Care Seeking Behaviour for Children with Suspected Pneumonia in Countries in Sub-Saharan Africa with High Pneumonia Mortality

Noordam, Aaltje Camielle; Carvajal, Liliana; Sharkey, Alyssa; Young, Mark; Cals, Jochen

doi:10.1371/journal.pone.0117919

Cited by 81 publications

(108 citation statements)

References 41 publications

(45 reference statements)

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“…Our findings revealed that caretakers were 1.8 times more likely to delay consulting a health facility if their child was a female than male. Similar findings were reported in studies done in Pakistan, India and Africa [16,18,19]. Surprisingly, age of child was not found to influence health facility consultation in this study.…”

Section: Discussionsupporting

confidence: 92%

Cross Sectional Survey of Care Seeking For Acute Respiratory Illness in Children Under 5 Years in Rural Kenya

Ndungu¹

2018

AJP

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Acute respiratory infection (ARI) is a leading cause of childhood morbidity and mortality in developing countries. In Kenya, diagnosis and treatment of ARI remains predominantly health facility based. This presumes that caretakers can recognize ARI symptoms promptly and make a decision to take the child to an appropriate health facility for treatment. Unfortunately, these presumptions have not been assessed. This study sought to establish determinants of health care seeking among caretakers of children under five years (CU5) of age with ARI. An analytic cross sectional survey was carried out in Githunguri Sub-County of Kiambu County. Households with CU5 who had recently suffered an episode of ARI were enrolled. Structured questionnaires, focused group discussions and key informant guides were used to gather information. Structured questionnaires were administered to caretakers to obtain information on socio-demographics, knowledge and health seeking practices. Bivariate and multivariate analysis was carried out with a p value of < 0.05. From 438 households sampled, 323 (73.7%) had CU5 in their households. Out of these, 240 (74.3%) of the children had an episode of ARI in the preceding 2 weeks. The mean age of the children was 29.2 months, with male to female ratio of 1:1. The mean mothers' age was 29.4 years, 71.2% were married, 54.8% had secondary education and 66.6% were of Christian-protestants faith and (90.0%) were in informal employment. Poor knowledge of pneumonia was documented in 92.5% of caretakers. One hundred and forty nine (62.1%) caretakers had delayed health facility consultation for ARI. The main factors associated with delayed facility consultation were poor knowledge of symptoms (p = 0.007) long distance to the nearest health facility (p = 0.002), means of transport used to access the nearest health facility (p = 0.001) and previous high expenditure at health facility (p = 0.011). On logistic regression, the main factors that independently determined delayed facility consultation were long waiting time (>1hour) before service provision (p = 0.001), use of a motorbike to access the nearest health facility (p = 0.001) and traveling for 4-4.9 kilo meters to the nearest health facility (p = 0.002). Travelling for long distance and long waiting time before service provision during the previous facility visit were the main determinants of delayed facility consultations. The study recommends increased sensitization on symptom recognition among caretakers, and intensified efforts to reduce turnaround time during health facility consultations in order to minimize delays in health facility consultation.

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Section: Discussionsupporting

confidence: 92%

Cross Sectional Survey of Care Seeking For Acute Respiratory Illness in Children Under 5 Years in Rural Kenya

Ndungu¹

2018

AJP

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“…The finding concurs with a study conducted in the communities of Nigeria, Ethiopia and De-mocratic Republic of Congo. 34 Although there was no reported significant association to other socio-demographic characteristics such as child's gender, location, and number of symptoms dissimilar from other reports, 5,28,32,35,36 this informs the need to strengthen efforts on educating caregivers on the signs and symptoms, the severity of the ARI episodes, and on when and where to immediately take the child to the health facility. The reason for this disparity is not clear but suggests that it was probably due to the variances in methodologies (different approach in data collection, study population, cultural differences and locale of the study).…”

Section: Discussionmentioning

confidence: 76%

Health-seeking practices of caregivers and determinants in responding to acute respiratory infection episodes in Biliran Island, Philippines

