Amsterdam 2015
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| Abstract #2325 - Kids in focus: Children and HIV | ||||
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Session: 7.5: Kids in focus: Children and HIV (Parallel) on Wednesday @ 11.30-13.00 in C001 Chaired by Naume Kupe, Ashraf Grimwood Authors: Presenting Author: Miss Alice Redfern - Sinovuyo Teen Project, South Africa |
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| Additional Authors: | ||||
| Aim: Within South Africa there is a high burden of illness related to the high incidence of HIV/AIDS, with disproportionately low levels of access to basic healthcare. Previous studies investigating access to care in South Africa have identified 3 main barriers affordability, accessibility and acceptability. However these have typically relied on self-reported barriers that often do not reflect the broader conditions in a household. Few large-scale studies have investigated the interactions between different social determinants of access to care. This paper investigates pathways affecting access to health care in children in AIDS affected households. | ||||
| Method / Issue: 5,993 children aged 10–17 were randomly ed and interviewed between 2009 and 2011 in three South African provinces: Mpumalanga, KwaZulu-Natal and Western Cape. Regression models tested the relationships between different standardized measures and an inability to access care for health problems. Key variables included being AIDS affected (being AIDS orphaned or having a caregiver sick with HIV/AIDS), food insecurity, household responsibilities (including household chores and medical care) and living in an urban or rural settlement | ||||
| Results / Comments: 13.6% (816) of children reported not being able to access necessary health care for at least one instance in the past month. Sub-group analysis of children with chronic illnesses, including asthma, epilepsy and diabetes, showed that 67.9% were not receiving the required treatment. AIDS affected children were less likely to be able to access health care for their own health problems (OR=1.47, p<0.001). Household poverty (OR=2.14, p<0.001) and child burden of care (OR = 1.89, p<0.001) were also associated with a lower access to care and were found to partially mediate the effect of being AIDS affected. Separately, as indicated by prior studies, there was also a direct effect of living in a rural location (OR=2.25, p<0.001) or at a long distance from the clinic, on ability to access care. | ||||
| Discussion: These results demonstrate that children in AIDS-affected families are struggling to access basic healthcare. This study highlights three opportunities for intervention design to improve access to health care for children in AIDS-affected families: 1. Providing financial support 2. Providing practical support within burdened the household 3. Providing assistance with long distance travel to clinics. | ||||
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