Catherine E Oldenburg1,2,3, Ali Sié4, Mamadou Ouattara4, Mamadou Bountogo4, Valentin Boudo4, Idrissa Kouanda4, Elodie Lebas5, Jessica M Brogdon5, Ying Lin5, Fanice Nyatigo5, Benjamin F Arnold5,6, Thomas M Lietman5,6,7. 1. Francis I Proctor Foundation, University of California, 513 Parnassus Ave, Box 0412, San Francisco, CA, 94143, USA. catherine.oldenburg@ucsf.edu. 2. Department of Ophthalmology, University of California, San Francisco, USA. catherine.oldenburg@ucsf.edu. 3. Department of Epidemiology & Biostatistics, University of California, San Francisco, USA. catherine.oldenburg@ucsf.edu. 4. Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso. 5. Francis I Proctor Foundation, University of California, 513 Parnassus Ave, Box 0412, San Francisco, CA, 94143, USA. 6. Department of Ophthalmology, University of California, San Francisco, USA. 7. Department of Epidemiology & Biostatistics, University of California, San Francisco, USA.
Abstract
BACKGROUND: Delays in care-seeking for childhood illness may lead to more severe outcomes. We evaluated whether community distance from a primary healthcare facility was associated with decreased healthcare utilization in a rural district of northwestern Burkina Faso. METHODS: We conducted passive surveillance of all government-run primary healthcare facilities in Nouna District, Burkina Faso from March 1 through May 31, 2020. All healthcare visits for children under 5 years of age were recorded on a standardized form for sick children. We recorded the age, sex, and community of residence of the child as well as any diagnoses and treatments administered. We calculated healthcare utilization per 100 child-months by linking the aggregate number of visits at the community level to the community's population of children under 5 months per a census that was conducted from August 2019 through February 2020. We calculated the distance between each community and its corresponding healthcare facility and assessed the relationship between distance and the rate of healthcare utilization. RESULTS: In 226 study communities, 12,676 primary healthcare visits were recorded over the three-month period. The median distance between the community and primary healthcare facility was 5.0 km (IQR 2.6 to 6.9 km), and median number of healthcare visits per 100 child-months at the community level was 6.7 (IQR 3.7 to 12.3). The rate of primary healthcare visits declined with increasing distance from clinic (Spearman's rho - 0.42, 95% CI - 0.54 to - 0.31, P < 0.0001). This relationship was similar for cause-specific clinic visits (including pneumonia, malaria, and diarrhea) and for antibiotic prescriptions. CONCLUSIONS: We documented a distance decay effect between community distance from a primary healthcare facility and the rate of healthcare visits for children under 5. Decreasing distance-related barriers, for example by increasing the number of facilities or targeting outreach to more distant communities, may improve healthcare utilization for young children in similar settings.
BACKGROUND: Delays in care-seeking for childhood illness may lead to more severe outcomes. We evaluated whether community distance from a primary healthcare facility was associated with decreased healthcare utilization in a rural district of northwestern Burkina Faso. METHODS: We conducted passive surveillance of all government-run primary healthcare facilities in Nouna District, Burkina Faso from March 1 through May 31, 2020. All healthcare visits for children under 5 years of age were recorded on a standardized form for sick children. We recorded the age, sex, and community of residence of the child as well as any diagnoses and treatments administered. We calculated healthcare utilization per 100 child-months by linking the aggregate number of visits at the community level to the community's population of children under 5 months per a census that was conducted from August 2019 through February 2020. We calculated the distance between each community and its corresponding healthcare facility and assessed the relationship between distance and the rate of healthcare utilization. RESULTS: In 226 study communities, 12,676 primary healthcare visits were recorded over the three-month period. The median distance between the community and primary healthcare facility was 5.0 km (IQR 2.6 to 6.9 km), and median number of healthcare visits per 100 child-months at the community level was 6.7 (IQR 3.7 to 12.3). The rate of primary healthcare visits declined with increasing distance from clinic (Spearman's rho - 0.42, 95% CI - 0.54 to - 0.31, P < 0.0001). This relationship was similar for cause-specific clinic visits (including pneumonia, malaria, and diarrhea) and for antibiotic prescriptions. CONCLUSIONS: We documented a distance decay effect between community distance from a primary healthcare facility and the rate of healthcare visits for children under 5. Decreasing distance-related barriers, for example by increasing the number of facilities or targeting outreach to more distant communities, may improve healthcare utilization for young children in similar settings.
Authors: Ali Sié; Boubacar Coulibaly; Sawadogo Adama; Lucienne Ouermi; Clarisse Dah; Charlemagne Tapsoba; Till Bärnighausen; John Daniel Kelly; Thuy Doan; Thomas M Lietman; Jeremy D Keenan; Catherine E Oldenburg Journal: Am J Trop Med Hyg Date: 2019-05 Impact factor: 2.345
Authors: Daniel R Feikin; Ly Minh Nguyen; Kubaje Adazu; Maurice Ombok; Allan Audi; Laurence Slutsker; Kim A Lindblade Journal: Trop Med Int Health Date: 2008-11-14 Impact factor: 2.622
Authors: Jean-Louis Koulidiati; Robin C Nesbitt; Nobila Ouedraogo; Hervé Hien; Paul Jacob Robyn; Philippe Compaoré; Aurélia Souares; Stephan Brenner Journal: BMJ Open Date: 2018-05-31 Impact factor: 2.692
Authors: Arthur Mpimbaza; Susan Nayiga; Grace Ndeezi; Philip J Rosenthal; Charles Karamagi; Anne Katahoire Journal: PLoS One Date: 2019-06-05 Impact factor: 3.240
Authors: Kieran S O'Brien; Paul Emerson; P J Hooper; Arthur L Reingold; Elena G Dennis; Jeremy D Keenan; Thomas M Lietman; Catherine E Oldenburg Journal: Lancet Infect Dis Date: 2018-10-03 Impact factor: 25.071
Authors: Oliver Gruebner; Sven Lautenbach; M M H Khan; Samuel Kipruto; Michael Epprecht; Sandro Galea Journal: PLoS One Date: 2015-10-09 Impact factor: 3.240
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Hamed Zandian; Alireza Zangeneh; Taddese Alemu Zerfu; Yunquan Zhang; Arash Ziapour; Sanjay Zodpey; Christopher J L Murray; Simon I Hay Journal: Nature Date: 2019-10-16 Impact factor: 49.962
Authors: Catherine E Oldenburg; Armin Hinterwirth; Millogo Ourohiré; Clarisse Dah; Moussa Ouédraogo; Ali Sié; Valentin Boudo; Cindi Chen; Kevin Ruder; Lina Zhong; Elodie Lebas; Fanice Nyatigo; Benjamin F Arnold; Kieran S O'Brien; Thuy Doan Journal: Am J Trop Med Hyg Date: 2022-06-13 Impact factor: 3.707
Authors: Ali Sié; Mamadou Ouattara; Mamadou Bountogo; Clarisse Dah; Guillaume Compaore; Elodie Lebas; Jessica M Brogdon; Ying Lin; William W Godwin; Kieran S O'Brien; Benjamin F Arnold; Thomas M Lietman; Catherine E Oldenburg Journal: Am J Trop Med Hyg Date: 2021-10-25 Impact factor: 3.707