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Khanewal District – Preventive Child Health

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Khanewal District – Preventive Child Health Project Report PR-PK-pn2khw-05 Pakistan Social audit of governance and delivery of public services: Khanewal district – preventive child health Anne Cockcroft, Khalid Omer, Ubaid Ullah Chaudhry, Rana Hssaan, Sohail Saeed, Amar Dass, Deborah Milne, Judith Matthis and Neil Andersson Social audit of governance and delivery of public services Khanewal District 2005 Preventive child health A Cockcroft, K Omer, UU Chaudhry, R Hssaan, S Saeed, A Dass, D Milne, J Matthis, N Andersson Khanewal, January 2006 Contents List of tables.......................................................................................................................ii List of figures................................................................................................................... iii Acknowledgements...........................................................................................................iv Summary....................................................................................................................................v Methods..............................................................................................................................v Findings.............................................................................................................................vi Introduction................................................................................................................................1 The social audit in focus districts...........................................................................................1 Operationalising the social audit in focus districts ............................................................2 Focus district national core group......................................................................................4 Methods......................................................................................................................................5 The topic for the social audit cycle....................................................................................5 Data collection instruments................................................................................................6 Sample and sampling .........................................................................................................7 Field teams.........................................................................................................................8 Data collection ...................................................................................................................8 Data entry and analysis ......................................................................................................9 Findings....................................................................................................................................11 The information base ...........................................................................................................11 Childhood Diarrhoea............................................................................................................12 Frequency of childhood diarrhoea ...................................................................................12 Variables potentially related to childhood diarrhoea.......................................................12 Analysis of risk of diarrhoea in children..........................................................................15 Treatment of diarrhoea in children ..................................................................................17 Experience of treatment for diarrhoea .............................................................................19 Childhood respiratory infections..........................................................................................21 Frequency of childhood respiratory infections ................................................................21 Variables potentially related to ARI ................................................................................21 Analysis of risk of childhood ARI...................................................................................23 Information from the lady health worker.........................................................................24 Treatment of ARI.............................................................................................................24 Childhood measles...............................................................................................................27 Frequency of childhood measles......................................................................................27 Analysis of risk of measles ..............................................................................................27 Payment for cases of measles ..........................................................................................28 Childhood immunisations ....................................................................................................29 Immunisation status of the children.................................................................................29 Why children are not immunised.....................................................................................30 Mothers’ knowledge and perceptions about immunisations............................................31 Decisions about immunisation for children .....................................................................33 Measles immunisation .........................................................................................................34 Frequency of immunisation .............................................................................................34 Analysis of receiving measles vaccine ............................................................................34 Lady health workers.............................................................................................................37 Public satisfaction with basic services.................................................................................40 Commentary.............................................................................................................................47 Annexes....................................................................................................................................50 CIET/District Government Khanewal: social audit 2005 i List of tables 1. The household sample by tehsil 11 2. Household features by tehsil 11 3. Children in the survey by tehsil 11 4. % households using different sources of drinking water 12 5. % households with different conditions for drinking water containers 12 6. % households using and having latrines 13 7. % households observed with different hygienic conditions in and around the house 14 8. Frequency of LHW visits to visited households 14 9. Variables potentially associated with the risk of diarrhoea in children 15 10. Model of effects of variables on risk of diarrhoea in children whose mothers had some education 16 11. Potential gains in diarrhoea prevention among children whose mothers have some education 16 12. % children taken to different types of facilities for treatment of diarrhoea in the past 12 months 18 13. Why mothers were satisfied with the treatment from the facility (% mothers) 20 14. Why mothers were dissatisfied with the treatment from the facility (% mothers) 20 15. % that paid, mean and median amounts paid for travel for treatment of diarrhoea 20 16. % that paid, mean and median amounts paid for diarrhoea treatment at the facility 20 17. % that paid, mean and median amounts paid for diarrhoea medicines or investigations outside facility 20 18. % households with different stove types for cooking 21 19. % households with different heating systems% households with different heating systems 22 20. Variables potentially associated with the risk of ARI in children 23 21. Potential gains in ARI prevention 23 22. % children taken to different types of facilities for treatment of ARI in the past 12 months 24 23. % that paid, mean and median amounts paid for travel for treatment of ARI 26 24. % that paid, mean and median amounts paid for ARI treatment at the facility 26 25. % that paid, mean and median amounts paid for ARI medicines/investigations outside the facility 26 26. Variables potentially associated with the risk of measles in children 27 27. Model of effects of variables on the chance of not having measles 28 28. Potential gains in measles prevention in children 10-59 months old 28 29. % children 12-23 months immunised% children 12-23 months immunised 29 30. Reasons why children (12-59 months) are not immunised 30 31. Mothers’ sources of information about immunisation for children 31 32. Why mothers felt immunisation was not worthwhile 32 33. Where mothers had heard about adverse effects of immunisations 32 34. Mother’s recall about advice on immunisations given by LHWs 33 35. Mother’s involvement in decisions about immunisation for the child (% children) 33 36. Variables potentially associated with the risk of measles in children 34 37. Model of effects of variables on the chance of having measles vaccine 34 38. Potential gains in increasing measles immunisation 36 39. Where LHWs heard about adverse effects of immunisation 37 40. Why children are not always immunised: LHW views 38 41. Suggestions of LHWs to ensure all children are immunised 38 42. Advice reportedly given by LHWs about diarrhoea prevention 38 43. Advice reportedly given by
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