The impact of a novel franchise clinic network on access to medicines and vaccinations in Kenya: a cross-sectional study
The impact of a novel franchise clinic network on access to medicines and vaccinations in Kenya: a cross-sectional study
复制标题
DOI：
10.1136/bmjopen-2011-000589
复制
发表时间：
2012-01-01
期刊：
影响因子：
2.9
通讯作者：
Adhvaryu, Achyuta
中科院分区：
文献类型：
--
作者：
Berk, Justin;Adhvaryu, Achyuta
目的：研究新的特许经营卫生诊所模式的影响（健康商店基金会的CFWShops）在肯尼亚全国代表性儿童样本中获得疫苗接种和急性疾病治疗的情况。设计：作者使用多变量线性和计数回归来检查接受疫苗接种或治疗与接近特许医疗诊所之间的关系，并对个人进行调整，家庭和诊所属性以及区域固定效应。设置：肯尼亚2008- 2009年人口与健康调查数据。参与者：6079名肯尼亚5岁以下儿童，其中2310名报告近期急性疾病。主要结果指标：所有儿童的结果是接受脊髓灰质炎疫苗接种的次数、接受白喉、百日咳、破伤风三联疫苗接种的次数、接受卡介苗接种的次数、接受麻疹疫苗接种的次数和接受疫苗接种的总次数。急性病儿童的结局是接受任何医疗，治疗发烧，治疗疟疾和治疗专门存放的CFWShops.Results：儿童生活在30公里内的CFWShop收到0.129（p=0.017）和0.113（p=0.025）多百白破和脊髓灰质炎剂量，分别和0.285多总疫苗接种（p=0.023）。在急性病儿童中，CFWShop附近与接受任何药物治疗的概率显著增加相关（0.142; p
Objectives: To study the impact of a new franchise health clinic model (The HealthStore Foundation's CFWShops) on access to vaccinations and treatment for acute illnesses in a nationally representative sample of children in Kenya.Design: The authors used multivariate linear and count regressions to examine associations between receipt of vaccinations or treatment and proximity to a franchise health clinic, adjusting for individual, household and clinic attributes as well as region fixed effects.Setting: Demographic and Health Survey data from Kenya, 2008-2009.Participants: 6079 Kenyan children younger than 5 years, of whom 2310 reported recent acute illness.Main outcome measures: Outcomes for all children were number of polio doses received, number of DPT doses received, receipt of BCG vaccine, receipt of measles vaccine and number of total vaccinations received. Outcomes for acutely ill children were receipt of any medical treatment, treatment for fever, treatment for malaria and treatments specifically stocked by CFWShops.Results: Children living within 30 km of a CFWShop received 0.129 (p=0.017) and 0.113 (p=0.025) more DPT and polio doses, respectively; and 0.285 more total vaccinations (p=0.023). Among acutely ill children, CFWShop proximity was associated with significant increases in the probabilities of receiving any medical treatment (0.142; p