This document summarizes Samikshya Gairhe's journal club presentation on a study assessing mothers' health care seeking behavior for common childhood illnesses in Northwest Ethiopia. The presentation includes an overview of the selected article, journal information, authors, abstract, introduction, methods, results, discussion, conclusion, and references. The study found that less than half of mothers sought health care during their child's illness, with most seeking care from local health posts and centers. Factors associated with increased health care seeking included the child's age being under 24 months and the perception that early treatment is important.

1. Journal Club Presentation
Presented By:
Samikshya Gairhe
Roll No: 21
BPH, VIII Semester, SHAS, PU.
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2. Presented for the partial fulfillment of requirement
of
PHA 451 Journal Club
of
Bachelor of Public Health, VIII Semester,
School of Health and Allied Sciences, Pokhara University
under the cardinal supervision of
Assistant Professor Dr. Hari Prasad Kaphle
By
Samikshya Gairhe,
Symbol No: 17370198
PU registration number: 2016-1-37-0122
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3. Selected Article for Presentation
• Simieneh MM, Mengistu MY, Gelagay AA, Gebeyehu MT. Mothers’ health care
seeking behavior and associated factors for common childhood illnesses,
Northwest Ethiopia: community based cross-sectional study. BMC health services
research.
• Volume 19
• Article number : 59
• Published online : 29 January 2019
• DOI : https://doi.org/10.1186/s12913-019-3897-4
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4. Journal Information
• BMC Health Services Research is an open access, peer-reviewed journal that
considers articles on all aspects of health services research.
• It was established in 2001.
• It has a special focus on eHealth, governance, health policy, health system quality
and safety, healthcare delivery and access to healthcare, healthcare financing and
economics, implementing reform, and the health workforce.
• Its publisher is BioMed Central which is a part of Springer Nature.
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5. Journal Information
• ISSN : 1472-6963
• SCImago Journal Rank (SJR) : 0.995
• As of 2019,
 2-year Impact Factor is 1.987
5-year Impact Factor is 2.564.
• Source Normalized Impact per Paper (SNIP) : 1.230
• All articles published in this journal are included in CABI, CAS, DOAJ, EmCare, Google
Scholar, Journal Citation Reports, MEDLINE, PubMed Central ,Science Citation Index
Expanded, SCImago, Scopus, Semantic Scholar.
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6. Editors
• Journal Editor
• Tillie Cryer (Master of Research degree in Veterinary Microbiology, from the Royal
Veterinary College, University of London)
• Manuscript Editor
• Anna Melidoni (PhD in Molecular Biology, from Queen Mary, University of London)
• Assistant Editors
• James Edwards and Anisa Lowe
• Statistical Reviewer
• Finian Bannon (Queens University Belfast, UK)
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7. Journal Information
• There are four main types of peer review : Single-blind, Double-blind, Open peer,
Transparent peer
• When a manuscript is submitted to a journal, it is assessed to see if it meets the
criteria for submission. If it does, the editorial team will select potential peer
reviewers within the field of research to peer-review the manuscript and make
recommendations.
• It levies an article-processing charge of £1690.00/$2490.00/€2040.00 for each
article accepted for publication, plus VAT or local taxes where applicable.
• It routinely waive charges for authors from low-income countries.
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8. 12/10/2020 Samikshya Gairhe 8
Fig: Peer review process

9. Critical Appraisal of Journal
• It is a paid journal.
• It is a peer reviewed journal.
• It has open access.
• Manuscript submission is done online.
• The impact factor of the journal is quite good.
• It takes average of 3.3 months for the manuscript under review or at the editorial
office.
• It takes average of 1.7 months between date of manuscript submission and date of
receiving the editorial decision after the first review round (only manuscript sent
to reviewers).
• It takes 23 weeks of time from submission to publication.
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10. Tittle of Article
Mothers’ health care seeking behavior and associated factors for
common childhood illnesses, Northwest Ethiopia: community based
cross-sectional study
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11. Critical Appraisal of Tittle
• The title indicates the topic and focus of the study.
• It also indicates the research question, aim and objectives of the study.
• It gives an idea of study population i.e. mothers and study setting i.e. Northwest
Ethiopia.
• It also gives idea about the study design which is cross sectional study.
• The title is neither short nor long, which is good and also it is catchy.
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12. Authors
• The authors are:
1. Muluye Molla Simieneh
2. Mezgebu Yitayal Mengistu
3. Abebaw Addis Gelagay
4. Mulugeta Tesfa Gebeyehu
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13. Authors Information
Authors Publications Citations Working
as
Engaged In
Muluye Molla
Simieneh
3 18 - Department of Public Health,
College of Health Sciences, Debre
Markos University
Mezgebu Yitayal
Mengistu
11 42 Associate
Professor
Institute of Public Health, College of
Medicine and Health Sciences,
University of Gondar
Abebaw Addis
Gelagay
28 - - Institute of Public Health, College of
Medicine and Health Sciences,
University of Gondar
Mulugeta Tesfa
Gebeyehu
4 11 - Department of Public Health,
College of Health Sciences, Debre
Markos University
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Source: Research gate and LinkedIn Profile

14. Critical Appraisal of Authors
• The authors’ name and other details is mentioned.
