Health care seeking behavior for common childhood morbidities in Ethiopia: The effects of maternal behavior and access to key health services

Abstract Background: Childhood morbidities such as diarrhea and pneumonia are the leading causes of death in Ethiopia. Appropriate healthcare-seeking behavior of mothers for common childhood illnesses could prevent a significant number of these early deaths; however, little nation-wide research has been conducted in Ethiopia to assess mothers’ healthcare-seeking behavior for their children.Method: The study used the Ethiopian Demographic and Health Surveys (EDHS) conducted in 2016 on a nationally representative sample of 10641 children under the age of five. The main determinants of care-seeking during diarrhea and Acute Respiratory Infection (ARI) episodes were assessed using multiple logistic regression analyses while adjusting for complex survey design.Results: Only 43% and 35% of households sought medical attention for their children in episodes of diarrhea and ARI, respectively, during a reference period of two weeks before the survey. The odds of seeking care for diarrhea are lower for non-working mothers versus working mothers. The likelihood of seeking care for diarrhea or ARI is higher for fathers who had education versus no education. The place of delivery for the child, receiving postnatal checkup and getting at least one immunization in the past determined the likelihood of seeking care for ARI, but not for diarrhea. The odds of seeking care are higher for both diarrhea and ARI among households that are headed by females and where mothers experienced domestic violence. Religion and types of family structure are also significant factors of seeking care for diarrhea episodes, but not for ARI.Conclusion: Given the high morbidity and mortality rates for children in Ethiopia, a deeper understanding of the health-seeking behaviour of mothers may provide insights for identifying the potential gaps and developing improvement of mothers’ awareness and perception towards childhood problems

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Disparities in mothers’ healthcare seeking behavior for common childhood morbidities in Ethiopia: based on nationally representative data

BMC Health Services Research ◽

10.1186/s12913-021-06704-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nigatu Regassa Geda ◽

Cindy Xin Feng ◽

Susan J. Whiting ◽

Rein Lepnurm ◽

Carol J. Henry ◽

...

Keyword(s):

Health Care ◽

Rural Areas ◽

Access To Health Care ◽

Working Mothers ◽

Medical Attention ◽

Demographic And Health Surveys ◽

Healthcare Seeking ◽

Seeking Behavior ◽

Healthcare Seeking Behavior ◽

Nationally Representative

Abstract Background Childhood morbidities such as diarrhea and pneumonia are the leading causes of death in Ethiopia. Appropriate healthcare-seeking behavior of mothers for common childhood illnesses could prevent a significant number of these early deaths; however, little nation-wide research has been conducted in Ethiopia to assess mothers’ healthcare-seeking behavior for their under five children. Methods The study used the Ethiopian Demographic and Health Surveys (EDHS) data. The EDHS is a cross sectional survey conducted in 2016 on a nationally representative sample of 10,641 respondents. The main determinants of care-seeking during diarrhea and acute respiratory infection (ARI) episodes were assessed using multiple logistic regression analyses while adjusting for complex survey design. Results Only 43% and 35% of households sought medical attention for their children in episodes of diarrhea and ARI, respectively, during a reference period of 2 weeks before the survey. The odds of seeking care for diarrhea are lower for non-working mothers versus working mothers. The likelihood of seeking care for diarrhea or ARI is higher for literate fathers compared to those with no education. The place of delivery for the child, receiving postnatal checkup and getting at least one immunization in the past determined the likelihood of seeking care for ARI, but not for diarrhea. The odds of seeking care are higher for both diarrhea and ARI among households that are headed by females and where mothers experienced Intimate Partner Violence (IPV) violence. Religion and types of family structure are also significant factors of seeking care for diarrhea episodes, but not for ARI. Conclusions The findings call for more coordinated efforts to ensure equitable access to health care services focusing on mothers living in deprived household environment. Strengthening partnerships with public facilities, private health care practitioners, and community-based organizations in rural areas would help further improve access to the services.

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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)

BMC Public Health ◽

10.1186/s12889-021-10232-x ◽

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).

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Analysis of Healthcare Seeking Behavior

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v7i1.5681 ◽

2015 ◽

Vol 7 (1) ◽

Author(s):

Chrissy Dangel ◽

Steven Allgeier ◽

Adam Haas ◽

Amanda Johnson

Keyword(s):

Emergency Department ◽

Water Contamination ◽

Poison Control ◽

Poison Control Center ◽

Health Seeking ◽

Control Center ◽

Healthcare Seeking ◽

Health Seeking Behaviors ◽

Seeking Behavior ◽

Healthcare Seeking Behavior

This paper describes analyses of health seeking behaviors from two surveillance datastreams: Poison Control Center (PCC) calls and Emergency Department (ED) visit records. These analyses were conducted in order to quantify behaviors following the development of symptoms after water contamination exposure and to understand the motivation, decision-making and timing behind healthcare seeking behaviors.

