Factors contributing to high mortality due to pneumonia among under-fives in Kalabo District, Zambia.

摘要

OBJECTIVE: To determine factors contributing to high mortality caused by pneumonia among children under 5 years of age in Kalabo District. METHODS: In a cross-sectional descriptive study 78 mothers and 16 health workers were interviewed using structured questionnaires. Focus group discussions were held with groups of women who did not take part in the survey. Registers, patient records, drug stock control cards, drug stores and equipment were reviewed or checked. RESULTS: Pneumonia is an important public health problem in Kalabo District. Knowledge about the disease and its treatment is inadequate, both in health workers and in mothers. Low birth weight and distance contribute to high mortality. Mother and Child Health (MCH) clinic visits protect against mortality. CONCLUSION: The community should be educated to recognize the signs and symptoms of pneumonia and to understand the importance of early and adequate treatment. As MCH clinics can play an important role, health workers, especially at rural health centre level, should be re-trained in case definition, case management and the use of available protocols. Strategies to fight the impact of pneumonia in the district should be part of an integrated package of care focusing on all prevalent childhood diseases, as they overlap in many cases.