English Abstract
ABSTRACT:
This study was carried out in the Western Region in Bahrain during the period March-May 1987. It aims to
identify the factors that may be associated with the utilization of primary care provided for children aged
less than five years. Two hundred fifty eight children aged 6 to 59 months were selected randomly from eight villages in the region. The data were collected by interviewing the mothers, and checking the health
records and birth certificates, while the distance to the health centre was measured on the map. These data included personal characteristics, socioeconomic characteristics; situational factors; mothers' knowledge and attitude; and utilization of the primary care. The studied children were 55% males and 45% females with average age of 33.3 ±15.6. The results show that
the majority of the children were from large families (72.9%) , of low socioeconomic status (67.8%) and about 73% of their mothers wre illiterate. Utilization of the preventive care revealed that only 36.4% had received all the immunizations required for them. A major factor behind this, is the mmr vaccine as it is newly introduced to the services. So mothers may not be aware enough of it. Age of the child was significantly associated with theuse of the preventive care, and the highest percentage of excellent users(56.7$)was among children aged 24-35 months. The percentage of excellent users was also found to be higher among children in the extended families (40.3%) than those in the nuclear families (32.8%) and this was also statistically significant. Child's sickness was a significant reason for incomplete immunization, and the positive mother's attitude toward the health services was associated with higher percentage of excellent users of the preventive care. Utilization of curative services shows that the percentage of excellent users 73.3% was more than the double that (36.4%) of preventive services. Children in the small families were more users of the curative care, than those in the medium or large families, as they had the lowest percentage of non-users (7.1%) and this was statistically significant. However, the highest percentage of good users (28.6%) among them and the highest percent- age of poor users (8.9%) among children of medium families,indicate that these families are more likely, than thelarge ones, to treat their children at other facilities or to leave them home with or without remedies.
This imight suggest the importance of mother's education, mother's attitude, and socioeconomic status
which were found in the study to be significant factorsin the use of curative services. Children of educated
mothers had lower percentage of non-users (6.2%) than those of non-educated mothers (16.4%). Also, children in the middle and high socioeconomic classes had lower percentage of non-users (7.9% and 11.1$) than those in lower class (18.1%). However, the higher percentages of poor and good users among children of educated mothers(12.5%) and 18.8 %) support the suggestion that educated mothers are more likely to treat their children at home, and the highest percentages of poor and good users among children in the high socioeconomic class(11.1% and 33.3%), support the suggestion that childrenin this class are more likely to be treated in other health facilities. The obstacles which were expressed by mothers did not show any significant effect on utilization of curative care, while attitude of the mother toward the treatment and treating children at the health centre, showed a positive significant associa- tion. However, the results suggest that there was some degree of dissatisfaction with effectiveness of the treatment as those perceived the treatment as "effective" had higher percentage of non-users (17.5%) than those
perceived the treatment as "sometimes effective" (12.4%).
