Determinants of Health Care Seeking for Diarrheal Illness in Young Children in Urban Slums of Kolkata, India

Manna, Byomkesh; Nasrin, Dilruba; Kanungo, Suman; Roy, Sarbani; Ramamurthy, Thandavarayan; Kotloff, Karen L.; Levine, Myron M.; Sur, Dipika

doi:10.4269/ajtmh.12-0756

Cited by 32 publications

(31 citation statements)

References 22 publications

(17 reference statements)

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“…This is consistent with the most recent care-seeking estimates for Maharashtra, where similar proportions of facility-based care-seeking were observed by child sex for diarrhea, fever, and symptoms of ARI [5]. Similar care-seek-VIEWPOINTS RESEARCH THEME 2: IMPROVING COVERAGE MEASUREMENT ing by child sex has also been reported elsewhere in India [42]. While sex did not appear to be associated with the decision to seek care, this does not exclude potential bias at other stages of the management of childhood illness.…”

Section: Discussionsupporting

confidence: 88%

Determinants and patterns of care-seeking for childhood illness in rural Pune District, India

Marsh¹,

Hirve²,

Lele³

et al. 2020

Journal of Global Health

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Determinants and patterns of care-seeking for childhood illness in rural Pune District, India Background An estimated 1.2 million children under five years of age die each year in India, with pneumonia and diarrhea among the leading causes. Increasing care-seeking is important to reduce mortality and morbidity from these causes. This paper explores the determinants and patterns of care-seeking for childhood illness in rural Pune district, India.Methods Mothers having at least one child <5 years from the study area of the Vadu Health and Demographic Surveillance System were enrolled in a prospective cohort study. Household sociodemographic information was collected through a baseline questionnaire administered at enrollment. Participants were visited up to six times between July 2015 and February 2016 to collect information on recent childhood acute illness and associated care-seeking behavior. Multivariate logistic regression explored the associations between care-seeking and child, participant, and household characteristics. ResultsWe enrolled 743 mothers with 1066 eligible children, completing 2585 follow-up interviews (90% completion). Overall acute illness prevalence in children was 26% with care sought from a health facility during 71% of episodes. Multivariable logistic regression showed care-seeking was associated with the number of reported symptoms (Odds ratio (OR) = 2.4, 95% confidence interval (CI) = 1.5-3.9) and household insurance coverage (OR = 2.2, 95% CI = 1.1-4.3). We observed an interaction between the associations of illness severity and maternal employment on care-seeking. Somewhat-to-very severe illness was associated with increased care-seeking among both employed (OR = 5.0, 95% CI = 2.2-11.1) and currently unemployed mothers (OR = 7.0, 95% CI = 3.9-12.6). Maternal employment was associated with reduced care-seeking for non-severe illness (OR = 0.3, 95% CI = 0.1-0.7), but not associated with care-seeking for somewhat-to-very severe illness. Child sex was not associated with care-seeking. ConclusionsThis study demonstrates the importance of illness characteristics in determining facility-based care-seeking while also suggesting that maternal employment resulted in decreased care-seeking among non-severe illness episodes. The nature of the association between maternal employment and care-seeking is unclear and should be explored through additional studies. Similarly, the absence of male bias in care-seeking should be examined to assess for potential bias at other stages in the management of childhood illness.

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Section: Discussionsupporting

confidence: 88%

Determinants and patterns of care-seeking for childhood illness in rural Pune District, India

Marsh¹,

Hirve²,

Lele³

et al. 2020

Journal of Global Health

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“…A study in Niger also revealed that one third of acute diarrheal under-five-year-old children were not taken to health facilities [31]. Another study, in Kolkata slums in India, reported that educated mothers/caregivers sought care at health facilities and home [32]. …”

Section: Discussionmentioning

confidence: 99%

Utilization of health facilities and predictors of health-seeking behavior for under-five children with acute diarrhea in slums of Addis Ababa, Ethiopia: a community-based cross-sectional study

