Maternal responses to childhood fevers: a comparison of rural and urban residents in coastal Kenya
Maternal responses to childhood fevers: a comparison of rural and urban residents in coastal Kenya
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DOI：
10.1046/j.1365-3156.1999.00489.x
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发表时间：
1999-12-01
影响因子：
3.3
通讯作者：
Snow, RW
中科院分区：
文献类型：
--
作者：
Molyneux, CS;Mung'ala-Odera, V;Snow, RW
城市化是撒哈拉以南非洲的一个重要人口现象，农村向城市的移徙仍然是城市增长的一个主要因素。在经济持续衰退的背景下，这些人口变化与城市贫困和健康状况不佳的增加有关。卫生服务提供的发展需要反映人口和疾病生态变化所产生的新需求。在疟疾流行的肯尼亚沿海地区，我们比较了终身农村（n = 248）和城市居民（n = 284）Mijikenda母亲对儿童发烧的反应。尽管农村和城市研究地区在人口结构和实际获得生物医学服务方面存在显著差异，但农村和城市母亲寻求治疗的模式相似：大多数母亲只寻求生物医学治疗（88%）。在接受治疗的农村和城市发热患者中，69%首先使用或仅使用商店购买的药物，49%的患者联系了政府或私人诊所。较高比例的城市非正规供应商只储存处方药，城市母亲更有可能联系私人而不是政府机构。我们的结论是，改善自我治疗有巨大的潜力，以减少发病率和死亡率在低收入的城市地区，经常被认为是农村地区。然而，由于农村和城市地区之间存在着根本的社会经济、文化和结构差异，在城市环境中，可能必须修改农村解决这一问题的办法。
Urbanization is an important demographic phenomenon in sub-Saharan Africa, and rural-urban migration remains a major contributor to urban growth. In a context of sustained economic recession, these demographic processes have been associated with a rise in urban poverty and ill health. Developments in health service provision need to reflect new needs arising from demographic and disease ecology change. In malaria-endemic coastal Kenya, we compared lifelong rural (n = 248) and urban resident (n = 284) Mijikenda mothers' responses to childhood fevers. Despite marked differences between the rural and urban study areas in demographic structure and physical access to biomedical services, rural and urban mothers' treatment-seeking patterns were similar: most mothers sought only biomedical treatment (88%). Shop-bought medicines were used first or only in 69% of the rural and urban fevers that were treated, and government or private clinics were contacted in 49%. A higher proportion of urban informal vendors stocked prescription-only drugs, and urban mothers more likely to contact a private than a government facility. We conclude that improving self-treatment has enormous potential to reduce morbidity and mortality in low-income urban areas, as has frequently been argued for rural areas. However, because of the underlying socio-economic, cultural and structural differences between rural and urban areas, rural approaches to tackle this may have to be modified in urban environments.