aspects of child health in rural Bangladesh: morbidity and hospitalizations, including severity of illness; care-seeking for childhood illness; and home-care for illness. The survey was carried out among a population of about 380,000 in Matlab upazila (subdistrict). Generic MCE Household Survey tools were adapted, translated, and pretested. Trained interviewers conducted the survey in the study areas. In total, 2,289 under-five children were included in the survey. Results showed a very high prevalence of illness among Bangladeshi children, with over two-thirds reported to have had at least one illness during the two weeks preceding the survey. Most sick children in this population had multiple symptoms, suggesting that the use of the IMCI clinical guidelines will lead to improved quality of care. Contrary to expectations, there were no significant differences in the prevalence of illness either by sex or by socioeconomic status. About one-third of the children with a reported illness did not receive any care outside the home. Of those for whom outside care was sought, 42% were taken to a village doctor. Only 8% were taken to an appropriate provider, i.e. a health facility, a hospital, a doctor, a paramedic, or a community-based health worker. Poorer children than less-poor children were less likely to be taken to an appropriate healthcare provider. The findings indicated that children with severe illness in the least poor households were three times more likely to seek care from a trained provider than children in the poorest households. Any evidence of gender inequities in child healthcare, either in terms of prevalence of illness or care-seeking patterns, was not found. Care-seeking patterns were associated with the perceived severity of illness, the presence of danger signs, and the duration and number of symptoms. The results highlight the challenges that will need to be addressed as IMCI is implemented in health facilities and extended to address key family and community practices, including extremely low rates of use of the formal health sector for the management of sick children. Child health planners and researchers must find ways to address the apparent population preference for untrained and traditional providers which is determined by various factors, including the actual and perceived quality of care, and the differentials in care-seeking practices that discriminate against the poorest households.
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            Access to health care in relation to socioeconomic status in the Amazonian area of Peru

            Background Access to affordable health care is limited in many low and middle income countries and health systems are often inequitable, providing less health services to the poor who need it most. The aim of this study was to investigate health seeking behavior and utilization of drugs in relation to household socioeconomic status for children in two small Amazonian urban communities of Peru; Yurimaguas, Department of Loreto and Moyobamba, Department of San Martin, Peru. Methods Cross-sectional study design included household interviews. Caregivers of 780 children aged 6–72 months in Yurimaguas and 793 children of the same age in Moyobamba were included in the study. Caregivers were interviewed on health care seeking strategies (public/private sectors; formal/informal providers), and medication for their children in relation to reported symptoms and socio-economic status. Self-reported symptoms were classified into illnesses based on the IMCI algorithm (Integrated Management of Childhood Ilness). Wealth was used as a proxy indicator for the economic status. Wealth values were generated by Principal Component Analysis using household assets and characteristics. Results Significantly more caregivers from the least poor stratum consulted health professionals for cough/cold (p < 0.05: OR = 4.30) than the poorest stratum. The poorest stratum used fewer antibiotics for cough/cold and for cough/cold + diarrhoea (16%, 38%, respectively) than the least poor stratum (31%, 52%, respectively). For pneumonia and/or dysentery, the poorest used significantly fewer antibiotics (16%) than the least poor (80%). Conclusion The poorest seek less care from health professionals for non-severe illnesses as well as for severe illnesses; and treatment with antibiotics is lacking for illnesses where it would be indicated. Caregivers frequently paid for health services as well as antibiotics, even though all children in the study qualified for free health care and medicines. The implementation of the Seguro Integral de Salud health insurance must be improved.
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              Cobertura de vacunación en niños y adolescentes en México: esquema completo, incompleto y no vacunación

              Objetivo. Evaluar cobertura de vacunación en niños y adolescentes. Material y métodos. Estudio basado en los resultados de la Encuesta Nacional de Salud y Nutrición 2012. Resultados. Cobertura en menores de un año fue <70% para tres vacunas y menor a 50% para cinco vacunas. En niños de 15 a 23 meses fue 59.8% para cuatro vacunas y 51% para seis, a los seis años 93.2% tenían una dosis de SRP. Cobertura para tres vacunas en adolescentes fue menor a 50%. Proporción de no vacunados fue 4.7% en menores de un año, 0.2% en 15 a 23 meses, 6.8 % a los seis años y 37% en adolescentes. Cobertura de BCG, HB y neumococo en menores de un año y de SRP a los 15 a 23 meses fue mayor a 80%. No derecho habiencia y analfabetismo materno y de adolescentes fueron variables explicativas de esquema incompleto. Conclusiones. Se requiere fortalecer el sistema de información, promoción de la salud, capacitación y vacunación diaria sin horarios restrictivos, asegurando abasto oportuno y suficiente de vacunas.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                hpsal
                Hacia la Promoción de la Salud
                Hacia promoc. Salud
                Universidad de Caldas. Vicerrectoría de Investigaciones y Postgrados (Manizales, Caldas, Colombia )
                0121-7577
                December 2016
                : 21
                : 2
                : 13-26
                Affiliations
                [02] Cartagena orgnameHospital Universitario del Caribe Colombia
                [03] Cartagena orgnameUniversidad de Cartagena Colombia
                [01] Cartagena orgnameUniversidad de Cartagena Colombia icastilloa@ 123456unicartagena.edu.co
                Article
                S0121-75772016000200002
                10.17151/hpsal.2016.21.2.2
                add7a27f-bf2e-41a7-af7d-2a33f34ce9d9

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 19 January 2016
                : 14 November 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 33, Pages: 14
                Product

                SciELO Colombia


                Integrated management of childhood illness,disease prevention,salud del niño,estrategias,child health,estratégias,Atención integrada a las enfermedades prevalentes de la infancia,saúde da criança,AIEPI,prevenção de doenças,prevención de enfermedades,Atenção integrada às doenças prevalentes na infância,strategies

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