Skip Navigation

This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by MAGNANI, R. J
Right arrow Articles by TANKARI, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by MAGNANI, R. J
Right arrow Articles by TANKARI, K.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 1996 Oxford University Press

research-article

The Impact of Primary Health Care Services on Under-Five Mortality in Rural Nigera

ROBERT J MAGNANI*, JANET C RICE*, NANCY B MOCK*, AHMED A ABDOH**, DAVID M MERCER{dagger} and KADRI TANKARI{ddagger}

* Tulane University Medical Center, School of Public Health & Tropical Medicine, Department of International Health & Development 1440 Canal Street, Suite 2200–12, PO Box 13, New Orleans, LA 70112-2737, USA.
** University of Manitoba, Winnipeg Manitoba. Canada
{dagger} Program for Appropriate Technologies in Health Seattle, Washington, USA.
{ddagger} World Health Organization Dakar, Senegal.

BACKGROUND: Despite large investments in basic primary health care in sub-Saharan Africa over the past two decades, quantifying the contribution of national programme efforts to the reduction of infant/child mortality in the region has proven difficult. This study takes advantage of the phased implementation of the national Rural Health Improvement Programme in Niger and conveniently timed survey data to reassess programme impact on under-five mortality during the 1980–1985 period.

METHODS: Health service use and under-five mortality rates for children born in the 5 years prior to the 1985 survey are compared for three groups of villages: villages served by a dispensary, villages served by village health teams (VHT), and villages without access to modem primary care services. Multi-level regression analyses using both household- and community-level variables are undertaken in estimating the magnitude of effects.

RESULTS: Children residing in villages proximate to health dispensaries were approximately 32% less likely to have died during the study period than children without access to modern health services. Village health teams were not, however, associated with significantly lower mortality probabilities. Formal tests for endogeneity indicated that these effects were not the result of non-uniform/non-random allocation of resources.

CONCLUSIONS: The findings are largely supportive of the key premise underlying selective primary health care Interventions—that packages of basic services can be effectively mounted nationally in poor countries and have a significant Impact over a short time period. In Niger, less than optimal implementation of VHT appears to have reduced the magnitude of the impact achieved.

Keywords child mortality, primary healthcare, programme impact, Niger

Revised 1 October 1995


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.