Factors Influencing Timely Response to Health Care Seeking for Diarrheal Episodes Among Children Under Five by Caregivers in Rural Uganda

Abstract

Timely response to health care seeking for diarrhoea episodes has a high potential to reduce child mortality rates.This study aimed to investigate the factors influencing timely response to health care seeking for diarrheal episode among children under five by caregivers. A cross-sectional research design that involved qualitative and quantitative research methods was conducted among 1,780 systematically selected households. Multiple logistic regressions were carried out to identify the factors associated with timely health care seeking behaviors among caregivers. Over 76% (95% CI: 72.8-78.4%) of the caregivers sought treatment in the first 24 hours after the onset of the diarrhea episode. Caregivers who were aged 30-39 were 0.63 times less likely to seek timely treatment for diarrhea episode (adjusted odds ratio (AOR) =0.83, 95%CI: 0.34-1.99) compared to caregivers who were aged 19-29 years. Female caregivers were 1.95 times more likely to seek timely treatment (adjusted odds ratio (AOR) =1.95, 95%CI: 1.05-1.11) compared to males. Those caregivers who had no education were 0.32 times less likely to seek timely treatment (adjusted odds ratio (AOR) =0.51, 95%CI: 0.69-1.09) compared to caregivers that had secondary education. Caregivers who knew the signs of diarrhoea were 0.97 times more likely to seek timely treatment (adjusted odds ratio (AOR) =0.97, 95%CI: 0.54-3.32) compared to caregivers who did not know the signs of diarrhea. Caregivers who believed that diarrhea kills were 2.41 times more likely to seek timely treatment (adjusted odds ratio (AOR) =2.41, 95%CI: 2.03-2.94) compared to caregivers who did not believe that diarrhea kills. Caregivers who stayed near the health units (≤5km) were 0.57 times likely to seek timely health care compared to those who stayed in far places. Health care seeking within 24 hours for diarrheal episodes among children under five by caregivers was found to be high in the selected study areas. Knowledge about signs of diarrhoea, belief that diarrhoea kills, knowledge about administering ORS, fair transport cost, waiting time and distance from the health units are the factors that influence timely health seeking among children with diarrhoea. The study recommends intensification of timed and targeted counseling (ttC) of caregivers about timely health seeking in the subsequent programming and equipping VHTs with diarrhea treatment medicines.

Health care utilization for common childhood illnesses in rural parts of Ethiopia: evidence from the 2016 Ethiopian demographic and health survey

“…The observations of our study indicated that health care utilization for diarrhea illness was in agreement with a study conducted in the rural parts of South Africa (50%) [31]. On the other hand, our finding is lower than previous studies conducted in the rural parts of Niger (70.4%) and Uganda (76%) [17, 19]. The finding of the study also showed that health care utilization for fever illness was higher than a study conducted in Nigeria [32].…”

“…In the rural parts of Kenya, health care was sought for only one-third of the children with both fever and diarrhea illnesses [16], and 82% of the caregivers used health centers for treating diarrhea in rural Uganda [17]. Nearly three-quarters (74.3%) of the children with fever, 77.3% of the children with Acute Respiratory Infection (ARI) and 23.0% of the children with diarrhea were initially treated at a health facilities in rural Tanzania [18].…”

Determinants of delay in care seeking for diarrheal diseases among mothers/caregivers with under-five children in public health facilities of Arba Minch town, southern Ethiopia; 2019

“…Mothers/caregivers of female children were more likely to delay than mothers/caregivers of male children. The finding is consistent with previous research in Woliso, Ethiopia, India and rural Uganda [18,24,28] and study reported by Global DHS on care seeking and access to health care for childhood illness reported that males were more likely to seek care early [25]. In addition, the existing literature in different developing countries regarding health care seeking for females display that female disadvantage in health care seeking [29].…”

<p>Determinants of Delayed Treatment-Seeking for Childhood Diarrheal Diseases in Southwest Ethiopia: A Case–Control Study</p>

“…This finding is consistent with results from other studies. 7,15 Being far away from health facilities imposes a challenge on mothers/ caregivers because it enforces them to travel long distances which could result in tiredness, being off from a job, and may incur additional costs for transportation.…”

“…13 Delayed care seeking could affect child health significantly and can lead to complications that make medical care less effective or, in some cases, useless. 14 The majority of caregivers of children with diarrheal diseases in developing counties did not seek healthcare timely 7,11,15 or not sought at all. [16][17][18][19][20] For instance, a study from India reported that about 33.8% of children with diarrheal diseases were taken to a health facility one day after the onset of the illness.…”