Access to health care and mortality of children under 5 years of age in the Gambia: a case–control study
Merrin E Rutherford, John D Dockerty, Momodou Jasseh, Stephen RC Howie, Peter Herbison, David J Jeffries, Melissa Leach, Warren Stevens, Kim Mulholland, Richard A Adegbola & Philip C Hill
Volume 87, Number 3, March 2009, 216-224
Table 2. Association between traditional indicators of access to health care and mortality in children under 5 years of age, FDSS, the Gambia
| Variable | Cases No. (%) | Controls No. (%) | Crude OR (95% CI) | Adjusted OR (95% CI) |
|---|---|---|---|---|
| Location of residence | ||||
| Urban/peri-urban | 57 (40.7) | 386 (55.1) | 1.0 | 1.0 |
| Rural | 83 (59.3) | 314 (44.9) | 1.8 (1.2–2.6) | 4.9 (1.2–20.2)a |
| Distance to health centre, in km | ||||
| 0–3 | 62 (44.3) | 400 (57.1) | 1.0 | 1.0 |
| > 3 to 6 | 57 (40.7) | 214 (30.6) | 1.7 (1.2–2.6) | 1.2 (0.5–2.6) |
| > 6 | 21 (15.0) | 86 (12.3) | 1.6 (0.9–2.8) | 1.8 (0.6–5.6)b |
| Distance, in km, and travel time, in minutes, index | ||||
| < 3 km and < 30 min | 51 (36.4) | 328 (46.9) | 1.0 | 1.0 |
| > 3 km and < 30 min or < 3 km and > 30 min | 33 (23.6) | 142 (20.3) | 1.5 (0.9–2.4) | 1.2 (0.7–2.1) |
| > 3 km and > 30 min | 56 (40.0) | 230 (32.9) | 1.6 (1.0–2.4) | 1.1 (0.7–1.9)c |
| Cost of reaching health centre, in dalasi | ||||
| 0–4 | 113 (80.7) | 600 (85.7) | 1.0 | 1.0 |
| 5–9 | 20 (14.3) | 58 (8.3) | 1.8 (1.1–3.2) | 0.9 (0.3–3.2) |
| ≥ 10 | 7 (5.0) | 42 (6.0) | 0.9 (0.4–2.1) | 0.7 (0.2–2.4)d |
FDSS, Farafenni demographic surveillance system; OR, odds ratio.Factors included in multivariate analysis:
a Allocated health centre, distance to a health centre, readily available money, child vitamin A status, child vaccination status;
b Allocated health centre, travel time to a health centre, readily available money, child vitamin A status, child vaccination status;
c Rural residence;
d Travel time to a health centre, distance to a health centre, readily available money, child vitamin A status, vaccination status, rural residence.