@article{fdi:010095790,
  title = {{C}are pathways for critically ill children aged 0-5 years arriving at district hospitals in {B}urkina {F}aso, {G}uinea, {M}ali, and {N}iger (2022) : a cross-sectional study},
  author = {{G}res, {E}. and {L}ouart, {S}. and {M}eda, {B}. and {P}eters-{B}okol, {L}. and {K}argougou, {G}. {D}. and {H}edible, {G}. {B}. and {S}awadogo, {A}. {G}. and {Z}air, {Z}. and {K}oli{\'e}, {J}. {S}. and {B}onnet, {E}mmanuel and {R}idde, {V}al{\'e}ry and {L}eroy, {V}. and {O}u{\'e}draogo, {S}. {Y}. and {Z}ombr{\'e}, {V}. {M}. {S}. and {C}herif, {M}. {S}. and {D}iallo, {I}. {S}. and {K}aba, {D}. {F}. and {D}iakit{\'e}, {A}. {A}. and {S}idib{\'e}, {A}. and {S}ouleymane, {H}. {A}. and {D}ikouma, {F}. {T}. {I}. and {A}gbeci, {H}. and {C}atala, {L}. and {D}ahourou, {D}. {L}. and {D}esmonde, {S}. and {G}res, {E}. and {B}okol, {L}. {P}. and {T}avarez, {J}. and {C}ousien, {A}. and {B}ecquet, {R}. and {B}riand, {V}al{\'e}rie and {J}ournot, {V}. and {L}enaud, {S}. and {S}eri, {B}. and {Y}ao, {C}. and {A}nago, {G}. and {B}adiane, {D}. and {K}inda, {M}. and {N}eboua, {D}. and {D}ia, {P}. {S}. and {S}hepherd, {S}. and {D}i {M}auro, {N}. and {N}o{\¨e}l, {G}. and {N}yoka, {K}. and {T}aokreo, {W}. and {L}ompo, {O}. {B}. {C}. and {V}ignon, {M}. and {A}ba, {P}. and {D}iallo, {N}. and {N}garadoum, {M}. and {L}{\'e}no, {S}. and {S}ow, {A}. {T}. and {B}ald{\'e}, {A}. and {S}oumah, {A}. and {B}ald{\'e}, {B}. and {B}ah, {F}. and {M}illimouno, {K}. {C}. and {H}aba, {M}. and {B}ah, {M}. and {S}oumah, {M}. and {G}uilavogui, {M}. and {S}ylla, {M}. {N}. and {D}iallo, {S}. and {D}ounfangadouno, {S}. {F}. and {B}ah, {T}. {I}. and {S}ani, {S}. and {G}nongoue, {C}. and {G}aye, {S}. and {G}uilavogui, {J}. {P}. {Y}. and {T}our{\'e}, {A}. {O}. and {S}avadogo, {A}. {S}. and {S}angala, {F}. and {T}raore, {M}ahamadou and {K}onare, {T}. and {C}oulibaly, {A}. and {K}eita, {A}. and {D}iarra, {D}. and {T}raor{\'e}, {H}. and {S}angar{\'e}, {I}. and {K}on{\'e}, {I}. and {T}raore, {M}ahamadou and {D}iarra, {S}. and {O}poue, {V}. and {K}eita, {F}. {K}. and {D}ougabka, {M}. and {D}emb{\'e}l{\'e}, {B}. and {D}oumbia, {M}. {S}. and {K}eita, {S}. and {B}ouille, {S}. and {C}almettes, {S}. and {L}amontagne, {F}. and {H}arouna, {K}. {H}. and {M}outari, {B}. and {I}ssaka, {I}. and {A}ssoumane, {S}. {O}. and {D}ioiri, {S}. and {S}idi, {M}. and {A}lio, {K}. {S}. and {A}mina, {S}. and {A}gbokou, {R}. and {H}amidou, {M}. {G}. and {S}ani, {S}. {M}. and {M}ahamane, {A}. and {A}bdou, {A}. and {O}usmane, {B}. and {K}abirou, {I}. and {M}ahaman, {I}. and {M}amoudou, {I}. and {B}aguido, {M}. and {A}bdoul, {R}. and {S}ahabi, {A}. and {S}eini, {F}. and {H}amani, {Z}. and {N}iome, {M}. and {T}oviho, {X}. and {S}anouna, {I}. and {K}ouam, {P}. and {A}bdoulaye-{M}amadou, {R}. and {B}usi{\`e}re, {S}. and {T}riclin, {F}. and {H}ema, {A}. and {B}ayala, {M}. and {T}apsoba, {L}. and {Y}aro, {J}. {B}. and {S}ougue, {S}. and {B}akyono, {R}. and {L}ompo, {Y}. {A}. and {M}algoubri, {B}. and {D}ouamba, {F}. and {S}ore, {G}. and {W}angraoua, {L}. and {Y}amponi, {S}. and {B}ayala, {S}. {I}. and {T}iegna, {S}. and {K}am, {S}. and {Y}oda, {S}. and {K}arantao, {M}. and {B}arry, {D}. {F}. and {S}anou, {O}. and {N}acoulma, {N}. and {S}emde, {N}. and {O}uattara, {I}. and {W}ango, {F}. and {G}neissien, {Z}. and {C}ongo, {H}. and {D}iarra, {Y}. and {O}uattara, {B}. and {M}aiga, {A}. and {D}iabate, {F}. and {G}oita, {O}. and {G}ana, {S}. and {S}ylla, {S}. and {C}oulibaly, {D}. and {S}akho, {N}. and {K}adio, {K}. and {Y}ougbar{\'e}, {J}. and {Z}ongo, {D}. and {T}ougouma, {S}. and {D}icko, {A}. and {N}anema, {Z}. and {B}alima, {I}. and {O}uedraogo, {A}. and {O}uattara, {A}. and {C}oulibaly, {S}. {E}. and {B}ald{\'e}, {H}. and {B}arry, {L}. and {H}aba, {E}. {D}. and {S}idibe, {T}. and {S}angare, {Y}. and {T}raore, {B}. and {D}agobi, {A}. {E}. and {S}alifou, {S}. and {C}h{\'e}tima, {B}. {G}. {M}. and {A}bdou, {I}. {H}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground{U}nder-five mortality remains high in {W}est {A}frica, where sick children are expected to first attend the primary health care before being referred to a hospital if necessary. {H}owever, little is known about how families navigate between home and higher levels of care to meet their children's health needs, despite multiple known barriers (including social, financial, and geographical accessibility). {W}e analysed the care pathways of children aged 0-5 years before they presented to the district hospital with a serious illness and the determinants of these care pathways in four {W}est {A}frican countries.{M}ethods{F}rom {M}ay to {A}ugust 2022, we conducted a cross-sectional study over a one-month data collection in seven district hospitals participating in the {AIRE} project aimed to introduce pulse oximetry at primary health care level in {B}urkina {F}aso, {G}uinea, {M}ali, and {N}iger. {A}ll children aged 0-5 years, classified as severe or priority cases by clinicians at referral district hospitals were included after parental consent. {D}ata about care pathways since the onset of their disease were collected from caregivers, and the {L}evesque framework was used to analyse the accessibility issues.{R}esults{A} total of 861 severely ill children were included, with 33% being neonates: 20.3% in {B}urkina {F}aso, 9.2% in {G}uinea, 9.5% in {M}ali, and 61% in {N}iger. {I}n {B}urkina {F}aso and {N}iger, most children followed the recommended care pathway and first visited a primary health centre before arriving at the hospital, with 81.1% and 73.3% of children, respectively. {H}owever, they were only 51.2% in {M}ali and 13.9% in {G}uinea. {U}sing alternative pathways was common, particularly in {G}uinea, where 30.4% of children first consulted a pharmacist, and {M}ali, where 25.6% consulted a traditional medicine practitioner. {O}verall, primary care was perceived to be more geographically accessible and less expensive, but parents were much less convinced that it could improve their child's health compared to hospital care.{C}onclusion{T}he recommended pathway is largely adhered to, yet parallel pathways require attention, notably in {G}uinea and {M}ali. {A} better understanding of healthcare-seeking behaviours can help remove barriers to care, improving the likelihood that a sick child will receive optimal care.},
  keywords = {{C}hild health ; {P}athway of care ; {P}rimary health care ; {R}eferral to hospital ; {B}urkina {F}aso ; {G}uinea ; {M}ali ; {N}iger ; {BURKINA} {FASO} ; {GUINEE} ; {MALI} ; {NIGER}},
  booktitle = {},
  journal = {{BMC} {P}ublic {H}ealth},
  volume = {25},
  numero = {1},
  pages = {3934 [13 p.]},
  year = {2025},
  DOI = {10.1186/s12889-025-24835-1},
  URL = {https://www.documentation.ird.fr/hor/fdi:010095790},
}