• The authors have published other articles relating to women and child health as
well.
• The authors’ area of study is mainly towards women issues, reproductive and child
health and health services.
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15. Abstract
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16. Critical Appraisal of Abstract
• The abstract is structured and answers the introduction, method, results and
conclusion.
• The abstract is informative.
• The abstract is in accordance with the guideline of the journal i.e. 350 words.
• The information given in the abstract matches with what is given in details.
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17. Introduction
• The introduction part focuses on the global situation of the Under-5 mortality
where 5.6 million under 5 children died in 2016. In Ethiopia there were 67 deaths
per 1000 live births in the same year.
• It highlights the importance of appropriate health care seeking behavior of mothers
to decrease the severity of the childhood illness and deaths due to it since
utilization of maternal and child care is low in rural Ethiopia.
• It identifies the aim of the study to assess the level of health care seeking behavior
and associated factors among rural mothers/care givers during their child’s illness.
Furthermore it mentions that the findings of this study will be used by health care
planners and health professionals to take appropriate measures.
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18. Critical Appraisal of Introduction
• The introduction part focuses on the global as well as national situation of child
mortality in Ethiopia and possible contributing factors for seeking care.
• The need of the study across regions and districts of Ethiopia is clearly stated and
logically presented.
• It is meaningful and built on relevant literature.
• The citations are followed with correct references in the list of references.
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19. Materials and methods
• Study Design : Community based cross sectional study.
• Study Setting : Aneded district of Northwest Ethiopia
• Study Period : February to March 2016
• Sample Size : 410
It was calculated by considering (P1 = 69%) the proportion of media exposed
mothers who sought health care and (P2 = 47.7%) the proportion of non-media
exposed mothers who sought health care for their children illnesses , 5% level
significance, 80% power, design effect of 2 and 10% non response rate
The sample size was determined using two population proportion formula.
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20. Materials and methods
• Study Population : Mothers or caregivers who were living in rural district and
who had a child or children under 5 years of age with history of any common
childhood illness like diarrhea, fever, and/or ARI three months preceding the
survey.
• Sampling Technique: Multistage cluster sampling technique was used.
 Among the 19 rural Kebeles in the district, 5 were selected using simple
random sampling technique and the sample size was proportionally allocated
to each kebele by considering the total population and each households were
visited until the sample size was reached.
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21. Materials and methods
• Data collection tool :Pre-tested structured questionnaire which was drawn from
Andersen’s Behavioral Model and a review of relevant published literature.
• Data Analysis:
The collected data were entered into Epi- Data version 3.1 and exported to
SPSS version 20 for analysis.
Descriptive statistics was computed to summarize the descriptive results
Principal component analysis (PCA) was employed to measure the level of
wealth of the household.
Bivariate and Multivariable logistic regression modeling used to identify
factors associated.
Odds Ratio with 95% confidence interval was used to determine the presence
of an association.
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22. Materials and methods
• Ethical Approval : Ethical approval was taken from the Ethical Review Board
(IRB) of University of Gondar, Institute of Public Health. Verbal consent was
obtained from each study participant and this was approved by the ethical
committee.
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23. Critical Appraisal of Materials and Methods
• The design is cross sectional which is appropriate as per the problem.
• The sample is representative of the population of interest.
• There’s not any evidence of sampling error.
• Non-response rate of 10% is incorporated.
• The methods are appropriate and described in detail.
• The methods are in accordance with the ethical standards for protection of human
subjects.
• No exclusion criteria is described.
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24. Results
• A total of 410 mothers/caregivers participated in this study where 86.8% of the
mothers were unable to read and write.
• Only 48.8% sought health care at health institutions during their children illnesses
where health posts and health centers were the most common sources of health
care services.
• 73% of those who didn’t seek health care had perception that the disease would
resolve by itself and 42.2% perceived that curse is the cause of childhood illness
• 18.5% of respondents decided on their own to seek medical care for their child’s
illness.
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25. Results
• Mothers/caregivers who had children aged < 24 months were 1.7 times more
likely to seek health care compared to those who had children aged > 24 months
of age.
• Mothers reporting that children should be treated early during their illness
(regardless of the disease type) were 3.5 times more likely to seek health care than
their counterparts.
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26. Critical Appraisal of Results
• The results are presented in logical and comprehensible manner.
• The results are presented in the form of charts and tables.
• The charts and tables are numbered and titled properly.
• The tables are simple and alignment of information is done properly.
• The data given in the text and table do match with each other and the results are
based on aim and objectives of the study.
