Introduction
Methodology
Results
Demographics
Patient Demographics | Frequency (n) | Percentage (%) | |
---|---|---|---|
Gender | Female | 53 | 34.4 |
Male | 99 | 64.3 | |
Ambiguous | 2 | 1.3 | |
Referral Status | Self-referral | 120 | 77.9 |
Referred from health facility | 34 | 22.1 | |
Diagnoses | Anorectal Malformation | 38 | 24.7 |
Hirschsprung Disease | 22 | 14.3 | |
Urogenital anomalies | 32 | 20.8 | |
Appendicitis | 6 | 3.9 | |
Hernia | 20 | 13.0 | |
Biliary atresia | 3 | 1.9 | |
Duodenal stenosis | 6 | 3.9 | |
Abdominal injuries | 2 | 1.3 | |
Nephroblastoma | 10 | 6.5 | |
Lipoma | 6 | 3.9 | |
Hypersplenism | 6 | 3.9 | |
Intussusception | 3 | 1.9 | |
Type of surgery | Elective surgery | 141 | 92.2 |
Emergency surgery | 12 | 7.8 | |
Caregiver Demographics | Frequency (n) | Percentage (%) | |
Occupation | Self employed | 98 | 63.6 |
Public employee | 24 | 15.6 | |
Homemaker | 28 | 18.2 | |
Unemployed | 4 | 2.6 | |
Education | Higher Education | 25 | 16.2 |
No education | 11 | 7.1 | |
Primary | 63 | 40.9 | |
Secondary | 55 | 35.7 | |
Age group | 15-19 | 3 | 2.0 |
20-24 | 16 | 10.4 | |
25-29 | 39 | 25.3 | |
30-34 | 40 | 26.0 | |
35-39 | 31 | 20.1 | |
40-44 | 17 | 11.0 | |
>45 | 8 | 5.2 | |
Marital status | Married/cohabiting | 125 | 81.2 |
Single | 18 | 11.7 | |
Widowed/Separated | 10 | 6.5 | |
Unknown | 1 | 0.7 | |
Other members of the family | Widowed/Separated | IQR (25, 75 percentiles) | |
Adults in immediate family | Unknown | 2 – 2 | |
Children in immediate family | 2 | 2 – 4 |
Time to Seek Care, Reach Care and Receive Care
Variable | Elective (n = %) | Emergency (n = %) | P value | |
---|---|---|---|---|
ASA Score | 1 | 126 (89.4) | 11 (91.7) | 0.999 |
2 | 9 (6.4) | 0 (0.0) | ||
3 | 1 (0.7) | 0 (0.0) | ||
Unknown | 5 (3.6) | 1 (8.3) | ||
Post-Op Complication | Mild | 6 (4.3) | 1 (8.3) | 0.024 |
Moderate | 2 (1.4) | 2 (16.7) | ||
No complication | 133 (94.3) | 9 (75.0) | ||
Clavien Dindo | I | 63 (44.7) | 0 (0.0) | 0.002 |
II | 76 (53.9) | 12 (100.0) | ||
III | 1 (0.7) | 0 (0.0) | ||
IV | 0 (0.0) | 0 (0.0) | ||
Unknown | 1 (0.7) | 0 (0.0) | ||
Surgical Site Infection | No | 124 (87.9) | 8 (66.7) | 0.022 |
Yes | 11 (7.8) | 4 (33.3) | ||
Unknown | 6 (4.3) | 0 (0.0) | ||
Discharge after surgery | Recovery room then ward | 112 (79.4) | 10 (83.3) | 0.320 |
Intensive care | 29 (20.6) | 1 (8.3) | ||
Unknown | 0 (0.0) | 1 (8.3) | ||
Hospitalization status at 30 days | Alive and discharged | 113 (80.1) | 10 (83.3) | 0.999 |
Alive still in ward | 20 (14.2) | 2 (16.7) | ||
Dead | 2 (1.4) | 0 (0.0) | ||
Unknown | 6 (4.3) | 0 (0.0) |
Insurance Status
Variable | Frequency (n) | Percentage (%) |
---|---|---|
Materials owned by caregiver [%] | Land: 97 House: 92 Animals: 48 Bank account: 59 Electrical equipment: 114 Bicycle: 35 Motor vehicle: 32 | Land: 63.0 House: 59.7 Animals: 31.2 Bank account: 38.3 Electrical equipment: 74.0 Bicycle: 22.7 Motor vehicle: 20.8 |
Self-reported socioeconomic status: amount of money owned by caregiver [%] | Enough money for food: 47 Enough money for food and clothes only: 54 Enough money for food, clothes, and savings: 49 Enough money for the above and certain expensive goods: 4 | Enough money for food: 30.5 Enough money for food and clothes only: 35.1 Enough money for food, clothes, and savings: 31.8 Enough money for the above and certain expensive goods: 2.6 |