Reñosa

Tan

Kamigaki

et al. 2020

Journal of Global Health Reports

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Background Despite the substantial programs addressing childhood illnesses, pneumonia still ranks as the leading cause of childhood mortality in the Philippines. Hence, this study was designed to determine the current health seeking behavior and its determinants among caregivers of children under five years old. Methods A prospective cohort study of 3,056 children under five years old was undertaken in selected barangays in two municipalities of Biliran Island, Philippines. These children were visited every two weeks from February 2014 to June 2015 to find out if they had any respiratory infections. Mothers documented signs and symptoms of respiratory infections and actions taken in response to the observed signs and symptoms in a disease calendar. Research staff confirmed calendar entries and accuracy of the data and encoded it into a database. The most severe Integrated Management of Childhood Illnesses (IMCI) category was selected to represent an illness period. A new episode was counted when there was >7 days interval of no clinical signs from a previous episode. Results Results revealed that mothers may appear to recognize critical signs of illness but are not appropriately responding to them. Of the 191 pneumonia cases, 53.4% sought health care facilities, while 47.6% either took no action or resorted to self-medication. Overall rate of self-medication was highest among pneumonia cases and lowest among the Very Severe Pneumonia group. On average, 38.0% of acute respiratory infection (ARI) episodes self-medicated with antipyretics and antibiotics (33.0%). The number of children under five years old in the household and age of child at the time of the episode were identified as determinants for self-medication. Conclusions The findings suggest that there was inappropriateness and delay in seeking care for childhood pneumonia in rural areas.

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“…Unfortunately, only one in five caregivers in developing countries can recognize the danger signs of pneumonia like rapid breathing and chest indrawing, and only half of children under 5 with pneumonia are taken to an appropriate healthcare provider [6]. In a population based survey carried out in six countries in Sub-Saharan Africa, only about 18% and 30% of children with suspected pneumonia in Nigeria and Ethiopia, respectively, were taken to hospital for healthcare [7]. In a systematic review of ninety-one studies that reported recognition and/or care seeking for diarrhoea, pneumonia, and malaria in low and middle income countries (LMICs), it was shown that the median sensitivity of recognition of pneumonia among caregivers was low (45.8%) and care seeking from community health worker for pneumonia was 4.2% [8].…”

Section: Introductionmentioning

confidence: 99%

Danger Signs of Childhood Pneumonia: Caregiver Awareness and Care Seeking Behavior in a Developing Country

Ndu

Ekwochi

Osuorah

et al. 2015

International Journal of Pediatrics

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Background. Efforts to reduce child mortality especially in Africa must as a necessity aim to decrease mortality due to pneumonia. To achieve this, preventive strategies such as expanding vaccination coverage are key. However once a child develops pneumonia prompt treatment which is essential to survival is dependent on mothers and caregiver recognition of the symptoms and danger signs of pneumonia. Methods. This community based cross-sectional study enrolled four hundred and sixty-six caregivers in Enugu state. It aimed to determine knowledge of caregivers about danger signs of pneumonia and the sociodemographic factors that influence knowledge and care seeking behaviour of caregivers. Results. There is poor knowledge of the aetiology and danger signs of pneumonia among caregivers. Higher maternal educational attainment and residence in semiurban area were significantly associated with knowledge of aetiology, danger signs, and vaccination of their children against pneumonia. Fast breathing and difficulty in breathing were the commonest known and experienced WHO recognized danger signs while fever was the commonest perceived danger sign among caregivers. Conclusion. Knowledge of danger signs and health seeking behaviour among caregivers is inadequate. There is need for intensified public and hospital based interventions targeted at mothers to improve their knowledge about pneumonia.

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Care Seeking Behaviour for Children with Suspected Pneumonia in Countries in Sub-Saharan Africa with High Pneumonia Mortality

Cited by 81 publications

References 41 publications

Cross Sectional Survey of Care Seeking For Acute Respiratory Illness in Children Under 5 Years in Rural Kenya

Cross Sectional Survey of Care Seeking For Acute Respiratory Illness in Children Under 5 Years in Rural Kenya

Health-seeking practices of caregivers and determinants in responding to acute respiratory infection episodes in Biliran Island, Philippines

Danger Signs of Childhood Pneumonia: Caregiver Awareness and Care Seeking Behavior in a Developing Country

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