Determinants of care-seeking behaviour for fever, acute respiratory infection and diarrhoea among children under five in Nigeria

Abstract

Background Despite available, inexpensive and effective treatments, malaria, diarrhoea, and pneumonia still contribute the majority of the global burden of childhood morbidity and mortality. Nigeria has the highest absolute numbers of child deaths worldwide. Appropriate care-seeking is important for prompt diagnosis, appropriate and timely treatment, and prevention of complications. The objective of this cross-sectional study was to examine the prevalence of and factors associated with appropriate care-seeking for childhood illnesses. Methods We used the most recent Nigeria Demographic and Health Survey (2018) to assess the prevalence of appropriate care-seeking among mothers of children under five with symptoms of common childhood illnesses. For diarrhoea, we defined appropriate care-seeking as seeking care from a formal health provider. For fever and acute respiratory infection (ARI), appropriate care-seeking was defined as seeking care from a formal provider the day of or after symptom onset. Multivariate logistic regression was carried out to assess factors associated with optimal care-seeking for each illness. Results At least 25% of parents did not seek any care for children with fever or ARI; this figure was over one third for diarrhoea. Only 15% and 13% of caregivers showed appropriate care-seeking for their children with fever and ARI respectively, and 27% of mothers sought care from a formal provider for diarrhoea. Predictors of appropriate care-seeking varied according to childhood illness. Previous facility delivery was the only risk factor associated with increased odds of appropriate care-seeking for all three illnesses; other risk factors varied between illnesses. Conclusion Overall, care-seeking for childhood illnesses was suboptimal among caregivers in Nigeria. Interventions to increase caregivers’ awareness of the importance of appropriate care-seeking are needed alongside quality of care interventions that reinforce people’s trust in formal health facilities, to improve timely care-seeking and ultimately reduce the high burden of child deaths in Nigeria.

Prompt treatment of fever and its associated factors among under-five children in sub-Saharan Africa: A multilevel analysis of evidence from 36 countries

“…Furthermore, the odds of prompt treatment for fever were higher among mothers who gave birth at a health facility compared with those who gave birth at home. This finding was in agreement with studies conducted in Ethiopia [ 36 ] and Nigeria [ 37 ]. This might be due to the fact that mothers who gave birth at a health facility might have better awareness and trust about healthcare services, easily understand the significance of seeking healthcare services, and understand the availability of services wanted for the treatment of their febrile children.…”

Magnitude and determinant of healthcare-seeking behavior for childhood acute respiratory tract infections in Ethiopia: a cross-sectional study

“…Mothers who gave birth in a health facility were more likely to seek health care in the event of an ARI episode than mothers who gave birth at home. The finding is similar to a study done in Ethiopia [ 35 ], and Nigeria [ 45 ]. The possible reason might be that women who deliver at health facilities may have an opportunity for health promotion, which increases the likelihood of a subsequent visit to the health care facility [ 46 , 47 ].…”

A situational assessment of treatments received for childhood diarrhea in the Federal Republic of Nigeria

“…This findings demonstrate sub-optimal use of formal healthcare services for child health throughout the country and particularly among individuals in the northern fringes as revealed by previous studies [ 12 , 29 , 30 ]. Some authors attributed this to the prevailing cultural differences in perception of health and diseases, and the availability and distance to healthcare facilities [ 30 ].…”

“…About 3% of the children from Taraba state that had diarrhea in 2018 received ORS and zinc supplements compared with 72% in Nasarawa state [ 5 ]. Appropriate and timely care-seeking in formal health facilities would allow for prompt and correct diagnosis, appropriate management and avert complications [ 12 , 13 ].…”