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National and sub-national variation in patterns of febrile case management in sub-Saharan Africa

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Listed:
  • Victor A. Alegana

    (University of Southampton
    Kenya Medical Research Institute-Wellcome Trust Research Programme)

  • Joseph Maina

    (Kenya Medical Research Institute-Wellcome Trust Research Programme)

  • Paul O. Ouma

    (Kenya Medical Research Institute-Wellcome Trust Research Programme)

  • Peter M. Macharia

    (Kenya Medical Research Institute-Wellcome Trust Research Programme)

  • Jim Wright

    (University of Southampton)

  • Peter M. Atkinson

    (University of Southampton
    Lancaster University
    Queen’s University Belfast
    Chinese Academy of Sciences)

  • Emelda A. Okiro

    (Kenya Medical Research Institute-Wellcome Trust Research Programme)

  • Robert W. Snow

    (Kenya Medical Research Institute-Wellcome Trust Research Programme
    University of Oxford)

  • Andrew J. Tatem

    (University of Southampton
    Flowminder Foundation)

Abstract

Given national healthcare coverage gaps, understanding treatment-seeking behaviour for fever is crucial for the management of childhood illness and to reduce deaths. Here, we conduct a modelling study triangulating household survey data for fever in children under the age of five years with georeferenced public health facility databases (n = 86,442 facilities) in 29 countries across sub-Saharan Africa, to estimate the probability of seeking treatment for fever at public facilities. A Bayesian item response theory framework is used to estimate this probability based on reported fever episodes, treatment choice, residence, and estimated travel-time to the nearest public-sector health facility. Findings show inter- and intra-country variation, with the likelihood of seeking treatment for fever less than 50% in 16 countries. Results highlight the need to invest in public healthcare and related databases. The variation in public sector use illustrates the need to include such modelling in future infectious disease burden estimation.

Suggested Citation

  • Victor A. Alegana & Joseph Maina & Paul O. Ouma & Peter M. Macharia & Jim Wright & Peter M. Atkinson & Emelda A. Okiro & Robert W. Snow & Andrew J. Tatem, 2018. "National and sub-national variation in patterns of febrile case management in sub-Saharan Africa," Nature Communications, Nature, vol. 9(1), pages 1-7, December.
    • Handle: RePEc:nat:natcom:v:9:y:2018:i:1:d:10.1038_s41467-018-07536-9
    DOI: 10.1038/s41467-018-07536-9
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    Cited by:

    1. Cristiano, S. & Ulgiati, S. & Gonella, F., 2021. "Systemic sustainability and resilience assessment of health systems, addressing global societal priorities: Learnings from a top nonprofit hospital in a bioclimatic building in Africa," Renewable and Sustainable Energy Reviews, Elsevier, vol. 141(C).

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