172909 Children in rural Nepal: Reasons for seeking medical aid and parental supportive behaviour at last attendance

Tuesday, October 28, 2008

Sylvia Janich , Department of Public health, Dresden Medical School; Nepalmed e.V., Dresden, Germany
Susanne Wiesmeth , Department of Public health, Dresden Medical School, Dresden, Germany
Dinesh Devkota , Amppipal Hospital, Amppipal, Gorkha District, Nepal
Babu Ram Giri, BBA, PGDHCM , Amppipal Hospital, Amppipal, Gorkha District, Nepal
Che Wankie, MPH , Department of Health Science, California State University, Long Beach, Long Beach, CA
Sabine Twork, MD, PhD, MPH , Department of Public health, Dresden Medical School, Dresden, Germany
Robert Friis, Prof PhD , Health Science, California State University Long Beach, Long Beach, CA
Joachim Kugler, Prof MD PhD , Department of Public health, Dresden Medical School, Dresden, Germany
Less is known about reasons for seeking medical aid for children and parental supportive behaviour in rural Nepal. These are first results from a cross-sectional study in the Amppipal hospital (Gorkha district) which provides health care for about 200.000 inhabitants from the Gorkha, Lamjung and Tanahun district. During that period 101 children aged 0 to 15 years presented there. Data concerning health care provision at the last attendance were available from 90 children averagely aged 4.0 years (56.7% male, 34.4% female children; missing percent = missing data). Reasons for seeking medical aid: 61.1% due to high fever, diarrhoea or cough, 6.7% for immunisation, 31.1% for other reasons. Time after recognising child's illness until care: 92.2% within 24 hours, 1.1% more than 24 hours. Providing fluids during last illness by the mother: 52.2% more than usual, 31.1% less than usual, 6.7% gave nothing to drink. Providing meals during last illness by the mother: 18.9% more than usual, 2.2 about the same, 37.8% less than usual, 23.3 stopped providing food, 1.1% never gave food (exclusively breast feeding). The children presented with typical health problems for that age, mostly with infectious diseases of the gut and respiratory tract accompanied by fever. However, it is discussable whether parents should be better informed about supporting child's reconvalescence by appropriate provision of food and fluid.

Learning Objectives:
We would like to analyse, for what reasons children in rural Nepal are seeking medical aid. Additionally we would like to discuss how parent's behaviour concerning reconvalescence should be interpreted and what to advise to the parents.

Keywords: Access to Health Care, Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a last year medical student and write my doctoral thesis about this topic. I have working experiences as a medical intern in Nepal, Poland, Switzerland and Germany and have special working experiences in the field of pediatrics, general medicine, surgery, internal medicine, emergency medical aid, urology, gynecology, psychiatry and public health. In 2005 I became a member of Nepalmed e.V. and get involved with the working group of public relations, since 2007 I am one of the main project coordinators of Nepalmed e.V. In 2006 I successfully passed the elective course in public health of the Dresden Medical School. In order of Nepalmed e.V. and Amppipal Hospital and with the assistance of Prof. Dr. med. J. Kugler, Department of Public health, Dresden Medical School, I developed and boss the “Survey about the nutrient and health status of children in Amppipal Hospital, District Gorkha, Nepal 2007/2008”. Prof. Robert Friis, Department of Health Science, California State University, supports the data evaluation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.