A Multilevel Modelling of Barriers to Healthcare Access and Healthcare Seeking for Childhood Illnesses Among Childbearing Women in Burundi

Abstract

BackgroundPoor health seeking behaviour continue to be major challenge in accessing healthcare in sub-Saharan Africa despite the availability of effective treatment for most childhood illnesses. The current study investigated the barriers to healthcare access and health seeking for childhood illnesses in Burundi.Methods The study utilized data from the 2016-17 Burundi Demographic and Health Survey (BDHS). A total of 11,828 childbearing women who had complete information on all the variables of interest were included in our study. The outcome variable for the study was healthcare seeking for childhood illnesses. The data were analyzed using STATA version 14.2 for windows. Chi-square test of independence and a multilevel modelling were carried out to generate the results. Statistical significance was pegged at 95% confidence intervals (CIs).Results Overall, 80.55% of women in Burundi sought care for their children’s illness. We found that women who perceived getting money for medical care for self as a big problem [AOR=0.82; CI=0.73-0.91] and considered going for medical care alone as a big problem [AOR=0.84; CI=0.73-0.96], had lower odds of seeking healthcare for their children, compared to those who considered these indicators as not a big problem. The results also showed that cohabiting mothers [AOR=0.86; CI=0.76-0.96], those taking healthcare decisions alone [AOR=0.83; CI=0.71-0.97], women in female headed households [AOR=0.85;CI=0.74-0.98], women with children larger [AOR=0.86;CI=0.77-0.96] and smaller than average [AOR=0.76;CI=0.67-0.87], single birth children [AOR=0.65; 0.47-0.89], and women in rural areas [AOR=0.79; CI=0.63-0.99] had lower odds of seeking care for their children’s illness.ConclusionFindings suggest that Burundi should strengthen maternal health care regarding women’s healthcare accessibility and health seeking behaviours, especially with residential consideration and among women from the poorest wealth quintile, those cohabiting and those with lower parity. The Burundian government through multi-sectoral partnership should strengthen health systems (e.g. pay-for-performance [P4P]) for maternal health and address structural determinants of women’s health by creating favourable conditions to improve the status of women and foster their overall socioeconomic well-being.

Addressing the need for an appropriate skilled delivery care workforce in Burundi to support Maternal and Newborn Health Service Delivery Redesign (MNH-Redesign): a sequential study protocol

“…Moreover, for an estimated 11.5 million population, the country has less than 200 medical specialists across all disciplines of whom more than 95% are located in Bujumbura capital city which is home to only 2.7% of Burundi's population 19 . Under those circumstances, Burundians continue to face difficulties to access and use quality health care services [20][21][22][23] . This places Burundi among countries that continue to register higher maternal and neonatal mortality ratios as the reduction of maternal and neonatal deaths requires equitable access to quality health care services which constitute a cornerstone of the survive, thrive, and transform agenda 1,24 .…”