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Child Sufferings and Health Inequalities: An Outcome of Poverty and Financial Constraints in the Rural-Urban Perspective

Author(s): F. Naseem*1, I. Z. Qureshi2, M. N. Adnan3, A. Rashid4
Affiliation(s): 1Science and Mathematics, Govt. Degree College for Women, B-Block, Satellite Town, Rawalpindi, Rawalpindi, 2Biological Sciences, Quaid-i-Azam University, Islamabad, 3Geography Department, F.G. Postgraduate College (Men), H-8, Islamabad, 4Department of Environmental Sciences, PMAS Arid Agriculture, University, Rawalpindi, Pakistan
Keywords: Health equity, child mortality, infection control, paediatric medicine
Background:

Wide spread disparities between rural and urban areas regarding access to health facilities are common in developing countries. Expending financial resources with less focus on rural areas has caused several complications among infants and overall children health. A continuous monitoring is required to assess the arising illness problems which are not comprehended by even parents of these children. This has become particularly important in the context of poverty, literacy and health-care quality gap that exist between rural and urban population.

Summary/Objectives:

For this work we selected an urban centre near Mansehra District (located in Tehsil Balakot) and its adjacent rural part. Survey of clinics and paediatric units at local hospitals was conducted and 69 families were interviewed. Our focus was to compare the health services infrastructure and quality of medical care that children of rural and urban areas are getting. In particular we aimed to investigate infection control policies practised by the child healthcare units. Effort was also made to highlight child health disparities in the study area on the basis of data collected regarding commons illness among children, their diet related anomalies and infant mortality rate.

Results:

Compare to urban child environment, a high degree of pathogens and most common health-care-associated infection sites were observed rural areas. The former area revealed lower percentage of child illnesses for all indicators except dental problems (Figure). We observed a wide gap for nutrition related anomalies and access to antibiotics mainly because of poverty in rural population. Few health outlets with inadequate number of child specialists in the study area of rural part have aggravated child mortality and infection control problems which was not fully considered in paediatric medicine. In addition, rural population complained for treatment without taken into account the specificity of the needs and environment of the paediatric patient.

Lessons learned:

Comparison of rural and urban health facilities revealed widespread disparity that has strong influence on child health. Due to less purchasing power in rural population, antibiotics were not available in medical stores and neither were offered free of cost at local hospitals. Consequently in future it seems that immunological naivety of young children, especially neonates will translates into an enhanced susceptibility to many infections. In particular, respiratory illnesses and under nutrition would a challenge for rural local health authorities. We suggest urgent interventions on infection control practices in resource-limited settings and emphasize on inclusion of microbiologist in the infection control team and antibiotic policies.

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