Treatment of childhood diarrhea in rural Egypt

Längsten, Ray; Hill, Kenneth

doi:10.1016/0277-9536(94)00163-n

Cited by 29 publications

(33 citation statements)

References 13 publications

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“…Therefore, caretakers who take boys to public facilities may not intend to pay for services, whereas for girls, caretakers may decide at the facility to pay for services that are offered at designated times. Most children who died at some stage in the study were taken to private doctors and hospitals during their terminal illness, and studies in Egypt show that private care is poorer than care at public facilities (e.g., Langsten and Hill 1995). Indeed, a high percentage of children, and particularly girls, attending private providers before death may have received substandard care.…”

Section: Discussionmentioning

confidence: 96%

“…Child-level controls for need include the following: age; reported severity of diarrhoea, fever, cough, or rash or report of severe symptoms; reported co-morbidity; and number of living brothers and sisters. The first three of these controls are associated with taking children to private care in Egypt (Makinson 1985;Langsten and Hill 1995), while the number of living brothers and sisters controls for the effects of sex-composition on competition for resources. The sex-composition of older siblings was considered but rejected as a possible control because Makinson (1986) shows that this variable has a minor effect on sex differentials in mortality in Egypt.…”

Section: Setting and Datamentioning

confidence: 99%

“…Subsequently the focus is restricted to treatment by a private doctor, for which the largest crude difference by sex is apparent. This focus is appropriate because private services are preferred in Egypt (Langsten and Hill 1995). Measures of marital household structure include residence with parentsin-law, with brothers-in-law, and with the husband, and difference in age between spouses.…”

Section: Setting and Datamentioning

confidence: 99%

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Maternal resources, proximity of services, and curative care of boys and girls in Minya, Egypt 1995–97

Yount¹

2004

Population Studies

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Despite declines in the risk of dying among children in Egypt, girls' excess mortality in early childhood persists. Using data from a representative sample of children in Minya, Egypt, I assess whether maternal resources, marital household structure, and proximity of services influence disparities by sex in curative care. The results show that boys visit any source of care marginally more often than girls. Among children who receive care, boys more often receive private care. Higher maternal education has no effect on the relative odds of private care, whereas maternal residence with marital relatives reduces the odds that girls receive private care. Having a public clinic in the neighbourhood, at which private services may be offered, increases girls' odds of receiving private care. Higher and more equitable levels of care-seeking at public and private services of higher quality may reduce differences in the survival of boys and girls in a highly sex-stratified setting.

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Section: Discussionmentioning

confidence: 96%

Section: Setting and Datamentioning

confidence: 99%

Section: Setting and Datamentioning

confidence: 99%

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Maternal resources, proximity of services, and curative care of boys and girls in Minya, Egypt 1995–97

Yount¹

2004

Population Studies

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“…Contrary to prior work, we mitigated doubts that these results may be driven by other factors because we controlled for key confounders. [20][21][22] We found that controlling for confounders reduced estimates on the public-private discrepancy, but the adjusted effect of 15.1% points was still sizable and significant. Juxtaposing these results with the portion of children that received care in the private sector (24%) and the portion of children that were not treated with ORT in our sample (33.2%) implies that eliminating the publicprivate difference in ORT provision would decrease the portion of children not receiving ORT by 3.7% points (0.24 + 0.151 = 0.037).…”

Section: Discussionmentioning

confidence: 87%

“…With the exception of an 18-year-old study from Egypt, 21 all prior studies fail to take into account any confounding factors that could bias the estimates. Finally, because SSA accounts for a disproportionate share of childhood mortality and that several SSA countries have a robust but diverse private sector with differences in quality as well as government oversight, there are no recent studies evaluating the role of the private sector in low take-up of ORS in SSA.…”

Section: Introductionmentioning

confidence: 99%

Private Sector Provision of Oral Rehydration Therapy for Child Diarrhea in Sub-Saharan Africa

Sood

Wagner²

2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Although diarrheal mortality is cheaply preventable with oral rehydration therapy (ORT), over 700,000 children die of diarrhea annually and many health providers fail to treat diarrheal cases with ORT. Provision of ORT may differ between for-profit and public providers. This study used Demographic and Health Survey data from 19,059 children across 29 countries in sub-Saharan Africa from 2003 to 2011 to measure differences in child diarrhea treatment between private for-profit and public health providers. Differences in treatment provision were estimated using probit regression models controlling for key confounders. For-profit providers were 15% points less likely to provide ORT (95% confidence interval [CI] 13-17) than public providers and 12% points more likely to provide other treatments (95% CI 10-15). These disparities in ORT provision were more pronounced for poorer children in rural areas. As private healthcare in sub-Saharan Africa continues to expand, interventions to increase private sector provision of ORT should be explored.

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The role of private providers in treating child diarrhoea in Latin America

2007

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Diarrhoeal disease, a leading cause of child mortality, disproportionately affects children in low-income countries - where private and non-governmental providers are often an important source of health care. We use 10 Living Standards Measurement Surveys from Latin America to model the choice of care for child diarrhoea in the private sector compared to the public sector. A total of 36.8% of children in the combined data set saw a private provider rather than a public one when taken for treatment. Each additional quintile of household economic status is associated with an increase of 6.5 percentage points in the probability that a child with diarrhoea is taken to a private provider (p<0.001). However, treatments provided in the private sector are manifestly of worse quality than in the public sector. A total of 33.0% of children visiting a public provider received Oral Rehydration Solution, compared to 13.7% of those visiting a private provider. Conversely, children treated by a private provider are more likely to receive drugs, most commonly unnecessary antibiotics. Ironically, when it comes to treatment for child diarrhoea, wealthier and better educated households in Latin America are paying for treatment in the private sector that is ineffective in comparison with treatments that are commonly and inexpensively available.

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Treatment of childhood diarrhea in rural Egypt

Cited by 29 publications

References 13 publications

Maternal resources, proximity of services, and curative care of boys and girls in Minya, Egypt 1995–97

Maternal resources, proximity of services, and curative care of boys and girls in Minya, Egypt 1995–97

Private Sector Provision of Oral Rehydration Therapy for Child Diarrhea in Sub-Saharan Africa

The role of private providers in treating child diarrhoea in Latin America

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