Manahiri, Joyce2019-11-082020-01-072019-11-082020-01-072018Manahiri, J (2018) Access to health care services and its influence on health status of children in Bahi district, Dodoma region, Tanzania.Doctoral dissertation, University of Dar es Salaam, Dar es Salaam.http://localhost:8080/xmlui/handle/123456789/3063Available in print form, East Africana Collection, Dr. Wilbert Chagula Library, Class mark (THS EAF RJ101.T34M362)This study assessed utilisation of health care services and influence on health status of under five children in Bahi District, Dodoma Region. This was a cross-sectional study carried out at 442 households with under five child born to mothers aged 15 to 49 years. The study used both quantitative and qualitative data collected through questionnaire, Focus Group Discussions (FGD) and documentary review. The study found that health services for under five children were mainly delivered through Mphangwe Dispensary including Bahi and Mwitikira Health Centers. However, such services were inaccessible and not utilized by some under five children. Findings revealed further that children given medicine other than panadol were 4.7 times more likely to die than those given panadol only (OR 4.689: 95% CI=1.597-13.772). That was due to incomplete dose and lack of adherence to prescribed medicines. Mothers aged 15-34 were 3.2 times more likely to experience child mortality than those aged 35-49 (OR: 3.230: 95% CI=1.177-8.867). It was because younger mothers did not have nursing experience. Mothers from households owning a mobile phone were 6 times more likely to experience child deaths than their counterparts with no phones (OR: 6.034; 95% CI=1.339-27.191). Their husbands owned mobile phones but did not use them for health matters. Children living less than 5 kilometres from health facilities were 2.6 times more likely to get malaria/diarrhoea/pneumonia than those residing more than five kilometres (OR: 2.381; 95% CI=1.312-5.077). Living near cultivated fields and swamps were sources for mosquito breeding and unimproved water sources. Households, whose sources of income involved agricultural products and household property were 3 times more likely to have stunted children than those who used agriculture and other sources (OR: 3.107; 95% CI=1.016-9.502). Agriculture was prone to harsh climatic condition(s). Children with health insurance membership were 4.4 times less likely to be stunted than those without such scheme (OR: O.225; 95% CI=0.661-0.826). Children from households that owned television/radio were 2.5 times less likely to be wasted than those who did not own such items (OR: 0.395; 95% CI= 0.235-0.664). Children who were given supplementary foods were 2.2 times less likely to be wasted than those who did not receive (OR: 0.45; 96% CI=0.236-0.857). The study found that there were poor implementation of child health programs by health practitioners and lack of commitment on program related tasks given to mothers/caretakers.Therefore, the study concludes that some under five children did not have access to available health services. Factors that had shown effect on child health imply that access and utilization of health services influence on a child's health status. However, contradictory findings show that some factors cannot show their effect on the child's health if there is no enabling environment. Similarly, prevalence of some health problems in particular places is determined by factors other than lack of access and utilization of health care services. In addition, the study recommends that health practitioners should assess quality of health services and make them attractive to users. Likewise, they should assess implementation of child health programs so as to identify gaps for better performance. On the other hand, mothers/caretakers should shape their health seeking behaviour and be committed as well as accept child health initiatives established by the government and other health practitioners in their settings.enChild health servicesMedical careBahi districtDodoma regionTanzaniaThesis