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Unmet Needs for Medical Care for Sick Children in Rural Bangladesh

Implications for Improving Child Health Services

Nurul Alam is Associate Scientist, Public Health Sciences Division, ICDDR, B, Centre for Health and Population Research, GPO Box 128, Dhaka 1000, Bangladesh. E-mail: nalam{at}icddrb.org

While a country's health policy aims to provide health services to all who need them, very little in known about unmet need for medical care from users’ perspectives in Bangladesh. This study examines unmet medical need of 2,123 under-15 sick children by illness and child's socio-economic characteristics in rural Bangladesh. The 1996 health and socio-economic survey conducted in Matlab (Peterson et al. 1996) recorded children's chronic and acute morbidity and unmet needs for medical services in mothers’ views to combat illness. The survey also recorded household socio-economic data. Logistic regression was used to examine the effects of illness and household socio-economic characteristics on unmet medical need for sick children.

The results reveal that unmet need for medical care was 5.4 per cent for children with acute illnesses, and 30.2 per cent for children with chronic illnesses. It was lower for girls than for boys. Economic inequalities existed: odds ratio of unmet medical need for children in top one-third of households was 0.42 (95 per cent CI = 0.28–0.64) times the unmet medical need for children in lowest one-third. The critically high unmet needs for children's chronic morbidity reveal that the chronic disease control programme needs urgent revisiting and strengthening.

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