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SOCIAL SUPPORT AND HEALTHCARE-SEEKING BEHAVIOR OF OLDER PERSONS IN NIGERIA

Innovation in Aging ◽

10.1093/geroni/igz038.518 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S143-S144

Author(s):

Funmi Togonu-Bickersteth ◽

Joshua O Aransiola ◽

Catherine O Oyetunji-Alemede ◽

Opeyemi Ekundayo ◽

Oluwasegun Oluwaleimu

Keyword(s):

Social Support ◽

Older Persons ◽

Healthcare Facility ◽

Care Utilization ◽

Binary Logistic Regression Analysis ◽

Health Seeking ◽

Healthcare Facilities ◽

Healthcare Seeking ◽

Seeking Behavior ◽

Healthcare Seeking Behavior

Abstract Abstract The choice of healthcare facility by older persons is an important factor in their healthcare seeking behavior, and this can be associated with a number of factors. This study investigated the relationship between social support and healthcare facility choice of older persons in Nigeria. Other factors associated with the choice of healthcare facilities by older persons were also identified. Quantitative data were collected from a sample of 3,696 elderly aged 60 years above (55.6% male; 44.4% females; mean age = 69.2, SD = 8.60) who were selected through multi-stage systematic random sampling. Binary logistic regression analysis revealed that older persons who received social support were more likely to seek treatment in formal healthcare facilities, while older persons who did not receive any form of social support were more likely to seek treatment in informal healthcare facilities. Membership of social or religious groups was found to be a predictor of health seeking behavior among the older adults. Sex, age, level of education, and ability to handle activities of daily living (ADL), and ease of access to the nearest health facility, were found to be significantly associated with choice of healthcare facilities. The article concludes that there is need for conscious planning to provide formal supports to ease access of older persons to available health facilities. Such facilitation should include financial support and removal of existing physical and cultural barriers to health care utilization by older persons.

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Magnitude of Common Childhood Illness, Health Care Seeking Behavior, and Associated Factors in Efratana Gidim District, East Amhara, Ethiopia, 2020

10.21203/rs.3.rs-871754/v1 ◽

2021 ◽

Author(s):

Genanew Kassie Getahun ◽

Fentayehu Abebil ◽

Sindew Mahmud ◽

Ewunetu Firdawok

Keyword(s):

Associated Factors ◽

Statistical Significance ◽

Child Death ◽

Childhood Illness ◽

P Value ◽

Care Seeking ◽

Prevention Measures ◽

Healthcare Seeking ◽

Seeking Behavior ◽

Healthcare Seeking Behavior

Abstract Background Childhood infectious illness mainly diarrheal diseases, febrile illnesses, and acute respiratory tract infection remains the leading cause of morbidity and mortality among children below five years. Delay and inappropriate healthcare-seeking behavior of caregivers’ were the major reason for under-five child death in developing countries including Ethiopia. According to WHO, a timely healthcare-seeking practice can effectively save the lives of children by 20%, particularly from ARIs, and significantly minimize morbidities. Therefore the aim of this study was to assess the magnitude of common childhood illness, healthcare-seeking behavior, and associated factors in Efratana Gidim District, East Amhara, Ethiopia, 2020. Methods A community based crossectional study was conducted from March 15 to April 15, 2020, among urban and rural respondents. Multistage sampling technique was employed with a total of 661 respondents by using semi-structured questionnaire through face to face interviews. Bivariate and multivariate logistic regression analyses were carried out to assess the association between healthcare-seeking behavior and predictor variables. Odds ratio along with 95% confidence interval was used to measure the strength of associations and statistical significance was considered at p-value < 0.05. Results the overall two weeks prevalence of childhood illness was 24.1%, (95% CI: 21.1%-27.3%) and 59.1%, (95% CI: 51.1%-66.8%) of caregivers sought treatment at health facility. Moreover, fever, cough, and diarrhea accounted for 16.9%, 16.8%, and 11% respectively. Caregivers’ level of education (AOR = 2.56:95%CI: 1.09, 5.99) and residence (0.26: 95%CI: 0.09, 0.73) were significant factors for childhood illness and experience of child death (AOR = 3.766; 95%CI: 1.726, 8.873), diarrheal symptoms (AOR = 3.914; 95%CI: 2.043, 10.828) and access to transportation (AOR = 3.352; 95%CI: 1.049, 10.710) were predictors of healthcare seeking behavior of caregivers. Conclusion the prevalence of common childhood illness was high however; treatment-seeking behavior of caregivers for common childhood illness was low. Caregivers’ experience of child death before, symptoms of diarrhea, and access to transportation were predictors of Healthcare-seeking behavior. Therefore repeated health education on basic prevention measures of common childhood illnesses and health promotion strategies to enhance caregivers’ Healthcare-seeking behavior are critically important. .

