scholarly journals Understanding factors influencing care seeking for sick children in Ebonyi and Kogi states, Nigeria

2019 ◽  
Author(s):  
Leanne Dougherty ◽  
Kate Gilroy ◽  
Abimbola Olayemi ◽  
Omitayo Ogesanmola ◽  
Felix Ogaga ◽  
...  
Keyword(s):  
Decision Making ◽  
Child Care ◽  
Sick Child ◽  
Service Providers ◽  
Care Seeking ◽  
Household Decision ◽  
Under Five ◽  
Under Five Children ◽  
Household Decision Making ◽  
Decision Making Processes

Abstract Background Nigeria has one of the highest child mortality rates in the world, with an estimated 750,000 deaths annually among children under age five. The majority of these deaths are due to pneumonia, malaria, or diarrhea. Many parents do not seek sick-child care from trained, biomedical providers, contributing to this high rate of mortality. Methods This qualitative study explores factors enabling or preventing parents from seeking care for sick under-five children in Nigeria’s Kogi and Ebonyi states, including gender-related roles and social norms. Interviews were conducted with parents of sick under-five children and service providers, and focus group discussions were held with community leaders to assess how care-seeking behavior was influenced by four modes from the Colvin et al conceptual framework for household decision-making and pathways to care. These include (1) caregivers’ recognition and response to illness, (2) seeking advice and negotiating access within the family, (3) making use of community-based treatment options, and (4) accessing biomedical services. Results Parents were found to have a general understanding of illness symptoms but did not always attribute illness to biomedical causes. Intra-household decision-making processes were shaped by gender dynamics between men and women, and were found to have great effects on decisions to seek care. Use of traditional medicine and self-treatment were found to be common first steps in treatment before turning to the biomedical care system. Once the decision to seek biomedical care was taken, the route of seeking care varied between seeking care at chemists and then continuing to health facilities or starting with a health facility and then accessing prescriptions from a chemist. Conclusion We conclude that care-seeking decisions do not follow a linear process; that intra-household decision-making processes particularly among parents should not be underestimated in addressing sick-child care seeking; and that, given the role of mothers as primary caregivers, their knowledge in illness recognition and agency in care-seeking decision-making, and seeking biomedical care, is deserving of future study.

scholarly journals Understanding factors influencing care seeking for sick children in Ebonyi and Kogi states, Nigeria

2019 ◽  
Author(s):  
Leanne Dougherty ◽  
Kate Gilroy ◽  
Abimbola Olayemi ◽  
Omitayo Ogesanmola ◽  
Felix Ogaga ◽  
...  
Keyword(s):  
Decision Making ◽  
Child Care ◽  
Sick Child ◽  
Service Providers ◽  
Care Seeking ◽  
Household Decision ◽  
Under Five ◽  
Under Five Children ◽  
Household Decision Making ◽  
Decision Making Processes

Abstract Background Nigeria has one of the highest child mortality rates in the world, with an estimated 750,000 deaths annually among children under age five. The majority of these deaths are due to pneumonia, malaria, or diarrhea. Many parents do not seek sick-child care from trained, biomedical providers, contributing to this high rate of mortality. Methods This qualitative study explores factors enabling or preventing parents from seeking care for sick under-five children in Nigeria’s Kogi and Ebonyi states, including gender-related roles and social norms. Interviews were conducted with parents of sick under-five children and service providers, and focus group discussions were held with community leaders to assess how care-seeking behavior was influenced by four modes from the Colvin et al conceptual framework for household decision-making and pathways to care. These include (1) caregivers’ recognition and response to illness, (2) seeking advice and negotiating access within the family, (3) making use of community-based treatment options, and (4) accessing biomedical services. Results Parents were found to have a general understanding of illness symptoms but did not always attribute illness to biomedical causes. Intra-household decision-making processes were shaped by gender dynamics between men and women, and were found to have great effects on decisions to seek care. Use of traditional medicine and self-treatment were found to be common first steps in treatment before turning to the biomedical care system. Once the decision to seek biomedical care was taken, the route of seeking care varied between seeking care at chemists and then continuing to health facilities or starting with a health facility and then accessing prescriptions from a chemist. Conclusion We conclude that care-seeking decisions do not follow a linear process; that intra-household decision-making processes particularly among parents should not be underestimated in addressing sick-child care seeking; and that, given the role of mothers as primary caregivers, their knowledge in illness recognition and agency in care-seeking decision-making, and seeking biomedical care, is deserving of future study.

