What are the trends in seeking health care for fever in children under-five in Sierra Leone? evidence from four population-based studies before and after the free health care initiative

Bognini, Joel Dofinissery; Samadoulougou, Sékou; Ouédraogo, Mady; Smart, Francis; Kankoye, David Tiga; Sankoh, Osman; Kirakoya‐Samadoulougou, Fati

doi:10.1371/journal.pone.0263364

Cited by 10 publications

(8 citation statements)

References 17 publications

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“…Our nding contrasted with the nding from a multi-country study using DHS data that focussed on the utilisation of conventional healthcare for childhood illness in which living in a household headed by a man was associated with conventional healthcare [7]. However, individual country studies found that the odds of utilising conventional healthcare for childhood illness were higher when the household head was a woman [50,51]. Our regression analysis indicates that women not involved in decision-making at home and who had issues getting permission to visit the hospital were more likely to seek care for their child's fever/cough from TMP.…”

Section: Discussioncontrasting

confidence: 96%

The use of traditional medicine practitioners for childhood illness among childbearing women: a multi-level Analysis of Demographic and Health Surveys in 32 sub-Saharan African countries

James

Gyasi

Kasilo

et al. 2022

Preprint

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Background: Understanding traditional medicine practitioners (TMP)-seeking behaviour for childhood diseases may be important to reducing child mortality. However, a comprehensive picture of TMP utilisation and its associated factors for childhood illness in sub-Saharan Africa (SSA) is lacking. This study aimed to estimate the prevalence of women with children under five years old who sought the service of a traditional medicine practitioner to treat their children’s illness and identify individual and community-level factors associated with such a pattern of use. Methods We utilised extracted Demographic and Health Surveys (DHS) data collected between 2010 and 2021 among 353,463 under-fives children from 32 SSA countries. Our outcome variable was the use of TMP for childhood illness (diarrhoea or fever/cough or both). We used STATA v14 to conduct descriptive, bivariate, and two-level multivariable multi-level modelling. Results Approximately [2.80% (95%CI: 1.88-3.90)] women who sought healthcare for childhood illnesses utilised the service of a TMP with the highest in Ivory coast [16.3% (95%CI: 13.87-19.06)] followed by Guinea (13.80% (95%CI: 10.74-17.57)] to the lowest in Sierra Leone [0.10%(95%CI:0.01-1.61)]. Specifically, approximately [1.95% (95%CI: 1.33-2.68)] and [1.09% (95%CI: 0.67-1.60)] women sought the service of a TMP for childhood diarrhea and fever/cough, respectively. Women with no formal education [AOR=1.62;95%CI:1.23-2.12], no media access [AOR=1.19;95%CI:1.02-1.39), who lived in a household headed by a man [AOR=1.64;95%CI:1.27-2.11],without health insurance [AOR=2.37;95%CI: 1.53-3.66], who considered it a problem getting permission to visit a health facility [AOR=1.23;95%CI:1.03-1.47] and perceived the size of their children at birth to be above average[AOR=1.20;95%CI:1.03-1.41] had higher odds of using TMP for childhood illness. Conclusion Despite the low usage of TMP for childhood illness, our findings highlight that TMPs continue to have a role in managing childhood illness in SSA. It is essential that policymakers and service providers consider the potential role of TMPs in designing, reviewing and implementing child health policies and interventions in SSA. Also, child health policies and interventions should be focused on the characteristics of women who use TMPs for childhood diseases identified in our study.

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Section: Discussioncontrasting

confidence: 96%

The use of traditional medicine practitioners for childhood illness among childbearing women: a multi-level Analysis of Demographic and Health Surveys in 32 sub-Saharan African countries

James

Gyasi

Kasilo

et al. 2022

Preprint

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“…Furthermore, in this study, the tendency to initially self-medicate the child in response to routine childhood illnesses was commonplace that likely interfered with early and appropriate care-seeking. Previous studies in low- and middle-income countries have also observed an increased likelihood of caregivers resorting to self-medication for treating perceived minor paediatric ailments that were consistent with their past experiences [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 94%

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

Sharma¹,

Basu²,

Manna³

et al. 2022

Cureus

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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.

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“…Sierra Leone on the other hand, was more consistent in burden reduction across all three causes (27.0% malaria reduction (4.8–44.2), 63.1% diarrhoea reduction (58.0–66.6), 56.1% LRI reduction (44.1–61.2)), possibly due to large reductions in micronutrient (vitamin A and zinc) deficiency 27 . Further, in 2010, Sierra Leone introduced a government program intended to improve access to healthcare (Free Health Care Initiative) which has improved access to and equity for maternal and child health services 29 , 30 .…”

Section: Resultsmentioning

confidence: 99%

The overlapping burden of the three leading causes of disability and death in sub-Saharan African children

Reiner

Hay

2022

Nat Commun

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Despite substantial declines since 2000, lower respiratory infections (LRIs), diarrhoeal diseases, and malaria remain among the leading causes of nonfatal and fatal disease burden for children under 5 years of age (under 5), primarily in sub-Saharan Africa (SSA). The spatial burden of each of these diseases has been estimated subnationally across SSA, yet no prior analyses have examined the pattern of their combined burden. Here we synthesise subnational estimates of the burden of LRIs, diarrhoea, and malaria in children under-5 from 2000 to 2017 for 43 sub-Saharan countries. Some units faced a relatively equal burden from each of the three diseases, while others had one or two dominant sources of unit-level burden, with no consistent pattern geographically across the entire subcontinent. Using a subnational counterfactual analysis, we show that nearly 300 million DALYs could have been averted since 2000 by raising all units to their national average. Our findings are directly relevant for decision-makers in determining which and targeting where the most appropriate interventions are for increasing child survival.

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What are the trends in seeking health care for fever in children under-five in Sierra Leone? evidence from four population-based studies before and after the free health care initiative

Cited by 10 publications

References 17 publications

The use of traditional medicine practitioners for childhood illness among childbearing women: a multi-level Analysis of Demographic and Health Surveys in 32 sub-Saharan African countries

The use of traditional medicine practitioners for childhood illness among childbearing women: a multi-level Analysis of Demographic and Health Surveys in 32 sub-Saharan African countries

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

The overlapping burden of the three leading causes of disability and death in sub-Saharan African children

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