Science Journal of Public Health

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Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015

Received: 17 December 2016    Accepted: 09 January 2017    Published: 09 February 2017
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Abstract

In Sudan despite the current implementation of universal health coverage policy, routine monitoring reports highlight that patients frequently bypass Primary Health Care (PHC) facilities in favor of higher-level hospitals, though hospitals are costly and time consuming. The main objective of this study was to study the extent of bypassing the public PHC facilities and factors associated with the decision of caretakers to bypass such facilities seeking care for their under-five year’s children with common illnesses in Sharg-Alneel locality, 2015. The study proposed strategies and interventions to the Sudan government -Federal Ministry of Health (FMoH) - to improve PHC service utilization The study was cross- sectional comparative study, interviewer administered questionnaires and facility assessment checklist was used for data collection. The data was analysed using SPSS. The study interviewed 497 caretakers, 87% of them pursued health care for their children directly from secondary hospitals. The main reasons for bypassing the closest public health facilities were unavailability of doctors, lack of health insurance services and higher cost of services. The proportion of bypassing a PHC facility for child care is significantly associated with child sex, child age, presenting symptoms of diarrhea, fever, difficult breathing and severe vomiting, caretakers’ occupation as well as the economic status. In a resource limited country, health policy to achieve universal health coverage is better to focus on quality of care as well as quantity. Community mobilization and interventions to improve access and utilization of quality PHC services are all recommended. Furthermore, more research on bypassing behaviour is also recommended.

DOI 10.11648/j.sjph.20170502.14
Published in Science Journal of Public Health (Volume 5, Issue 2, March 2017)
Page(s) 77-87
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

PHC, Child Health Services Utilization, Accessibility, Caretaker

References
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Author Information
  • Community Medicine, Federal Ministry of Health, Directorate General of Human Resources for Health Development, HRH Policy and Planning Director, Khartoum, Sudan

  • Community Medicine, Director General of the National Health Insurance Fund, Khartoum, Sudan

  • Community Medicine, Federal Ministry of Health, Directorate General of Primary Health Care, Maternal and Child Health Director, Khartoum, Sudan

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    Malaz Elbashir Ahmed, Talal Elfadil Mahdi, Nada Jaffar Osman Ahmed. (2017). Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015. Science Journal of Public Health, 5(2), 77-87. https://doi.org/10.11648/j.sjph.20170502.14

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    Malaz Elbashir Ahmed; Talal Elfadil Mahdi; Nada Jaffar Osman Ahmed. Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015. Sci. J. Public Health 2017, 5(2), 77-87. doi: 10.11648/j.sjph.20170502.14

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    AMA Style

    Malaz Elbashir Ahmed, Talal Elfadil Mahdi, Nada Jaffar Osman Ahmed. Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015. Sci J Public Health. 2017;5(2):77-87. doi: 10.11648/j.sjph.20170502.14

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  • @article{10.11648/j.sjph.20170502.14,
      author = {Malaz Elbashir Ahmed and Talal Elfadil Mahdi and Nada Jaffar Osman Ahmed},
      title = {Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015},
      journal = {Science Journal of Public Health},
      volume = {5},
      number = {2},
      pages = {77-87},
      doi = {10.11648/j.sjph.20170502.14},
      url = {https://doi.org/10.11648/j.sjph.20170502.14},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.sjph.20170502.14},
      abstract = {In Sudan despite the current implementation of universal health coverage policy, routine monitoring reports highlight that patients frequently bypass Primary Health Care (PHC) facilities in favor of higher-level hospitals, though hospitals are costly and time consuming. The main objective of this study was to study the extent of bypassing the public PHC facilities and factors associated with the decision of caretakers to bypass such facilities seeking care for their under-five year’s children with common illnesses in Sharg-Alneel locality, 2015. The study proposed strategies and interventions to the Sudan government -Federal Ministry of Health (FMoH) - to improve PHC service utilization The study was cross- sectional comparative study, interviewer administered questionnaires and facility assessment checklist was used for data collection. The data was analysed using SPSS. The study interviewed 497 caretakers, 87% of them pursued health care for their children directly from secondary hospitals. The main reasons for bypassing the closest public health facilities were unavailability of doctors, lack of health insurance services and higher cost of services. The proportion of bypassing a PHC facility for child care is significantly associated with child sex, child age, presenting symptoms of diarrhea, fever, difficult breathing and severe vomiting, caretakers’ occupation as well as the economic status. In a resource limited country, health policy to achieve universal health coverage is better to focus on quality of care as well as quantity. Community mobilization and interventions to improve access and utilization of quality PHC services are all recommended. Furthermore, more research on bypassing behaviour is also recommended.},
     year = {2017}
    }
    

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    T1  - Bypassing Primary Health Care Facilities for Common Childhood Illnesses in Sharg-Alneel Locality in Khartoum State, Sudan 2015
    AU  - Malaz Elbashir Ahmed
    AU  - Talal Elfadil Mahdi
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    AB  - In Sudan despite the current implementation of universal health coverage policy, routine monitoring reports highlight that patients frequently bypass Primary Health Care (PHC) facilities in favor of higher-level hospitals, though hospitals are costly and time consuming. The main objective of this study was to study the extent of bypassing the public PHC facilities and factors associated with the decision of caretakers to bypass such facilities seeking care for their under-five year’s children with common illnesses in Sharg-Alneel locality, 2015. The study proposed strategies and interventions to the Sudan government -Federal Ministry of Health (FMoH) - to improve PHC service utilization The study was cross- sectional comparative study, interviewer administered questionnaires and facility assessment checklist was used for data collection. The data was analysed using SPSS. The study interviewed 497 caretakers, 87% of them pursued health care for their children directly from secondary hospitals. The main reasons for bypassing the closest public health facilities were unavailability of doctors, lack of health insurance services and higher cost of services. The proportion of bypassing a PHC facility for child care is significantly associated with child sex, child age, presenting symptoms of diarrhea, fever, difficult breathing and severe vomiting, caretakers’ occupation as well as the economic status. In a resource limited country, health policy to achieve universal health coverage is better to focus on quality of care as well as quantity. Community mobilization and interventions to improve access and utilization of quality PHC services are all recommended. Furthermore, more research on bypassing behaviour is also recommended.
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