Adane

Mengistie

Mulat

et al. 2017

J Health Popul Nutr

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BackgroundInformation on health-seeking behavior and utilization of health facilities in slums of Addis Ababa is scarce, impeding the implementation of effective interventions. The purpose of this study is to assess the status of health facilities utilization and predictors for health-seeking behavior of mothers/caregivers of under-five children with acute diarrhea in slums of Addis Ababa, Ethiopia.MethodsA community-based cross-sectional study design was employed in five rounds of surveys in seven kebeles in slums of Addis Ababa among 472 mothers/caregivers of 472 under-five children with acute diarrhea in reference to Andersen’s behavioral model. Data were entered into EpiData Version 3.1 and analyzed using STATA Version 14.0. Descriptive statistics were used to examine patterns of health facilities utilization and multivariable logistic regression analysis was applied to identify predictors associated with health-seeking behavior.ResultsMost mothers/caregivers (70.8%) sought care either at home (14.2%) or health facilities (56.6%), whereas 29.2% reported that they did not seek any care. Of those who consulted health facilities, government health facilities (76.9%) were more utilized than private (18.0%) and informal (5.1%) health facilities. Nearly all (93.9%) of the mothers/caregivers using government health facilities used health centers, and of those who took their children to private health facilities (60.9%) used clinics and 26.1% used pharmacies/drug vendors. Mothers/caregivers visiting health facilities obtained mainly oral rehydration salt (ORS) (39.8%) and home-recommended fluids (HRF) (40.3%), but few of them (11.9%) obtained ORS plus zinc supplementation. Predisposing factors of literacy of mothers/caregivers (adjusted odds ratio (AOR) = 2.4; 95% CI 1.4–4.1) and occupation (AOR = 2.6; 95% CI 1.5–4.6), the enabling factors of households monthly income of 50 United States Dollars (US$) and above (AOR = 2.9; 95% CI 1.5–5.6) and availability of nearest health facilities within 15 min walking distance (AOR = 3.3; 95% CI 1.7–6.6), and the need factors of recognizing danger signs of fever (AOR = 4.3; 95% CI 2.4–7.6) and vomiting (AOR = 3.3; 95% CI 1.8–5.9) were significantly associated with health-seeking behavior.ConclusionsIncreasing the proximity of health facilities in slums and health education and socioeconomic development programs targeting illiterate mothers/caregivers and poor households may promote and increase health-seeking behavior and the accessibility of health facilities for the treatment of acute diarrhea in under-five children in Addis Ababa slums.

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“…Studies conducted have found the decision-making authority to be the father as well as the mother and the process of decision-making a complex one involving the elders as well. [9] Health-care seeking behavior is also largely influenced by various sociodemographic factors which affect the pattern and time taken to seek health care. Factors such as age, sex, family size, education, sanitation, and hygiene influence health-care seeking behavior.…”

Section: Introductionmentioning

confidence: 99%

“…[4] Literature on health-care seeking behavior of parents regarding child health problems and factors affecting it, in an urban slum setting in India is scarce. [9] Hence, our aim is to study the health-care seeking behavior of parents, especially in the urban setting as it is a resource limited and underserved group. Hence, a thorough understanding of health-care seeking behavior is of utmost importance in planning and formulation of interventions for controlling and decreasing child morbidities in a developing country like India.…”

Section: Introductionmentioning

confidence: 99%

Study of health-care seeking behavior of parents for child health problems in an urban slum area of Solapur

Mandlik¹,

Haralkar²,

Mulaje³

et al. 2017

Int J Med Sci Public Health

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Determinants of Health Care Seeking for Diarrheal Illness in Young Children in Urban Slums of Kolkata, India

Cited by 32 publications

References 22 publications

Determinants and patterns of care-seeking for childhood illness in rural Pune District, India

Determinants and patterns of care-seeking for childhood illness in rural Pune District, India

Utilization of health facilities and predictors of health-seeking behavior for under-five children with acute diarrhea in slums of Addis Ababa, Ethiopia: a community-based cross-sectional study

Study of health-care seeking behavior of parents for child health problems in an urban slum area of Solapur

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