Socio-demographic determinants of health-care seeking options and alternative management practices of childhood diarrhoeal illness: A household survey among mothers in Iraq

Abstract

BackgroundDiarrhoea remains a significant cause of child morbidity and mortality in Iraq. The objective of this study was to examine the current practices of home-based management of diarrhoeal illnesses among Iraqi children. We surveyed mothers of children below five years of age in order to identify the socio-demographic factors associated with maternal health-care seeking practices. MethodsA total of 500 mother-child pairs were interviewed in a cross-sectional household survey in Thi-Qar Governorate, south-eastern Iraq between March 2016 and February 2017. Logistic and multinomial regression models were utilized to infer socio-demographic predictors of the health-care seeking and alternative management practices adopted by the mothers. ResultsThe interviewees reported that 35.2% of their children had diarrhoea in the two weeks prior to the survey. The least likelihood of reported occurrence of diarrhoea was among mother-child pairs where the mothers had received university education, as compared to mothers who were illiterate or received only primary or secondary education. Lower odds (OR=0.4, P-value <0.001) of reported childhood diarrhoea was revealed among mothers aged >25 years old compared to those younger.Self-ordered medicine from a pharmacy was the most preferred alternative management option in almost half (52.4% (262/500)) of the interviewed mothers in Thi-Qar. Interestingly, 69.6% (348/500) of the mothers reported supplying their children suffering from diarrhoea with antibiotics. Relative to mothers with university education, those with high school education had more likelihood of selecting medical center (relative risk ratio (rrr) = 2.4) and pharmacy (rrr = 3.7) as against no treatment. ConclusionsLower maternal educational level, mothers' age <25 and the district of residence were important factors associated with diarrhoea occurrence among under-five children. In light of the findings from this study, intervention aimed at improving health-care seeking for managing diarrhoea in Iraqi children should jointly consider the influence of mothers age, education, as well as the level of -Acknowledgments