Factors associated with healthcare-seeking behavior for symptomatic acute respiratory infection among children in East Africa: a cross-sectional study

Abstract

Background Although there has been promising progress in the reduction of child mortality from ARI, the magnitude is high yet, especially in East Africa. Since mothers/guardians decide upon the type and frequency of healthcare services for children, their good healthcare-seeking behavior could prevent acute respiratory infections (ARI) related mortality and morbidity. This study aimed to investigate the pooled prevalence and factors associated with healthcare-seeking behavior of children younger than five years with ARI symptoms by using data from nationally representative surveys of East Africa. Methods We analyzed secondary data based on the eleven East African Demographic and Health Survey data. Both Individual and community level variables were considered for this study and a multilevel binary logistic regression model was fitted to identify associated factors of children’s healthcare-seeking behavior for ARI symptoms. STATA V.14 software was used to clean, recode and analyze the data. All variables with a p-value = 0.2 in the bi-variable analysis were considered for the multivariable multilevel analysis. Adjusted OR (AOR) with 95% CI was reported to reveal significantly associated factors in the multivariable multilevel analysis. Result The overall prevalence of healthcare-seeking behavior of under-five children for ARI symptoms was 64.4% in East Africa. In the multilevel analysis, the following characteristics were found to be the most important factors of children healthcare seeking behavior for ARI symptoms (P < 0.05): Rural residence [AOR = 0.51, 95% CI (0.37–0.65)], high community level media usage [AOR = 1.63, 95% CI (1.49–1.79)], high community level women education [AOR = 1.51, 95% CI (1.39–1.66)], primary education [AOR = 1.62, 95% CI (1.45–1.82)], secondary education and above [AOR = 1.99, 95% CI (1.71–2.32)], working mother [AOR = 1.33, 95% CI (1.20–1.48)], unmarried women [AOR = 1.15, 95% CI (1.04–1.27)], media access [AOR = 1.43, 95% CI (1.20–1.58)], richest [AOR = 1.39, 95% CI (1.29–1.51)], distance to health facility not a big problem [AOR = 1.11, 95% CI (1.02–1.21)], Place of delivery at health facilities [AOR = 1.77, 95% CI (1.60–1.95)], age of child 7–23 months [AOR = 1.59, 95% CI (1.39–1.82)], age of child 24–59 months [AOR = 1.24, 95% CI (1.09–1.41)] in comparison with children aged 0–6 months, family size > 10 [AOR = 1.53, 95% CI (1.22–1.92)]. Conclusions and recommendations The overall prevalence of children’s healthcare-seeking behavior for ARI symptoms was found relatively low in East Africa, ARI symptoms were determined by individual-level variables and community-level factors. Targeted interventions are needed to improve socioeconomic and health systems to overcome the problem of acute respiratory infection in children. Special attention is required to empower local health staff and health facilities to provide proper diagnosis and management of ARI cases in East Africa.

Factors Associated with Acute Respiratory Infections in Children Aged 0 - 5 Years in the Yénawa District of Cotonou (Benin) in 2023

“…These results are similar to those found by Chilot et al, who obtained a prevalence of 64.4% for East Africa from 2012 to 2020 [18].On the other hand, lower prevalences were reported by Demissie et al in Ethiopia in 2019 (58.7%) and Nshimiyimana et al in Uganda in 2016 with a prevalence of 40.3% for a sample of 13493 children under 5 years of age [19] [20].…”

Geographical weighted regression analysis of hotspots of acute respiratory infection and its associated factors among under- five children in Ethiopia, spatial and multilevel analysis

“…Among women who had attended secondary education, acute respiratory infection was reduced compared to that in women who had no education. This nding is supported by studies conducted in Ethiopia [28,29], Bangladesh [30], and Ghana [31]. Many scholars have revealed that educated women are aware of ARI symptoms and exhibit early healthcare-seeking behaviors.…”

“…Many scholars have revealed that educated women are aware of ARI symptoms and exhibit early healthcare-seeking behaviors. Furthermore, it might be attributable to the fact that education can enhance mothers' and caregivers' healthcare-seeking behaviors for children with ARI symptoms [29]. Moreover, education enables mothers to be informed about how to access and use information on children's health and make health decisions for their children [28,31].…”

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

“…The outcome of this study was seeking healthcare for children under the age of five who had ARI symptoms in the two weeks preceding the interview. Seeking medical care was defined as seeking treatment from any health facility, excluding treatment from a traditional practitioner, by their mother/caregiver in the two weeks preceding the survey, and coded as “1”, otherwise “0” [ 26 , 27 ].…”