The Recognition of and Care Seeking Behaviour for Childhood Illness in Developing Countries: A Systematic Review

Abstract

BackgroundPneumonia, diarrhoea, and malaria are among the leading causes of death in children. These deaths are largely preventable if appropriate care is sought early. This review aimed to determine the percentage of caregivers in low- and middle-income countries (LMICs) with a child less than 5 years who were able to recognise illness in their child and subsequently sought care from different types of healthcare providers.Methods and FindingsWe conducted a systematic literature review of studies that reported recognition of, and/or care seeking for episodes of diarrhoea, pneumonia or malaria in LMICs. The review is registered with PROSPERO (registration number: CRD42011001654). Ninety-one studies met the inclusion criteria. Eighteen studies reported data on caregiver recognition of disease and seventy-seven studies on care seeking. The median sensitivity of recognition of diarrhoea, malaria and pneumonia was low (36.0%, 37.4%, and 45.8%, respectively). A median of 73.0% of caregivers sought care outside the home. Care seeking from community health workers (median: 5.4% for diarrhoea, 4.2% for pneumonia, and 1.3% for malaria) and the use of oral rehydration therapy (median: 34%) was low.ConclusionsGiven the importance of this topic to child survival programmes there are few published studies. Recognition of diarrhoea, malaria and pneumonia by caregivers is generally poor and represents a key factor to address in attempts to improve health care utilisation. In addition, considering that oral rehydration therapy has been widely recommended for over forty years, its use remains disappointingly low. Similarly, the reported levels of care seeking from community health workers in the included studies are low even though global action plans to address these illnesses promote community case management. Giving greater priority to research on care seeking could provide crucial evidence to inform child mortality programmes.

Pediatric out-of-hospital deaths following hospital discharge: a mixed-methods study

“…However, the experiences of patients and caregivers from other hospitals and in other countries are reported similar to what we found. 19,24 Our sampled hospitals included a typical regional government hospital, similar to others in East Africa, and a private mission hospital. This mixture of health facilities provides as diverse a sample as could be derived from a single area.…”

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

“…[8] Studies have suggested that this delay could be attributed to factors such as cost of health care, consulting with the head of family or grandparents before seeking health care. [3] The decision-making authority is an equally important factor which influences health-care seeking behavior of parents. 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.…”

Impact of community oriented interventions on pediatric care-seeking practices - a multi-country study in Cambodia, Guatemala, Kenya And Zambia

“…ARI and fever symptoms were more frequently reported in Asia [21]. This study showed a higher proportion of care-seeking for ARI and fever than diarrhea for Cambodia, although proportions reporting no care were almost similar for fever and diarrhea for Kenya and Zambia.…”

“…This may be partly attributed to the CHW health promotion and community engagement strategies including Community Voice and Action and Community Scorecards in the intervention sites, encouraging service utilization and measures to enhance provider trust and facility operations and performance, though causal associations cannot be made. Convenience, promptness of care, courteous staff, and perceived quality of care, have been previously reported as reasons for seeking care from private rather than public facilities [21].…”