Trends and Factors Associated with Healthcare Utilization for Childhood Diarrhea and Fever in Ethiopia: Further Analysis of the Demographic and Health Surveys from 2000 to 2016

Abstract

Background. Healthcare use for childhood illness reduces the risk of under-five deaths from common preventable diseases. However, rates of healthcare seeking for childhood diarrhea and fever remain low in most low- and middle-income countries including Ethiopia. This study aimed to assess the trends and factors for healthcare diarrhea and fever in Ethiopia from 2000 to 2016. Methods. Analysis of healthcare use for diarrhea and fever trends was done using data from four Ethiopian Demographic Health Surveys. Descriptive statistics were used to report sample characteristics and healthcare use for diarrhea and fever trends, and chi-square tests were used to assess associations between independent variables and healthcare utilization in each survey. Binary logistic regression analysis was fitted to find the factors related to healthcare utilization for diarrhea and fever. All variables with odds ratio p values <0.05 were considered as significant determinants of the outcome. Results. Healthcare seeking for diarrheal illness significantly increased from 13% (95% CI: 12.5–13.5) in 2000 to 44% (95% CI: 43.2–44.78) in 2016, while healthcare uses for fever significantly increased from 22% (95% CI: 16.7–27.3) in 2000 to 35% (95% CI: 34.3–35.7) in 2016. Factors of healthcare seeking for diarrhea in 2000–2016 were as follows: maternal age <30 years, urban residence, being a male child, nonexposure to mass media and not hearing information about oral rehydration, no desire to have more children, poor wealth index, and region. Meanwhile, factors for healthcare seeking for fever in 2000–2016 were as follows: a long distance from the nearest health facilities, first birth order, nonexposure to mass media, no desire to have more children, maternal age <30 years, urban residence, region, absence of antenatal and postnatal care utilization, poor wealth index, and being born from uneducated mothers (p values < 0.05). Conclusions. Factors associated with healthcare utilization for diarrhea and fever differed between 2000 and 2016. Though Ethiopia has achieved a significant reduction in under-five mortality, it needs to accelerate the reduction through strengthening healthcare utilization for common childhood illness to avoid deaths from preventable diseases.

Individual- and Community-Level Risk Factors Associated with Childhood Diarrhea in Ethiopia: A Multilevel Analysis of 2016 Ethiopia Demographic and Health Survey

“…It was found that children whose birth order 4 th and above were more likely to be affected by diarrhea than 1st order children. It coincides with the previous studies in which birth order of a child increases and the probability of developing childhood diarrhea increases [ 8 , 15 , 33 ].…”

Barriers to accessing healthcare among women in Ghana: a multilevel modelling

“…Health insurance enables women to afford medical care, freely choose the type of care and choose between medical institutions according to their needs and expectations of care, without worrying about the cost [17]. We further observed that access to mass media showed decreased odds of healthcare accessibility barriers, which confirms previous studies in Ethiopia [47], India [48], Bangladesh [49], and rural Malawi [50]. The reason for this could be that listening to the radio and watching television increases ones' health literacy, which has been identified as key to healthcare utilization [51].…”

Mixed effects analysis of factors associated with barriers to accessing healthcare among women in sub-Saharan Africa: Insights from demographic and health surveys

“…Exposure to mass media also showed decreased odds of healthcare accessibility barriers, which corroborates earlier studies in Ethiopia [ 40 ], India [ 41 ], Bangladesh [ 42 ], and rural Malawi [ 43 ]. The reason for this could be that listening to radio, reading newspaper, and watching television increase ones’ health literacy, which has been identified as a key enabler to healthcare utilization [ 44 ].…”