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Can a Multitiered Copayment System Affect People’s Healthcare-seeking Behavior? A Case Study of Wenzhou, China

10.21203/rs.3.rs-673272/v1 ◽

2021 ◽

Author(s):

Lizheng Ge ◽

Yunyun Huang ◽

Tingke Xu ◽

Qianru Zhao ◽

Chun Chen ◽

...

Keyword(s):

Medical Care ◽

Healthcare System ◽

Tertiary Care ◽

Care Facility ◽

Healthcare Services ◽

Health Seeking ◽

Medical Care System ◽

Healthcare Seeking ◽

Seeking Behavior ◽

Healthcare Seeking Behavior

Abstract Background. Facilitating the primary health care (PHC) system and maintaining people’s reasonable health-seeking behavior are key to establishing a sustainable healthcare system. China has employed a multitiered copayment system to incentivize the public to utilize PHC services through its hierarchical medical care system; however, most people still prefer visiting tertiary care hospitals. Methods. This preliminary study was conducted in 2016 on 1831 individuals from four regions of Wenzhou in Zhejiang Province to explore the effect and influencing factors of the multitiered copayment system that drives their primary healthcare-seeking behavior. We question whether a quality gap in healthcare services influences the minimal effect of the multitiered copayment system, which existing literature has considered as an important factor in the lack of reform in the Chinese healthcare system. We discuss the effect of the policy following the current situation in which there exists a large gap and further consider the hypothetical situation of a reduced gap in the future. Result. The results indicate that the initial effects of the multitiered copayment system was limited. However, they become more pronounced after the equalization of the quality of healthcare services. Moreover, the main determinants in people’s selection of PHC institutions changed from age and needs variables (self-rated health status) to age and enabling variables (distance to a medical care facility). Conclusion. This study confirms that changes in the quality gap in healthcare services influence the multitiered copayment system. Hence, reducing this gap can help to achieve the intended outcome of the tiered healthcare insurance schedule.

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Maternal Empowerment Indicators Predict Health Care Seeking Behavior during Pregnancy: Evidence from Ethiopian National Data

Journal of Human Ecology ◽

10.31901/24566608.2021/74.1-3.3309 ◽

2021 ◽

Vol 74 (1-3) ◽

Author(s):

Victoria Matatio Elia Guli

Keyword(s):

Health Care ◽

Health Care Services ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Household Wealth ◽

Outcome Variable ◽

Demographic And Health Surveys ◽

Care Seeking ◽

Health Seeking ◽

Seeking Behavior

ABSTRACT The purpose of this study was to examine the leverage of women’s empowerment status and their living context in healthcare-seeking behavior during pregnancy. The study used the Ethiopian Demographic and Health Surveys (EDHS). In addition, the frequency of Antenatal Care (ANC) was used as an outcome variable to gauge women’s health seeking behavior. The negative binomial regression analysis results showed that the expected mean number of ANC visits was lower for mothers with lower education levels and for women living with husbands having poor education. On the other hand, the expected mean number of ANC visits was much higher for younger women, working women, for those with some household decision making autonomy, women living in better household wealth category, women living in smaller households, and those who had reasonable access to media (radio). Given the significant contribution of women’s status and living contexts, aggressive moves should be made to reduce the demand-side barriers to health care services, mainly promoting women’s education and participation in decisionmaking at household and community levels

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The Impacts of the Hierarchical Medical System on National Health Insurance on the Resident’s Health Seeking Behavior in Taiwan: A Case Study on the Policy to Reduce Hospital Visits

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16173167 ◽

2019 ◽

Vol 16 (17) ◽

pp. 3167 ◽

Cited By ~ 1

Author(s):

Yu-Hua Yan ◽

Chih-Ming Kung ◽

Horng-Ming Yeh

Keyword(s):

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Medical System ◽

Medical Attention ◽

Healthcare Seeking ◽

Outpatient Visits ◽

Seeking Behavior ◽

Healthcare Seeking Behavior ◽

Hierarchical Medical System

Objective: This study investigated the impacts of the hierarchical medical system under the national health insurance program on residents’ healthcare-seeking behavior in Taiwan. Background: Healthcare authorities in Taiwan initiated an allowance reduction for outpatient visits at regional hospitals and higher hierarchical hospitals in 2018. The ultimate goal is to implement a hierarchical medical system to provide residents accessible as well as consistent medical services. Methods: This research was conducted through a questionnaire survey, and data were collected between August and December 2018 from the records of subjects who had recently sought medical attention. A total of 1340 valid questionnaires were returned. Results: A principal finding was that there were significant differences in the knowledge of new policies by age, marital status, annual income, education level, and occupation (p < 0.001). Regarding the effects on healthcare-seeking behavior, there were significant differences from persons aged 40–49 years (p < 0.1), in junior high school (p < 0.05), not aware of the policy (p < 0.001), and awareness of both the hierarchical medical system and the policy to reduce outpatient visits to large hospitals (p < 0.001). Conclusion: The health administration authorities should devote more effort into promoting knowledge of the policy in order to better inform the public about the hierarchical medical system.