Insurance status | National Health Insurance Fund: 114 Private Insurance: 2 No insurance: 38 | National Health Insurance Fund: 74.0 Private Insurance: 1.3 No insurance: 24.7 |
Expenditure | Median (USD) | IQR (25, 75 percentiles) |
---|---|---|
Expenditure on food per day | $4.31 | $2.59 – $4.31 |
Out of pocket expenditure for travelling to the referring health facility | $1.29 | $0.43 – $4.31 |
Out of pocket expenditure for travelling to MNH | $4.31 | $0.69 – $10.78 |
Out of pocket expenditure for care at referring health facility | $28.03 | $6.47 – $86.24 |
Out of pocket expenditure for care at MNH | $20.27 | $4.48 – $64.68 |
Out of pocket expenditure of receiving care at both referring health facility and MNH | $69.00 | $2.16 – $172.49 |
Self-reported socioeconomic status | p-value | |||||
---|---|---|---|---|---|---|
Enough money for food (n = 47) | Enough money for food and clothes only n = 54) | Enough money for food, clothes, and savings (n = 49) | Enough money for the food, clothes, savings and certain expensive goods (n = 4) | |||
Urgency of surgery n (%) | Elective | 41 (87.2) | 50 (92.6) | 47 (95.9) | 3 (75.0) | 0.283a |
Emergency | 5 (10.6) | 4 (7.4) | 2 (4.1) | 1 (25.0) | ||
Missing | 1 (2.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) | – | |
Zone of residence of participants n (%) | Central | 0 (0.0) | 3 (5.6) | 1 (2.0) | 0 (0.0) | 0.617a |
Coastal | 33 (70.2) | 42 (77.8) | 32 (65.3) | 4 (100.0) | ||
Lake | 5 (10.6) | 2 (3.7) | 9 (18.4) | 0 (0.0) | ||
Northern | 2 (4.3) | 2 (3.7) | 2 (4.1) | 0 (0.0) | ||
Southern | 5 (10.6) | 5 (9.3) | 4 (8.2) | 0 (0.0) | ||
Zanzibar | 1 (2.1) | 0 (0.0) | 1 (2.0) | 0 (0.0) | ||
Missing | 1 (2.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) | – | |
Absolute distance travelled from home to MNH in km Median (IQR) | 46 (16 – 548) | 32 (18 – 449) | 23 (16 – 286) | 19 (12.6 – 232.5) | 0.497b | |
Referral Status | Self-referral | 37 (78.7) | 49 (90.8) | 32 (65.3) | 2 (50.0) | 0.006a |
Referred from health facility | 19 (21.3) | 5 (9.3) | 17 (34.7) | 2 (50.0) | ||
Caregiver age group | 15–19 | 0 (0.0) | 2 (3.7) | 1 (2.0) | 0 (0.0) | 0.375a |
20–24 | 5 (10.6) | 7 (13.0) | 4 (8.2) | 0 (0.0) | ||
25–29 | 12 (25.5) | 16 (29.6) | 11 (22.5) | 0 (0.0) | ||
30–34 | 8 (17.0) | 11 (20.4) | 18 (36.7) | 3 (75.0) | ||
35–39 | 14 (29.8) | 8 (14.8) | 9 (18.4) | 0 (0.0) | ||
40–44 | 4 (8.5) | 7 (13.0) | 5 (10.2) | 1 (25.0) | ||
> 45 | 4 (8.5) | 3 (5.6) | 1
(2.0) | 0 (0.0) | ||
Mode of transport taken to reaching care at MNH | Walking | 2 (4.3) | 2 (3.7) | 1 (2.0) | 0 (0.0) | 0.269a |
Bicycle | 0 (0.0) | 1 (1.9) | 0 (0.0) | 0 (0.0) | ||
Motorcycle | 3 (6.4) | 5 (9.3) | 4 (8.2) | 0 (0.0) | ||
Car | 3 (6.4) | 4 (7.4) | 6 (12.2) | 2 (50.0) | ||
Public Transport | 27 (57.5) | 34 (63.0) | 21 (42.9) | 0 (0.0) | ||
Ambulance | 1 (2.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) | ||
Missing | 11 (23.4) | 8 (14.8) | 17 (34.7) | 2 (50.0) | – |