FACTORS INFLUENCING ADMISSION TO HOSPITAL DURING TERMINAL CHILDHOOD ILLNESSES IN KENYA

Background. Access to essential clinical services offered by district hospitals or health centres forms an important component of primary he alth care activities in the developing world. Utilization of hospital facilities during life-threatening childhood illnesses will affect sur vivorship. Methods. We have examined clinical, geographical, social, e conomic and demographic features of families of 49 children who consul ted a hospital facility during a terminal illness and 88 who did not d uring a I-year prospective demographic and hospital-based surveillance of a rural community on the Kenyan Coast. Results. Of children who di ed without admission, 15% had symptoms which lasted only 1 day compare d to no children who were admitted (P = 0.004). Furthermore, those who died without admission tended to live further away from the nearest b us stage (P = 0.01) and had made greater use of traditional healers (P = 0.08). Mothers' education or household socioeconomic status did not influence admission to hospital. Conclusion. Health education is requ ired to improve early recognition of clinical signs warranting hospita l care and traditional healers should be included in any community-bas ed education programmes.