Factors associated with delay in treatment-seeking behaviour for fever cases among caregivers of under-five children in India: Evidence from the National Family Health Survey-4, 2015–16

Abstract

Background Fever is one of the common clinical symptoms found among children suffering from various illnesses. India carries a substantial burden of febrile illness among under-five children which heighten the risk of malnutrition, mortality and morbidity. This study aims to determine the factors associated with delay in treatment-seeking for fever among under-five children in India. Methods A cross-sectional study was carried out using the large-scale nationally representative data from the National Family Health Survey (NFHS-4), conducted in 2015–2016. The data were collected by using four survey questionnaires i.e., Household Questionnaire, Woman’s Questionnaire, Man’s Questionnaire, and Biomarker Questionnaire. Delay in treatment-seeking was defined as taking a child for treatment after 24 hours of fever onset. Bivariate and multivariate logistic regression models were performed to assess the factors associated with delay in treatment-seeking behaviour for fever in under-five children. Results In India, 31.12% (n = 7229) of the caregivers sought treatment for children after 24 hours of the onset of fever. Findings show no significant differences in delay in treatment-seeking behaviour by age groups and sex of children. Multivariate analysis revealed that the odds of delay in treatment-seeking behaviour of fever were higher among children from the poorest wealth quintile (AOR: 2.06; 95% CI: 1.85, 2.31), belonging to the scheduled tribe (AOR: 1.35; 95% CI: 1.24, 1.48), children who resided in rural areas (AOR: 1.14; 95% CI: 1.07, 1.22), children from the northeast region (AOR: 1.29; 95% CI: 1.14, 1.46), and children of caregivers who perceived distance to health facilities as a ‘big problem’ (AOR: 1.16; 95% CI: 1.09, 1.23). Conclusion The study shows a high prevalence of delay in seeking treatment for fever among caregivers of under-five children in India. Delay in seeking treatment is associated with socio-demographic and socio-economic factors. Therefore, there is a need for intensified health promotion programs to sensitize caregivers on the importance of early health-seeking behaviour.

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

“…Mothers who reported that distance to a health facility was not a big problem were more likely to have prompt treatment for fever than their counterparts. This finding was supported by studies conducted in Tanzania [ 14 ] and India [ 13 ]. This might be due to the fact that the challenges faced by mothers in accessing healthcare facilities decreased when they reported that distance to a health facility was not a big problem.…”

“…Children of mothers with rich household wealth status were more likely to have prompt treatment for fever compared with those with poor household wealth status. Studies conducted in Nigeria [15] and India [13] reported similar findings. This might be due to the fact that mothers with poor wealth status may not be able to afford the cost of healthcare services, and this is possible to prevent them from seeking prompt treatment for their febrile children.…”

“…In the current study, the pooled prevalence of prompt treatment of fever among under-five children in SSA countries was 26.11% (95% CI: 25.79%, 26.44%). This finding was lower than studies conducted in Nigeria (37.9%) [15], Tanzania (44.6%) [14], Mazabuka District, Zambia (42%) [18], Zambia (57.3%) [19], and India (37.9%) [13]. The possible justification for this discrepancy might be due to differences in study setting, geographical variation, sample size, sociocultural differences, and differences in health service accessibility between countries.…”

“…Despite being the largest killer of these diseases among children under the age of five, care seeking for febrile children often occurs too late, making community-based efforts vital to increasing access to prompt treatment [ 12 ]. Delayed treatment of fever cases among under-five children was 31.1% in India [ 13 ], 55.4% in Tanzania [ 14 ], and 62.1% in Nigeria [ 15 ]. It is well known that fever has some potentially harmful effects if it is not managed timely and appropriately [ 16 ].…”

“…Studies conducted elsewhere showed that the prevalence of prompt treatment of fever was 68.9% in India [ 13 ], 37.9% in Nigeria [ 15 ], 44.6% in Tanzania [ 14 ], 42% in Mazabuka District, Zambia [ 18 ], and 57.3% in Zambia [ 19 ]. Factors like child age [ 15 ], household wealth status [ 13 , 15 ], mother’s occupation [ 15 ], antenatal care (ANC) visits during pregnancy [ 15 ], pregnancy intention [ 15 ], number of under-five children in the household [ 14 ], distance to healthcare facility [ 13 , 14 ], residence [ 13 ], child sex [ 19 ], and mother’s education [ 19 ] were significantly associated with treatment of fever among under-five children.…”