Knowledge and Rates of Use of Preschool Consultation by the Mothers in the Area of Health Tshitenge/Democratic Republic of Congo ()
1. Introduction
The growth and development in the physical, intellectual, psychological and social are the main characteristic of childhood [1] and depend largely on the quality of care provided to children in preschool. It therefore serves not only to assess the nutritional status and health of the child, but it is also an excellent measure of inequality of human development that people face [2] .
Hence, the appropriate use of health services is important to the health improvement of the population especially in developing countries or economic, physical and social barriers exist. At the World Summit for Children, the international community has set itself the goal of promoting growth and its regular monitoring to be institutionalized in all countries in the late 1990s [3] .
For its part, Ngandu [4] states that assessing regular growth is the most direct way to detect disturbances in the health of this fragile; and also an essential preventive measure to decrease morbidity and mortality in childhood.
The observation was made that, after the last vaccination against measles and yellow fever (around the ninth month), very few children come to the SPC, while it should continue up to 5 years. Indeed, it is at this age that the child malnutrition begins to manifest, as that causes the slowdown in growth and mental problems, especially in children 0 to 5 years from hearing school performance [5] . Also it is from this age that on the one hand, breastfeeding goes to his removal, the child walks, talks, develops contact and sociability acquires independence, on the other hand the mother of pregnant again, so it’s at that age where malnutrition begins to manifest the most.
The determination of the risk faced children who drop out early SPC is higher in the age group of 24 to 34 months for acute malnutrition and underweight, and in that of 36 to 47 months for chronic malnutrition according to study in the health zone of Kisenso [4] . This malnutrition will have serious repercussions on health, their future development and that of society. In the absence of any intervention, these malnourished children are vulnerable to infections, deficiency diseases, neurological disabilities, and even death.
According to L’wed, use of SPC is still a public health problem in developing countries, and it is found that many children do not regularly attend the SPC activities. Therefore 1 child out of 22 dies in its first two years. This represents 6.2 million deaths of children under 5 years old in a year [6] .
UNICEF also confirms that the use of SPC still poses serious problems in the developing countries and especially in very remote areas, it is that more children under 5 years do not regularly follow the CPS Service and the likely causes in approximately 78.7% are: sufficient knowledge, literacy, multiparity, early pregnancy, negligence, various jobs for women, non-involvement of men in promotional services [7] .
The report of the preventive activities of the Provincial Health Division of Kasai Oriental in 2016 has revealed that the level of attendance at the pre consultation is less shrinking Tshitenge in the health area.
Based on the foregoing, we asked the questions of mothers of Tshitenge health zone, do they have sufficient knowledge about the preschool consultation? What is the rate of use of this pre-consultation service?
2. Material and Methods
2.1. Design
Our study is a prospective cross-sectional survey which has the advantage of allowing to collect, at the same time, information on various health events.
2.2. Method
The investigation by a questionnaire, was the used in this study and allowed us to collect donnéesnécessaires with mothers of children aged 0 to 5 years.
2.3. The Study Site
The study was conducted in four health areas of Tshitenge health zone.
2.4. Study Population
The study population consists of mothers with children aged 0 to 5 years in their households.
2.5. Sample
It is 422 mothers randomly selected from four of the area health areas. SPSS has enabled the analysis of data using the chi-square of Pearson (Khi2) to compare and test the statistical significance.
2.6. Data Sources
As indicated below each table, all collected data to source our surveys of mothers.
3. Results
3.1. Results of Descriptives Analyzes
The data in Table 1 show that on household occupation represent 49.5%. The distribution of the sample according to the ages of children under 5 years indicates that the most represented age group is between 12 to 23 months (28, 9%) followed by 0 to 11 month 25.8% and that of 24 to 35 months with 18.0%. Regarding the educational level of subjects of study, the majority (33.2%) have completed secondary studies unfinished, 27.7% A primary level, 18.2% Have completed secondary level education.For the number of children under 5 years, households in 1 (A) to 3 children represent 67.3%.Regarding the sex of children under 5 years, 57.1% were female with a sex ratio of 0.75.
Table 2 indicates that the knowledge of the age of onset of SPC at birth is 46.7%.
Regarding the knowledge related to the age where SPC must stop, 37.9% of mothers surveyed said that at birth to 8 months, 26.1% at 2 years and 19.2% at 1 year. Regarding the knowledge of the importance of CPS vaccination is 32.2%, followed by 21.1% nutrition and weighing 17.1%. Knowledge of the activities taking place at SPC: vaccination 30.3%, appointments securing the 26.8% and 19.4% weighed. 76.8% of mothers answered that the most important activity of the SPC is vaccination.
Table 3 indicates that 60.7% of the mothers surveyed reported having attended SPC during the last three months.Regarding the reason for the consultation SPC, vaccination represents 44.5%, 22.7% weighing and monitoring of growth 18.8%. As for the time of day when the CPS is organized 97.4% answered before noon. Time spent SPC most represented is less than one hour (68.5%), 100% of mothers reported they pay 100 FC and 100 per session, 72.7% had an SPC card and the appointment was noted on the plug at 74.6%.
