Health-Seeking Behaviour for Childhood Ailments in Caregivers of Under-Five Children in an Urban Resettlement Colony in Delhi, India

Abstract

This explorative qualitative study assesses the health-seeking behaviour for childhood ailments in caregivers of under-five children in a low-income neighbourhood in Delhi, India during July-September 2021. A total of 17 caregivers (mothers) of eight male and nine female under-five children were enrolled, with the mother being the caregiver in most (94%) cases. Caregivers consulted on common childhood ailments from multiple sources, including family, neighbours, healthcare providers (both licensed and unlicensed), frontline workers, and local pharmacists. The internet was often used as a source of child health information due to its ease of access but often "confused" caregivers due to the presence of too much information. Health-seeking behaviour of caregivers for childhood ailments could range from self-medication, local pharmacist dispensing, and private and public healthcare providers. Factors that influenced preference for the healthcare facility or provider were accessibility issues (waiting time, queuing), perceived physician competence, and associated out-of-pocket expenses. Caregivers reported dissatisfaction with government health facilities because of shorter operational hours, overcrowding, suboptimal sanitation, queuing with limited seating arrangements, and occasionally discourteous health staff. Self-medication and over-the-counter use of antibiotics was high due to a lack of awareness of the challenges of antibiotic resistance or any perceived side effects. Preference for unlicensed practitioners for medical treatment was low and based on long-term familial beliefs and acceptance. However, traditional practitioners enjoyed a high level of trust in the community from shared cultural values, enjoining attenuation of the perceived non-biological agents of childhood illnesses through non-medical supernatural interventions.

A meta-Ethnography on Parents’ Experiences of the Internet As a Source of Health Information

“…The first concept, the 24/7 available “go-to” among other confined sources for health information, includes both the aspect of availability and convenience, as well as parental preferences for the internet as the place to “go-to.” Even though parents, mainly represented by mothers, trusted healthcare professionals ( Alianmoghaddam et al, 2019 ; Altawil et al, 2023 ; Bernhardt & Felter, 2004 ; Casilang et al, 2020 ; Criss et al, 2015 ; Sharma et al, 2022 ; van der Gugten et al, 2016 ), the Internet constituted a practical and convenient source for information which was both affordable and accessible day and night throughout the week ( Alianmoghaddam et al, 2019 ). The Internet was considered helpful, accurate, detailed, easy accesible, and sufficient ( Altawil et al, 2023 ; Bäckström et al, 2021 ; Guerra-Reyes et al, 2016 ; Lupton et al, 2016; Madge & O’Connor, 2006 ; Wagg et al, 2022 ).…”

“…The Internet was considered helpful, accurate, detailed, easy accesible, and sufficient ( Altawil et al, 2023 ; Bäckström et al, 2021 ; Guerra-Reyes et al, 2016 ; Lupton et al, 2016; Madge & O’Connor, 2006 ; Wagg et al, 2022 ). A key aspect was that the Internet was used among, and as a supplemet to, other sources ( Altawil et al, 2023 ; Aston et al, 2018 ; Bernhardt & Felter 2004 ; Clapton-Caputo et al, 2021 ; Criss et al, 2015 ; Johnson, 2015 ; Lupton, 2016 ; Maslen & Harris, 2021 ; Moon et al, 2019 ; Neill et al, 2014 ; Sharma et al 2022 ; van der Gugten et al, 2016 ). Parents used Internet to prepare for ( Bernhardt & Felter, 2004 ), evaluate, and follow-up encounters with healthcare professionals ( Aston et al, 2018 ; Bernhardt & Felter, 2004 ; Casilang et al, 2020 ; Criss et al, 2015 ; Johnson, 2015 ; Madge & O’Connor, 2006 ; Moon et al, 2019 ; Neill et al, 2014 ; van der Gugten et al, 2016 ).…”

Identification of potential barriers for timely access to pediatric sibling eye check-up in a tertiary eye care hospital

“…Inadequate pediatric eye care services, the lack of visual screening programs for children, and unawareness about protocols and procedures at eye hospitals remain the major problems for parents to seek children eye treatment. [ 5 24 25 ] There is paucity of knowledge regarding barriers for sibling ophthalmic check-up in the literature.…”

“…One of the problems related to vision screening projects in several countries worldwide is the high level of absenteeism, which varies from 31.2 to 68.7%. [ 10 - 25 ] The main reasons provided by the parents or guardians to not attend the visit are the lack of guidance, financial difficulty in taking transportation to the locale of the exam, distance, not having someone else to look after other children, preference to have a visit scheduled by his/her private medical practitioner, forgetfulness, and the lack of awareness of the importance of the ophthalmologic exam or denial of the child’s low vision. [ 10 - 25 ] Similar factors can be applicable for delay or denial of sibling eye check-up.…”

“…[ 10 - 25 ] The main reasons provided by the parents or guardians to not attend the visit are the lack of guidance, financial difficulty in taking transportation to the locale of the exam, distance, not having someone else to look after other children, preference to have a visit scheduled by his/her private medical practitioner, forgetfulness, and the lack of awareness of the importance of the ophthalmologic exam or denial of the child’s low vision. [ 10 - 25 ] Similar factors can be applicable for delay or denial of sibling eye check-up. Even if the services are provided free of cost and parents are given an opportunity and education about timely sibling ophthalmic check-up, uptake of service at a proper time may be unmet.…”