title: Unmet need for additional medical care for sick children in mother's view in rural Bangladesh: implications for improving child health services.
abstract: While a country's health policy aims to provide health services to all who need them, very little in known about unmet need for additional medical care from users' perspectives in Bangladesh. This study examined unmet medical need (defined as whether a mother felt that, to manage sickness, her child had required medical care that was not available, regardless of reasons and medical care sought) of 2123 under-15 sick children by illness and child's socioeconomic characteristics in rural Bangladesh. The 1996 Health and Socioeconomic Survey conducted in Matlab recorded children's chronic (a disease or a condition lasting 3 months or more) and acute (a disease or a condition with a rapid onset and a short, severe course) morbidity, medical care sought to combat illness and unmet needs for additional medical services in mothers' views to manage the illness. The survey also recorded household socioeconomic data. Logistic regression was used to examine the data. The results reveal that unmet needs for additional medical care were 5.4% for children with acute illnesses, and 30.2% for children with chronic illnesses. For chronic illnesses, seeking medical care to manage illness from any health provider outside the home reduced unmet medical needs. Economic inequalities existed for both acute and chronic illnesses: the odds ratio of unmet medical needs for sick children of the least poor households was 0.42 (95% CI: 0.28-0.64) times that for sick children of the very poor households. The critically high unmet needs for children's chronic morbidity reveal that the chronic disease control programme in Bangladesh needs urgent revisiting and strengthening.
authors.affiliation: Public Health Sciences Division, ICDDR, B, Bangladesh.
authors.forename: Nurul
authors.initials: N
authors.lastname: Alam
mesh_terms: D000293:Adolescent; D001459:Bangladesh; D002648:Child; D002662:Child Health Services / Q000592:standards / Q000600:supply & distribution*; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D019538:Health Care Surveys; D006291:Health Policy; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D009035:Mothers / Q000523:psychology*; D020380:Needs Assessment; D015995:Prevalence; D011787:Quality of Health Care; D012111:Residence Characteristics; D019035:Rural Health Services / Q000592:standards / Q000600:supply & distribution*; D012959:Socioeconomic Factors