3.2. Results of Bivariate Analyzes
Table 4 indicates there is an association between the use of SPC and some socio-cultural characteristics of mothers such as the level of education (p = 0.002), the profession (P = 0.000) and the number of children under 5 years in the household (p = 0.028).
In Table 5, There is no significant link between the use of SPC and the knowledge of the age of onset SPC knowledge related to the age where SPC must stop, knowledge the importance of CPS, knowledge of the activities taking place at SPC. By cons there is a link between the use of SPC and the most important activity of SPC for the respondent (p = 0.043).
In Table 6, the time of day when the CPS is organized, spent time at SPC and the fact of having a listing of SPC are not statistically associated with the use of SPC, but there a connection between this and having a go on the card (p = 0.001) (Table 5).
4. Discussion
The data in Table 1 show that the household Occupation is 49.5%. The distribution of the sample according to the ages of children under 5 years indicates that the most represented age group is between 12 to 23 months (28, 9%) followed by 0 to 11 month 25.8% and that of 24 to 35 months with 18.0%. Regarding the educational level of subjects of study, the majority (33.2%) have completed secondary studies unfinished, 27.7% Primary level, 18.2% have completed secondary level education.
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Table 1. Distribution of respondents according to the socio-cultural.
Source: our field investigations.
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Table 2. Distribution of respondents by knowledge of SPC.
Source: our field investigations.
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Table 3. Distribution of respondents according to the use of pre-service.
Source: our field investigations.
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Table 4. Association between the sociocultural characteristics of respondents and the use of SPC.
Source: our field investigations.
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Table 5. Links between knowledge of SPC and its use.
Source: our field investigations.
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Table 6. Links between certain characteristics related to organization of the SPC service and use of SPC.
Source: our field investigations.
For the number of children under 5 years, households in 1 (A) to 3 children represent 67.3%. Regarding the sex of children under 5 years, 57.1% were female with a sex ratio of 0.75. Our results differ from those of Kasole who revealed in his study that the majority of mothers had, 40% had a level primary study [8] . By cons they approach Kamwasha Katonga who observed that 33.6% had a level of unfinished secondary study [5] .
Table 2 indicates that the knowledge of the age when SPC begins at birth is 46.7%. Regarding the knowledge related to the age where SPC must stop, 37.9% of mothers interviewed told from birth to 8 months, 26.1% at 2 years and 19.2% at 1 year .
Regarding the knowledge of the importance of CPS vaccination is 32.2%, followed by 21.1% nutrition and weighing 17.1%. Knowledge of the activities taking place at SPC: vaccination 30.3%, appointments securing the 26.8% and 19.4% weighed. 76.8% of mothers answered that the most important activity of the SPC is vaccination.
According to Table 3, 60.7% of the mothers surveyed reported having attended SPC or during the last three months. Regarding the reason for the consultation SPC vaccination is 44.5%, 22.7% weighing and monitoring of growth 18.8%.
As for the time of day when the CPS is organized 97.4% answered before noon. Time spent SPC most represented is less than one hour (68.5%), 100% of mothers reported they pay 100 FC and 100 per session, 72.7% had an SPC card. The appointment was noted on the card at 74.6%.
According to Table 3, there is no association between the use of SPC age of children under 5 years and sex of children under 5 years. By cons, there is a statistically significant link between the level of education (p = 0.002), the profession (P = 0.000), the number of children under 5 years (P = 0.028). These results are consistent with one hand a study of the Democratic Republic of Congo on Causes of low utilization of pre-consultation service in urban areas. If the Kamalondo health zone, conducted by Kamwasha Katonga which revealed an association between socio-demographic characteristics (level of education and profession mothers) on one hand and the reasons for non-attendance at least for preschool consultation ‘somewhere else ; there was a link is significant with the profession against it is not significant to the level of study [5] .
While in Rwanda, a prospective study by Munyamahoro and Ntaganira in the district From Rubavu, showed that the use of health services by households, including the pre-consultation was based on various factors related to both the individual (age, sex, level of education of the household head …) and in the [1] [4] [9] [10] environment.
In view of Table 5, there is no significant link between the use of SPC and the knowledge of the age when the early SPC knowledge related to the age where SPC has to stop, the knowledge of the importance of the SPC, knowledge of the activities taking place at SPC. By cons there is a link between the use of SPC and the most important activity of SPC for the respondent (p = 0.043).
Table 6 reveals that the time of day when the CPS is organized, time SPC and having a listing of SPC are not statistically associated with the use of SPC, but there a connection between this and having a go on the card (p = 0.001).
5. Conclusion
To achieve higher level of knowledge and further increase the utilization rate of preschool consultation, it should raise awareness of mothers on the use of preschool consultation even after completion of the immunization schedule for children 0 to 59 months, the revival of home visits for children whose mothers give preschool consultation a sufficient basis. For this, we suggest that the CPS in general and especially the growth of surveillance, continues steadily to 59 months. Thus, officials of Health Provincial Division must revitalize the activities of the pre-consultation in Tshitenge Health Zone.
Acknowledgements
We thank all the authors who read and made necessary corrections to improve scientifically and shape this article.