scholarly journals Understanding factors influencing care seeking for sick children in Ebonyi and Kogi states, Nigeria

2020 ◽  
Author(s):  
Leanne Dougherty ◽  
Kate Gilroy ◽  
Abimbola Olayemi ◽  
Omitayo Ogesanmola ◽  
Felix Ogaga ◽  
...  
Keyword(s):  
Decision Making ◽  
Child Care ◽  
Sick Child ◽  
Service Providers ◽  
Care Seeking ◽  
Household Decision ◽  
Under Five ◽  
Under Five Children ◽  
Household Decision Making ◽  
Decision Making Processes

Abstract Background : Nigeria has one of the highest child mortality rates in the world, with an estimated 750,000 deaths annually among children under age five. The majority of these deaths are due to pneumonia, malaria, or diarrhea. Many parents do not seek sick-child care from trained, biomedical providers, contributing to this high rate of mortality. Methods : This qualitative study explores factors enabling or preventing parents from seeking care for sick under-five children in Nigeria’s Kogi and Ebonyi states, including gender-related roles and social norms. Interviews were conducted with parents of sick under-five children and service providers, and focus group discussions were held with community leaders to assess how care-seeking behavior was influenced by four modes from the Colvin et al conceptual framework for household decision-making and pathways to care. These include (1) caregivers’ recognition and response to illness, (2) seeking advice and negotiating access within the family, (3) making use of community-based treatment options, and (4) accessing biomedical services. Results: Parents were found to have a general understanding of illness symptoms but did not always attribute illness to biomedical causes. Intra-household decision-making processes were shaped by gender dynamics between men and women, and were found to have great effects on decisions to seek care. Use of traditional medicine and self-treatment were found to be common first steps in treatment before turning to the biomedical care system. Once the decision to seek biomedical care was taken, the route of seeking care varied between seeking care at chemists and then continuing to health facilities or starting with a health facility and then accessing prescriptions from a chemist. Conclusion: We conclude that care-seeking decisions do not follow a linear process; that intra-household decision-making processes particularly among parents should not be underestimated in addressing sick-child care seeking; and that, given the role of mothers as primary caregivers, their knowledge in illness recognition and agency in care-seeking decision-making, and seeking biomedical care, is deserving of future study.

scholarly journals Early marriage and women’s empowerment: the case of child-brides in Amhara National Regional State, Ethiopia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mikyas Abera ◽  
Ansha Nega ◽  
Yifokire Tefera ◽  
Abebaw Addis Gelagay
Keyword(s):  
Decision Making ◽  
Married Women ◽  
Early Marriage ◽  
Household Decision ◽  
First Marriage ◽  
Household Decision Making ◽  
Regional State ◽  
Age At First Marriage ◽  
Decision Making Processes ◽  
Child Brides

Abstract Background Women, especially those who marry as children, experience various forms and degrees of exclusion and discrimination. Early marriage is a harmful traditional practice that continues to affect millions around the world. Though it has declined over the years, it is still pervasive in developing countries. In Ethiopia, Amhara National Regional State (or alternatively Amhara region) hosts the largest share of child-brides in the country. This study aimed at assessing the effects of early marriage on its survivors’ life conditions – specifically, empowerment and household decision-making – in western Amhara. Methods This study employed community-based cross-sectional study design. It adopted mixed method approach – survey, in-depth interview and focus group discussion (FGD) – to collect, analyse and interpret data on early marriage and its effects on household decision-making processes. The survey covered 1278 randomly selected respondents, and 14FGDs and 6 in-depth interviews were conducted. Statistical procedures – frequency distribution, Chi-square, logistic regression – were used to test, compare and establish associations between survey results on women empowerment for two groups of married women based on age at first marriage i.e., below 18 and at/after 18. Narratives and analytical descriptions were integrated to substantiate and/or explain observed quantitative results, or generate contextual themes. Results This study reported that women married at/after 18 were more involved in household decision-making processes than child-brides. Child-brides were more likely to experience various forms of spousal abuse and violence in married life. The study results illustrated how individual-level changes, mainly driven by age at first marriage, interplay with structural factors to define the changing status and roles of married women in the household and community. Conclusion Age at first marriage significantly affected empowerment at household level, and women benefited significantly from delaying marriage. Increase in age did not automatically and unilaterally empowered women in marriage, however, since age entails a cultural definition of one’s position in society and its institutions. We recommend further research to focus on the nexus between the household and the social-structural forms that manifest at individual and community levels, and draw insights to promote women’s wellbeing and emancipation.

