improving health services in regions suffering from years of neglect and war. The study results highlight the general hardship and isolation faced by populations, particularly living in rural areas, where communication and road infrastructures are limited and income-generating activities are virtually non-existent. The findings elucidate the need for improved outreach at the community level designed to share basic health-related information and to distribute essential drugs and supplies to rural populations. The results also underscore the tremendous need to improve livelihoods through development of improved farming systems and income-generating activities. The general lack of understanding about the three leading illnesses causing death of young children with regard to the illness signs and symptoms, causation, and appropriate treatment and prevention, was alarming. Our findings show that obstacles to seeking health care with trained providers were mixed and not solely related to cost and payment as is often hypothesized in DR Congo; in fact, in , where health care is far more costly, careseeking behaviours more frequently involved obtaining treatment with more expensive trained providers. The data illustrate that a tremendous obstacle faced for all three illnesses relates to lack of adequate knowledge together with local belief systems that often interfere with obtaining care with trained providers. In rural areas, where distances are great, distance was frequently mentioned as a barrier to seeking care. Lack of access to money in areas where subsistence farming is practiced also presents a major obstacle when cash payment for health care is required. Concerns about the quality of care and the behaviour of the health workers were commonly cited as barriers, and our in-depth investigation of health systems and personnel confirm the failure of the health structure to provide even basic services to the population. This, in part, may explain the common practice of self-medicating at home. Other barriers often not mentioned in the literature included an absent husband, making careseeking impossible, concerns about being referred to a hospital, and a debt at the health center which made the family ineligible for care. The study findings highlight the need to re-examine the current health structure and to carry out major reforms in the provision of health care. VI. RECOMMENDATIONS Based on the study findings, we recommend the following: Increase efforts to strengthen community-based activities, including outreach, information dissemination and economic development Combine health and agricultural development programs designed to increase food production introduce plant varieties that are more resistant to disease improve marketing systems improve soil fertility Introduce micro-finance projects in rural communities, learning from some of the success stories in Strengthen the community health worker system
improving health services in regions suffering from years of neglect and war. The study results highlight the general hardship and isolation faced by populations, particularly living in rural areas, where communication and road infrastructures are limited and income-generating activities are virtually non-existent. The findings elucidate the need for improved outreach at the community level designed to share basic health-related information and to distribute essential drugs and supplies to rural populations. The results also underscore the tremendous need to improve livelihoods through development of improved farming systems and income-generating activities. The general lack of understanding about the three leading illnesses causing death of young children with regard to the illness signs and symptoms, causation, and appropriate treatment and prevention, was alarming. Our findings show that obstacles to seeking health care with trained providers were mixed and not solely related to cost and payment as is often hypothesized in DR Congo; in fact, in , where health care is far more costly, careseeking behaviours more frequently involved obtaining treatment with more expensive trained providers. The data illustrate that a tremendous obstacle faced for all three illnesses relates to lack of adequate knowledge together with local belief systems that often interfere with obtaining care with trained providers. In rural areas, where distances are great, distance was frequently mentioned as a barrier to seeking care. Lack of access to money in areas where subsistence farming is practiced also presents a major obstacle when cash payment for health care is required. Concerns about the quality of care and the behaviour of the health workers were commonly cited as barriers, and our in-depth investigation of health systems and personnel confirm the failure of the health structure to provide even basic services to the population. This, in part, may explain the common practice of self-medicating at home. Other barriers often not mentioned in the literature included an absent husband, making careseeking impossible, concerns about being referred to a hospital, and a debt at the health center which made the family ineligible for care. The study findings highlight the need to re-examine the current health structure and to carry out major reforms in the provision of health care. VI. RECOMMENDATIONS Based on the study findings, we recommend the following: Increase efforts to strengthen community-based activities, including outreach, information dissemination and economic development Combine health and agricultural development programs designed to increase food production introduce plant varieties that are more resistant to disease improve marketing systems improve soil fertility Introduce micro-finance projects in rural communities, learning from some of the success stories in Strengthen the community health worker system
Examination%20Careseeking%20for%20the%20Sick%20Child%20in%20DR%20Congo.docx