Determinants of Delays in Health Care Utilization for Malaria Treatment (HCUMT) in Children under Five in Benin Southern Setting

Abstract

Untreated or poorly treated malaria case is reported to progress to the severe form over time. Studies showed a high prevalence of untimely utilization of health service in low-income countries. The objective was to identify the determinants of late use of malaria treatment in children under five years of age in Ouidah, Benin. The study was cross-sectional and carried out during June 2017. Data on sociodemographic characteristics and malaria management were collected in randomly selected 450 couple mother-child pairs using a questionnaire. A multivariate analysis using a logistic regression and the stepwise digressive method was used to identify the determinants of late use of malaria treatment in children under five years of age. The prevalence of delayed utilization of health facilities for malaria management in children under 5 years was 87.8% (95% CI: 81.6% -92.8). Delays in health care utilization depended on whether mothers were married (OR = 4.4, 95% CI: 2.2-8.8), they used the motorcycle as a means of travel to health facilities (OR = 2.3, 95% CI: 1.1-5.2), complained about the high cost of transport (OR = 2.4, 95% CI 1.2-4.7), or believed in the possibility of preventing malaria (OR = 2.4, 95% CI: 1.2 -4.7). When health care costs are paid by both the parents or by grandparents at the same time, then children were less likely to experience a delay (OR = 0.4, 95% CI: 0.2 -0.7). The prevalence of delays in health care utilization for malaria treatment (HCUMT) in children under five years is high in Ouidah in Benin south setting. Organization of simple malaria management through community training, regular and continuous supply of inputs (medicines and diagnostic tests) for malaria control would reduce the delays in HCUMT in children in Ouidah, Benin.

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“…This supports the role of education in fostering appropriate malaria treatment seeking behavior in postpartum women. Other factors that have been identified to play a role in influencing malaria treatment behavior include the cost of transportation, maternal ANC attendance, the individual's convenience concerning distance and time, and the availability and affordability of treatment 27,42‐49 …”

Ghanaian women’s knowledge on whether malaria treatment is covered by the national health insurance: A multilevel regression analysis of national data

“…Based on conceptual relevance and conclusions drawn by earlier studies [ 2 , 4 , 11 , 19 ], eleven independent variables were considered in the current study. Based on the hierarchical nature of the data, the variables were layered into three levels: individual, community and regional levels.…”

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“…Au Bénin, le nombre de décès liés au paludisme demeure encore élevé malgré les efforts fournis. Il existe un grand écart entre le nombre de décès espéré (105) comparativement aux 1747 décès enregistrés en 2015 [7]. Pour réduire le nombre de décès liés au paludisme, l'OMS recommande un diagnostic rapide et un traitement précoce utilisant les combinaisons thérapeutiques à base d'artémisinine [8,9].…”

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