Healthcare-seeking Behaviour for Common Infectious Disease-related Illnesses in Rural Kenya: A Community-based House-to-house Survey

Abstract

Community surveys of healthcare-use determine the proportion of illness episodes not captured by health facility-based surveillance, the methodology used most commonly to estimate the burden of disease in Africa. A cross-sectional survey of households with children aged less than five years was conducted in 35 of 686 census enumeration areas in rural Bondo district, western Kenya. Healthcare sought for acute episodes of diarrhoea or fever in the past two weeks or pneumonia in the past year was evaluated. Factors associa-ted with healthcare-seeking were analyzed by logistic regression accounting for sample design. In total, 6,223 residents of 981 households were interviewed. Of 1,679 children aged less than five years, 233 (14%) had diarrhoea, and 736 (44%) had fever during the past two weeks; care at health facilities was sought for one-third of these episodes. Pneumonia in the past year was reported for 64 (4%) children aged less than five years; 88% sought healthcare at any health facility and 48% at hospitals. Seeking healthcare at health facilities was more likely for children from households with higher socioeconomic status and with more symptoms of severe illness. Health facility and hospital-based surveillance would underestimate the burden of disease substantially in rural western Kenya. Seeking healthcare at health facilities and hospitals varied by syndrome, severity of illness, and characteristics of the patient.

Impact of community oriented interventions on pediatric care-seeking practices - a multi-country study in Cambodia, Guatemala, Kenya And Zambia

“…We found no association between male or female headed households in care-seeking for the bivariate analysis. Socioeconomic status has been shown to be positively correlated with care-seeking in other African countries [25,27,[29][30][31]. Wealth quintile was a significant predictor of careseeking in this study for Cambodia and Guatemala, and though the odds were higher for the wealthier quintiles in other countries, it was not statistically significant.…”

“…High rates of care-seeking from drug vendors has been reported for malaria especially in Africa [21], and other studies have effectively leveraged this behavior to enhance the skills of private drug retailers to prescribe artemisinin-based combination therapy for children presenting with these symptoms [26]. Another study in rural Kenya reported similar levels of treatment from traditional healers and community volunteers [27]. However, antibiotic treatment for ARI (<40%), and diarrhea (<10%), was much lower in this study, than that reported in the earlier study in Kenya (60%).…”

Incidences and Costs of Illness for Diarrhea and Acute Respiratory Infections for Children < 5 Years of Age in Rural Bangladesh

“…12 The field team collected data for all children aged < 5 years in sampled households. For outpatient treatment, the team inquired about costs of registration/visit fees, medicine, transportation, and wage loss.…”

Health Care Utilization and Access to Human Immunodeficiency Virus (HIV) Testing and Care and Treatment Services in a Rural Area with High HIV Prevalence, Nyanza Province, Kenya, 2007

“…Geographic accessibility, travel time, waiting time, age, health status, income, service costs, and education are factors shown to be associated with health care use [1][2][3][4][5][6][7][8][9] and improvements in facility physical infrastructure, staffing, and commodity availability and implementation of free highquality healthcare have demonstrated increases in health care utilization. [10][11][12][13] Routine national surveys tend to collect data on individuals' general health care use but often lack specific data on the healthcare service location.…”