scholarly journals Trends of inequalities in care seeking behavior for under-five children with suspected pneumonia in Ethiopia: evidence from Ethiopia demographic and health surveys (2005–2016)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gebretsadik Shibre ◽  
Betregiorgis Zegeye ◽  
Dina Idriss-Wheeler ◽  
Sanni Yaya
Keyword(s):  
Health Surveys ◽  
Demographic And Health Surveys ◽  
Care Seeking ◽  
Health Seeking ◽  
Under Five ◽  
Under Five Children ◽  
Care Seeking Behavior ◽  
Seeking Behavior ◽  
Index Of Inequality ◽  
Suspected Pneumonia

Abstract Background Pneumonia is a leading public health problem in under-five children worldwide and particularly in Africa. Unfortunately, progress in reducing pneumonia related mortality has been slow. The number of children with symptoms of pneumonia taken to health facilities for treatment is low in Ethiopia, and disparities among sub-groups regarding health seeking behavior for pneumonia have not been well explored in the region. This study assessed the trends of inequalities in care seeking behavior for children under five years of age with suspected pneumonia in Ethiopia. Methods Using cross-sectional data from the 2005, 2011 and 2016 Ethiopia Demographic and Health Surveys (DHS) and the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT), this study investigated the inequalities in health seeking behavior for children with suspected pneumonia. Four measures of inequality were calculated: Difference, Ratio, Slope Index of Inequality and Relative Index of Inequality. Results were disaggregated by wealth, education, residence, and sex with computed 95% Uncertainty Intervals for each point estimate to determine significance. Results The percentage of under-five children with symptoms of pneumonia who were taken to a health facility was significantly lower for children in the poorest families, 15.48% (95% UI; 9.77, 23.64) as compared to children in the richest families, 61.72% (95% UI; 45.06, 76.02) in 2011. Substantial absolute (SII = 35.61; 95% UI: 25.31, 45.92) and relative (RII = 4.04%; 95% UI: 2.25, 5.84) economic inequalities were also observed. Both educational and geographic inequalities were observed; (RII = 2.07; 95% UI: 1.08, 3.06) and (D = 28.26; 95% UI: 7.14, 49.37), respectively. Economic inequality decreased from 2011 to 2016. There was no statistically significant difference between male and female under-five children with pneumonia symptoms taken to health facility, in all the studied years. Conclusions Health care seeking behavior for children with pneumonia was lower among the poorest and non-educated families as well as children in rural regions. Policies and strategies need to target subpopulations lagging behind in seeking care for pneumonia treatment as it impedes achievement of key UN sustainable development goals (SDGs).

Working Women’s Decision-Making Power at Home: Evidence from Four North Indian Urban Clusters

Urbanisation ◽  
2021 ◽  
pp. 245574712110258
Author(s):  
Megan Maxwell ◽  
Milan Vaishnav
Keyword(s):  
Decision Making ◽  
Labour Market ◽  
Empirical Evidence ◽  
Working Women ◽  
Human Agency ◽  
Significant Heterogeneity ◽  
Household Decision ◽  
Household Decision Making ◽  
Theoretical Foundations ◽  
Shed Light

Do working women enjoy greater levels of human agency? While the theoretical foundations underlying this connection are clear, the empirical evidence is quite mixed. We leverage detailed, new data on intra-household decision-making and labour market behaviour from four north Indian urban clusters to shed light on this question. We find that women who work exercise greater say in important decisions around the home. However, this ‘work advantage’ exhibits significant heterogeneity across decision types, decision-making domains, and definitions of work.

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