Timely health care seeking and first source of care for acute febrile illness in children in Hawassa, southern Ethiopia

Predictors of Mothers' Care Seeking Behavior for Common Childhood Illnesses: Findings From the Afghanistan Health Survey 2015

BACKGROUND

Mothers' care seeking behavior for childhood illness is a key factor of utilizing healthcare for children. We examined predictors of mothers' care seeking for common childhood illnesses.

METHODS

This was a cross-sectional study, using data from the Afghanistan Health Survey (AHS) 2015. Data were used from women who sought healthcare for their unwell children. The women were asked whether their children were sick with fever, cough, faster breathing, or diarrhea in the past 2 weeks. The outcome variable was defined as whether the mother sought healthcare for her unwell child from a public clinic, a private clinic, or from a pharmacy store. The Andersen's healthcare seeking behavior model was used and multinomial regression analysis applied.

RESULTS

There were 4979 women, aged 15-49 years, whose under-5 children were sick in the past 2 weeks. Thirty-nine percent of women sought healthcare for their children from a health provider. Mother's age, child's age, child's sex, socioeconomic status, mothers' perceived severity of childhood illness, and number of under-5 children were predictors of mothers' care seeking behavior. The likelihood of healthcare seeking was lower for older children (Adjusted odds ratio [OR] [95% CI]: 0.51 [0.37-0.70] from public clinics; 0.33 [0.23-0.47] from private clinics; 0.36 [0.22-0.61] from pharmacy stores), and for girls (Adjusted OR [95% CI]: 0.74 [0.59-0.93] from private clinics). The likelihood of healthcare seeking was greater for children whose mothers knew symptoms of childhood illness (Adjusted OR [95% CI]: 2.97 [1.44-6.16] from public clinics; 7.20 [3.04-17.04] from pharmacy stores). The likelihood of healthcare seeking for children was greater in older mothers (Adjusted OR [95% CI]: 1.54 [1.11-2.12]). It was less likely for the mothers who have more children to seek healthcare for their children (Adjusted OR [95% CI]: 0.53 [0.43-0.65] from public clinics; 0.61 [0.48- 0.79] from private clinics; 0.51 [0.37-0.69] from pharmacy stores).

CONCLUSION

Health policy-makers may opt to use our findings, particularly mothers' knowledge (perceived severity) of symptoms of childhood illness to develop interventions to enhance timely assessment and effective treatment of common preventable childhood illnesses.

Differences in diagnosis, management, and outcomes of acute febrile illness by health facility level in southern Ethiopia

We assessed the diagnosis, management and outcomes of acute febrile illness in a cohort of febrile children aged under 5 years presenting at one urban and two rural health centres and one tertiary hospital between 11 August 2019 and 01 November 2019. Pneumonia was diagnosed in 104 (30.8%) of 338 children at health centres and 128 (65.0%) of 197 at the hospital (p < 0.001). Malaria was detected in 33 (24.3%) of 136 children at the urban health centre, and in 55 (55.6%) of 99 and 7 (7.4%) of 95 children at the rural health centres compared to 11 (11.6%) of 95 at the hospital. Antibacterials were prescribed to 20 (11.5%) of 174 children without guidelines-specified indications (overprescribing) at health centres and in 7 (33.3%) of 21 children at the hospital (p = 0.013). Antimalarials were overprescribed to 13 (7.0%) of 185 children with negative malaria microscopy at the hospital. The fever resolved by day 7 in 326 (99.7%) of 327 children at health centres compared to 177 (93.2%) of 190 at the hospital (p < 0.001). These results suggest that additional guidance to health workers is needed to optimise the use of antimicrobials across all levels of health facilities.