Observational studyPloS one2016
Factors Affecting Access to Healthcare: An Observational Study of Children under 5 Years of Age Presenting to a Rural Gambian Primary Healthcare Centre.
Observational study in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Impact of fortified versus unfortified lipid-based supplements on morbidity and nutritional status: A randomised double-blind placebo-controlled trial in ill Gambian children.PLoS medicine · 2017Trial
- Following the World Health Organization's Recommendation of Exclusive Breastfeeding to 6 Months of Age Does Not Impact the Growth of Rural Gambian Infants.The Journal of nutrition · 2017Trial
- The Factors Associated with Access to Healthcare Services for Cancer Patients in Saudi Arabia.Healthcare (Basel, Switzerland) · 2026Article
- Care management and determinants of day 14 mortality in severely ill children aged under 5 years subsequent to hypoxaemia diagnosed using routine pulse oximetry in primary care: evidence from the AIRE project.BMJ global health · 2025Article
- Prevalence and factors associated with severe illness in West African children under 5 years of age detected with routine pulse oximetry in primary care.BMJ global health · 2025Article
- Exploring mothers' and grandmothers' perceptions of animal-source complementary foods in the diets of young children in The Gambia: A qualitative study.Wellcome open research · 2025Article
- Mapping Access to Children's Hospitals in Texas.International journal of environmental research and public health · 2024Article
- Validation of the Emergency Department-Paediatric Early Warning Score (ED-PEWS) for use in low- and middle-income countries: A multicentre observational study.PLOS global public health · 2024Article
- Healthcare access for children in a low-income area in Cape Town: A mixed-methods case study.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2023Article
- Sub-national disparities in accessing anti-malarial drug treatment in eastern Indonesia.BMC public health · 2021Article
- Patient characteristics associated with COVID-19 positivity and fatality in Nigeria: retrospective cohort study.BMJ open · 2020Article
- Using longitudinal data to understand nutrition and health interactions in rural Gambia.Annals of human biology · 2020Review
- Nutritional status and disease severity in children acutely presenting to a primary health clinic in rural Gambia.BMC public health · 2019Article
- Demographic, Socioeconomic, and Geographic Factors Leading to Severe Malaria and Delayed Care Seeking in Ugandan Children: A Case-Control Study.The American journal of tropical medicine and hygiene · 2017Article
- Beyond causes of death: The social determinants of mortality among children aged 1-59 months in Nigeria from 2009 to 2013.PloS one · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
MAIN
objectivePrompt access to primary healthcare before onset of severe illness is vital to improve morbidity and mortality rates. The Gambia has high rates of child mortality and research is needed to investigate contributing factors further. This study aimed to identify factors affecting access to primary healthcare for children <5 years (y) in rural Gambia focusing on delayed presentation and severe illness at presentation as indicators in a setting where primary healthcare is delivered free of charge.
methodsData were extracted from an electronic medical records system at a rural primary healthcare clinic in The Gambia for children (0-5y) between 2009 and 2012. First clinic attendances with malaria, lower respiratory tract infections (LRTI) and diarrhoeal disease, the main contributors to mortality in this setting, were identified and categorized as delayed/non-delayed and severe/non-severe representing our two main outcome measures. Potential explanatory variables, identified through a comprehensive literature review were obtained from an ongoing demographic surveillance system for this population. Variables associated with either delayed/non-delayed and/or with severe/non-severe presentations identified by univariate analysis (p<0.1) were assessed in multivariate models using logistic regression (p<0.05).
resultsOut of 6554 clinic attendances, 571 relevant attendances were identified. Delayed presentation was common (45% of all presentations) and there was a significantly reduced risk associated with being from villages with free regular access to transport (OR 0.502, 95%CI[0.310, 0.814], p = 0.005). Children from villages with free regular transport were also less likely to present with severe illness (OR 0.557, 95%CI[0.325, 0.954], p = 0.033).
conclusionsTransport availability rather than distance to health clinic is an important barrier to accessing healthcare for children in The Gambia, and public health interventions should aim to reduce this barrier.
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