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27. Discussion
• The authors compare the study with similar studies conducted in Nairobi, Bahir
Dar, south western Nigeria, Bangladesh, rural Nigeria, rural Tanzania, Sub-
Saharan Africa, Ethiopia, Kenya, western Nepal and a tribal Community of
Gujarat, India.
• The authors also explain about how the limitation of the study was tried to
minimize.
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28. Discussion
Study Findings Past Study Remarks
Nearly half (48.8%) of participants
sought health care for their children
during common childhood illness.
This is consistent with a prior study
conducted in Amhara region
(49.6%), but lower than a survey
conducted in Nairobi (65%)
The finding was also lower than the
finding of a survey conducted in
Bahir Dar (87.2%)
This might be due to socio-
demographic differences
This might result from differences
in study settings. i.e. rural and
urban
Among mothers who sought health
care at health institutions, few
(27%) sought health care within 24-
h after they recognized their child’s
illness
This is consistent with a study
conducted in rural communities of
Osun State, south-western Nigeria
This might have been due to
mothers’ perception that the disease
was self limiting
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29. Discussion
Study Findings Past study Remarks
Mothers/caregivers who had
children aged < 24 months were
more likely to seek appropriate
health care compared to those with
older children
This is similar to studies in
Bangladesh, rural Nigeria, rural
Tanzania, Sub-Saharan Africa, and
Ethiopia
This might have been due to
mothers’ understanding that
children illnesses were more severe
in younger compared to older
children (> 2 years)
Distance from health institutions
was not significantly associated
with seeking appropriate health
care.
This is in contrast to studies in rural
Ensaro District, North Shoa Zone in
south-west Ethiopia
This might be due to all of the study
participants in this study were
found on average within a 5 km
distance from the nearest health
institution
Income was not significantly
associated with mother/caregiver
health care seeking behavior
This is inconsistence with studies
conducted in a Nigerian Teaching
Hospital and a Tribal Community
of Gujarat, India.
This might be due to the fact that, in
the present study, income was not
barrier to seek health care as
services are provided free of charge
for children under the age of five
years
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30. Critical Appraisal of Discussion
• It highlights the percentage of mothers who sought health care during childhood
illness and other important findings.
• The comparison between other similar studies is logical and reasoned well.
• Significant findings are explained nicely.
• According to the author, since the data were collected by interviewers, the data
might be affected by social desirability bias which is the limitation of the study
which is explained in the discussion.
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31. Conclusion
• The authors conclude that the proportion of mothers who sought appropriate
health care during their child’s illness was low.
• The authors also conclude that awareness of common childhood illnesses,
perceived illness severity, perception on early treatment and child age < 24 months
were positively associated with mothers’ or care givers’ health care seeking
behavior.
• The authors suggest a need for interventions to improve mother/caregiver
awareness and perception of common childhood illness
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32. Critical Appraisal of Conclusion
• The conclusions could have been more meaningful and a bit long.
• They are supported by the results drawn.
• It suggests need for awareness among mothers and perceptions about childhood
illness which is appropriate.
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33. References
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34. Critical Appraisal of References
• The references are for every citation in the text part, tables, legends etc. of the
article.
• All references are accurate and include recent publications.
• All the articles, journals and other media are accurately referenced.
• The referencing is done in Vancouver style.
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35. Strengths
• All the key words are well defined.
• Training was given to the data collectors and supervisors on the study objectives.
• Data collection techniques and the activity was supervised by study investigators.
• The comparison between results of other studies is done well with possible
reasons of differences.
• The article is reliable and is useful source for academic and non academic
purposes.
• The methodology of sampling and data collection is well explained.
• It sensitizes researchers to do more study and research in child issues.
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36. Weaknesses
• There is grammatical mistake in result section that doesn’t make sentence clear.
• The exclusion criteria has not been described.
• The dependent and independent variables could have been defined.
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37. Overall significance of the article
• It contributes for health care planners and health professionals to take appropriate
measures to decrease severity of childhood illness and its subsequent death.
• It contributes in alerting stakeholders to improve access to skilled health
professionals and reduce self medication practices for childhood illness.
• It suggests a need for interventions aimed at improving mother/caregiver
awareness and perception of common childhood illness.
• The study has a good generalizability in childhood illness issues.
• The study found out the misbeliefs and perceptions among people about the cause
of childhood illness.
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38. My research title
Health literacy and health seeking behaviors for childhood illness
among mothers of Under-5 years children in Rishing Rural
Municipality, Tanahun
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39. Contribution in conducting my research
• The sampling technique can be used similarly in my research.
• The findings from the study can be compared to that of my study.
• The references in the article can be studied for literature review.
• The questionnaire in the study can be helpful while designing questionnaire of my
research.
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40. Questions?
Queries?
Suggestions?
Feedbacks?
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41. Thank You!
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