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Delays in seeking and receiving health care services for pneumonia in children under five in the Peruvian Amazon: a mixed-methods study on caregivers' perceptions

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dc.contributor.author Pajuelo Travezaño, Monica Jhenny
dc.contributor.author Anticona Huaynate, Cynthia
dc.contributor.author Correa, Malena
dc.contributor.author Mayta Malpartida, Holger
dc.contributor.author Ramal Asayag, Cesar
dc.contributor.author Seminario, Juan R.
dc.contributor.author Gilman, Robert Hugh
dc.contributor.author Murphy, Laura
dc.contributor.author Oberhelman, Richard A.
dc.contributor.author Paz-Soldan Parlette, Valerie Andrea
dc.date.accessioned 2018-11-30T03:10:43Z
dc.date.available 2018-11-30T03:10:43Z
dc.date.issued 2018
dc.identifier.uri https://hdl.handle.net/20.500.12866/4037
dc.description.abstract BACKGROUND: Delays in receiving adequate care for children suffering from pneumonia can be life threatening and have been described associated with parents' limited education and their difficulties in recognizing the severity of the illness. The "three delays" was a model originally proposed to describe the most common determinants of maternal mortality, but has been adapted to describe delays in the health seeking process for caregivers of children under five. This study aims to explore the caregivers' perceived barriers for seeking and receiving health care services in children under five years old admitted to a referral hospital for community-acquired pneumonia in the Peruvian Amazon Region using the three-delays model framework. METHODS: There were two parts to this mixed-method, cross-sectional, hospital-based study. First, medical charts of 61 children (1 to 60 months old) admitted for pneumonia were reviewed, and clinical characteristics were noted. Second, to examine health care-seeking decisions and actions, as well as associated delays in the process of obtaining health care services, we interviewed 10 of the children's caregivers. RESULTS: Half of the children in our study were 9 months old or less. Main reasons for seeking care at the hospital were cough (93%) and fever (92%). Difficulty breathing and fast breathing were also reported in more than 60% of cases. In the interviews, caregivers reported delays of 1 to 14 days to go to the closest health facility. Factors perceived as causes for delays in deciding to seek care were apparent lack of skills to recognize signs and symptoms and of confidence in the health system, and practicing self-medication. No delays in reaching a health facility were reported. Once the caregivers reached a health facility, they perceived lack of competence of medical staff and inadequate treatment provided by the primary care physicians. CONCLUSION: According to caregivers, the main delays to get health care services for pneumonia among young children were identified in the initial decision of caregivers to seek healthcare and in the health system to provide it. Specific interventions targeted to main barriers may be useful for reducing delays in providing appropriate health care for children with pneumonia. en_US
dc.language.iso eng
dc.publisher BioMed Central
dc.relation.ispartofseries BMC Health Services Research
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Peru en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Cross-Sectional Studies en_US
dc.subject Infant en_US
dc.subject Child, Preschool en_US
dc.subject Caregiver en_US
dc.subject Caregivers en_US
dc.subject Child pneumonia en_US
dc.subject Delays en_US
dc.subject Health Services Research en_US
dc.subject Health system en_US
dc.subject Patient Acceptance of Health Care en_US
dc.subject Pneumonia en_US
dc.subject Seek care en_US
dc.subject Time-to-Treatment en_US
dc.title Delays in seeking and receiving health care services for pneumonia in children under five in the Peruvian Amazon: a mixed-methods study on caregivers' perceptions en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1186/s12913-018-2950-z
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.02
dc.relation.issn 1472-6963


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