Inventaire d'enquêtes Demostaf

Information sur la citation

Type Revue - Global Health Action
Titre Baseline population health conditions ahead of a health system strengthening program in rural Madagascar
Auteur(s)
Volume 10
Numéro 1
Publication (Jour/Mois/Année) 2017
Numéros de page 1329961
URL https://doi.org/10.1080/16549716.2017.1329961
Résumé
Background: A model health district was initiated through a program of health system strengthening (HSS) in Ifanadiana District of southeastern Madagascar in 2014. We report population health indicators prior to initiation of the program.
Methods: A representative household survey based on the Demographic Health Survey was conducted using a two-stage cluster sampling design in two strata – the initial program catchment area and the future catchment area. Chi-squared and t-tests were used to compare data by stratum, using appropriate sampling weights. Madagascar data for comparison were taken from a 2013 national study.

Results: 1522 households were surveyed, representing 8310 individuals including 1635 women ages 15–49, 1685 men ages 15–59 and 1251 children under age 5. Maternal mortality rates in the district are 1044/100,000. 81\% of women’s last childbirth deliveries were in the home; only 20\% of deliveries were attended by a doctor or nurse/midwife (not different by stratum). 9.3\% of women had their first birth by age 15, and 29.5\% by age 18. Under-5 mortality rate is high: 145/1000 live births vs. 62/1000 nationally. 34.6\% of children received all recommended vaccines by age 12 months (compared to 51.5\% in Madagascar overall). In the 2 weeks prior to interview, approximately 28\% of children under age 5 had acute respiratory infections of whom 34.7\% were taken for care, and 14\% of children had diarrhea of whom 56.6\% were taken for care. Under-5 mortality, illness, care-seeking and vaccination rates were not significantly different between strata.Conclusions: Indicators of population health and health care-seeking reveal low use of the formal health system, which could benefit from HSS. Data from this survey and from a longitudinal follow-up study will be used to target needed interventions, to assess change in the district and the impact of HSS on individual households and the population of the district.

Études utilisées

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Miller, C, H Ramananjato, Garchitorena, R Rabeza, Gikic, Cripps, Cordier, Razanadrakato, Randriamanambintsoa, Hall, Murray, Razanavololo, L Rich, and H Bonds. "Baseline population health conditions ahead of a health system strengthening program in rural Madagascar." Global Health Action 10, no. 1 (2017): 1329961.
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