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Determinants of Delay in Healthcare Seeking for Common Childhood Illnesses among Caregivers with Under-Five Children in Touboro Health District, Near Cameroon’ s Northeastern Border with Chad

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2021/v42i530453 ◽

2021 ◽

pp. 1-14

Author(s):

H. Ngouakam ◽

E. Nekehforba ◽

B. Tientche

Keyword(s):

Health District ◽

Health Seeking ◽

Children Under Five ◽

Healthcare Seeking ◽

Under Five ◽

Under Five Children ◽

Childhood Illnesses ◽

Female Children ◽

Seeking Behavior ◽

Healthcare Seeking Behavior

Aims: The study sought to determine the determinants of delay in health-seeking among caregivers with under-five children. Study Design: This was a mixed-method, cross-sectional study. Place and Duration of Study: The study took place in Touboro Health District involving 386 caregivers of under-five children from May to July 30, 2020. Methodology: A structured questionnaire and two focused group discussions were used to gather information on caregiver knowledge of healthcare-seeking behavior. Data were analyzed using SPSS version 25.0. Bivariable logistic regression was employed to identify factors associated with of healthcare seeking behavior. Results: Results of the 386 sick children, fever 39.9% (154/386), diarrhea 30.3% (117/386) and cough 24.9% (96/386) were the common symptoms. The majority of the caregivers of the under-five children had poor knowledge of 63% (243/386) about common infant illnesses. Caregivers of female children under-five(OR= 2.26, 95% CI: 1.29-3.96, P = 0.004), caregivers aged between 21 and 30 years (OR=5.53, 95% CI: 1.32-23.11, P = 0.019), caregivers whose occupation is housewife (OR=2.64 95% CI 1.23-5.68, P =10.013),) ,caregivers who host > 6children in a household (OR= 3.56 95% CI 1.42-8.92 , P =0.007) were key determinants of delay in health-seeking. Conclusion: Caregivers of female children under-five, caregivers aged between 21 and 30 years, caregivers whose occupation is housewife, caregivers under-five children residing in a rural area, caregivers who host more than 6 children in a household, households with an average monthly income of <10.000 FRS Cfa were predictors of delay appropriate health-seeking. There is a need to intensify health education focusing on childhood illnesses, and timely care-seeking to effectively respond to caregiver's expectations among others.

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Healthcare-Seeking Behavior among Chinese Older Adults: Patterns and Predictive Factors

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062969 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2969

Author(s):

Yanbing Zeng ◽

Yuanyuan Wan ◽

Zhipeng Yuan ◽

Ya Fang

Keyword(s):

Older Adults ◽

Predictive Factors ◽

Medical Insurance ◽

Utilization Rate ◽

Heckman Selection Model ◽

Healthcare Seeking ◽

Inpatient Services ◽

Medical Institutions ◽

Seeking Behavior ◽

Healthcare Seeking Behavior

This study aimed to investigate the patterns and predictive factors of healthcare-seeking behavior among older Chinese adults. A sample of 10,914 participants aged ≥60 years from the 2011, 2013 and 2015 China Health and Retirement Longitudinal Study (CHARLS) was included. The bivariate analyses and Heckman selection model was used to identify predictors of healthcare-seeking behavior. Results shows that the utilization rate of outpatient services increased from 21.61% in 2011 to 32.41% in 2015, and that of inpatient services increased from 12.44% to 17.68%. In 2015, 71.93% and 92.18% chose public medical institutions for outpatient and inpatient services, 57.63% and 17.00% chose primary medical institutions. The individuals who were female, were younger, lived in urban, central or western regions, had medical insurance, had poor self-rated health and exhibited activity of daily living (ADL) impairment were more inclined to outpatient and inpatient services. Transportation, medical expenses, the out-of-pocket ratio and the urgency of the disease were associated with provider selection. The universal medical insurance schemes improved health service utilization for the elderly population but had little impact on the choice of medical institutions. The older adults preferred public institutions to private institutions, preferred primary institutions for outpatient care, and higher-level hospitals for hospitalization.

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