Estimation in small areas: a trial on the prevalence of care seeking in case of fever in children under five years of age in 342 communes of Burkina Faso

Abstract

Background Generally caused by pneumonia and malaria, fever in children is one of the early signs easily identified by caregivers. These two diseases are also the leading causes of death among children under five in sub-Saharan Africa (SSA). This article proposes estimates of the prevalence of care seeking in the event of fever in children under five at the municipal level, the smallest geographical and administrative entity from which a local development policy can be driven and coordinated by the community. Methods The data used were collected during the 2018 malaria multiple indicator survey, those of the general population and housing census of 2019 as well as environmental data. The survey involved 5,489 children under 5 and the census 293,715 children under 5. The estimation approach used is that of Elbers Langjouw and Langjouw (ELL) which consists of combining, in a statistical model, data from several sources, mainly census and survey data, to obtain predictions at a geographical level lower than that of the survey, for indicators that are not measured in the population census. The method does this by finding correlations between common census variables and survey data. Result The results reveal communal inequalities in the prevalence of care seeking in case of fever in children under five. Of the 342 municipalities in which estimates have been made, 184 have prevalence below the national average, which is 68%. The commune of Toeni has the lowest prevalence of seeking care in the event of fever among the communes (47.2% with CI= [35.6; 58.7]). The highest prevalence is observed in the municipality of Loumbila with a value of 84.4% [76.6; 92.2]. Contribution : This article innovates by the analysis approach which is based on several sources of data to offer fine estimates, useful for more effective political action. Estimates at the municipal level will help localize interventions so that they are closer to the needs of the population and assess the effectiveness of programs and policy planning.