Childhood Mortality among Users and Non-Users of Primary Health Care in a Rural West African Community

Abstract

To evaluate the effectiveness of primary health care (PHC) interventions implemented through the Pahou PHC Project, the utilization of PHC by 74 children aged 4 to 35 months whodied in 1986 or 1987 was compared to that of 230 controls who survived and were individually matched by date of birth, sex and place of residence. The crude death rate was 35.9/1000/year. Measles vaccination before the first birthday siginificantly reduced the risk of mortality (RElative Risk/RR=0.4). Children with less than 75% weight for age early in 1986 had an increased risk (RR=4.3). Children who died had had significantly fewer contacts with the village health worker(VHW) in the last six months prior to death (RR=0.3). A similar association was not the VHW throughout life were better protected than children through regular personal contact with the household.