Factors Influencing Timely Response to Health Care Seeking for Diarrheal Episodes Among Children Under Five by Caregivers in Rural Uganda
Science Journal of Public Health
Volume 5, Issue 3, May 2017, Pages: 246-253
Received: Feb. 12, 2017; Accepted: Mar. 6, 2017; Published: Apr. 13, 2017
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James Muhumuza, Department of Health, HIV and Nutrition, World Vision, Kampala, Uganda
Lorna Barungi Muhirwe, Department of Health, HIV and Nutrition, World Vision, Kampala, Uganda
Charles Ssentamu, Department of Health, HIV and Nutrition, World Vision, Kampala, Uganda
Magnus Mordu Conteh, Global Health Programmes Strategic Partnerships and Innovation, World Vision, Dublin, Ireland
Nicola Martina Dunne, Global Health Programmes Strategic Partnerships and Innovation, World Vision, Dublin, Ireland
Rollanda Karumuna, Department of Environment Management, College of Agriculture and Environmental Sciences, Makerere University, Kampala, Uganda
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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.
Children, Diarrhea, Timely Health Care Seeking, Uganda
To cite this article
James Muhumuza, Lorna Barungi Muhirwe, Charles Ssentamu, Magnus Mordu Conteh, Nicola Martina Dunne, Rollanda Karumuna, Factors Influencing Timely Response to Health Care Seeking for Diarrheal Episodes Among Children Under Five by Caregivers in Rural Uganda, Science Journal of Public Health. Vol. 5, No. 3, 2017, pp. 246-253. doi: 10.11648/j.sjph.20170503.23
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C. L. F. Walker, I. Rudan, L. Liu, H. Nair, E. Theodoratou and Z. A. Bhutta, “Global burden of childhood pneumonia and diarrhoea,” Lancet, Vol. 381, No. 9875, 2013, pp. 1405-1416.
CDC, “Diarrhea: Common Illness, Global Killer,” 2016. http://www.cdc.gov/healthywater/global/diarrhea-burden.html.
R. K. Kakulu, “Diarrhoea among under five children and household water treatment and safe storage factors in Mkuranga District, Tanzania,”, (MSc Dissertation). Applied Epidemiology: Muhimbili University of Health and Allied Sciences, 2012.
A. Q. Aigbokhaode, E. C. Isah and A. R. Isara, “Health seeking behaviour among caregivers of under-five children in Edo State, Nigeria,” SEEJPH, Vol. 10, pp. 20152014-2041.
UNICEF/WHO, “Diarrhea: why children are still dying and what can be done,” 2009. http://apps.who.int/iris/bitstream/10665/44174/1/9789241598415_eng.pdf.
C. Boschi-Pinto, C. F. Lanata, W. Mendoza and D. Habte, “Diarrheal diseases”. In D. Jamison, R. Feachem, M. Makgoba, E. Bos, F. Baingana, K. Hofman, et al. (Eds). “Disease and mortality in Sub- Saharan Africa,” Washington, DC: World Bank, 2006; ch. 9.
G. H. Tee, G. Kaur, P. Ramanathan, N. M. Amal and K. Chinna, “Health seeking behavior among Malaysians with acute diarrheal disease,” Southeast Asian Journal of Tropical Medicine and Public Health, Vol. 42, No. 2, 2011, pp. 424-435.
C. F. Walker, J. Perin, M. Aryee, C. Boschi-Pinto and R. Black, “Diarrhea incidence in low- and middle-income countries in 1990 and 2010: a systematic review,” BMC Public Health, Vol. 12, 2012, pp. 220-233.
C. Boschi-Pinto, L. Velebit and K. Shibuya, “Estimating child mortality due to diarrhoea in developing countries,” Bulletin of the World Health Organization, Vol. 86, No. 9, 2008, pp. 710-717.
UBOS, “Uganda Demographic and Health Survey”, Uganda Bureau of Statistics and Macro International Inc Calverton, Maryland, USA; 2011.
C. J. Colvin, H. J. Smith, A. Swartz, J. W. Ahs, J. Heer and N. Opiyo, “Understanding careseeking for child illness in sub-Saharan Africa: a systematic review and conceptual framework based on qualitative research of household recognition and response to child diarrhoea, pneumonia and malaria,” Social Science and Medicine, Vol. 86, 2013, pp. 66-78.
B. M. Bagbi, O. Anthonia and E. F. O. Enato, “Assessment of Care-seeking Behaviour for Under Five Years Old Children with Malaria and Other Childhood Illnesses in Some Communities in Edo State, Nigeria,” Journal of Science and Practice of Pharmacy, Vol. 1, No. 1, 2014, pp. 49-58.
World Vision, “Access to Infant and Maternal Health (Aim Health)” Project Endline Review Evaluation Report Kampala-Uganda, Final Report of First Africa, 2015.
T. Assefa, T. Belachew, A. Tegegn and A. Deribew, “Mothers’ health care seeking behavior for childhood illnesses in Derra District, Northshoa Zone, Oromia Regional State, Ethiopia,” Ethiopian Journal of Health Sciences, Vol. 18 No. 3, 2008, pp. 87-94.
A. L. Page, S. Hustache, F. J. Luquero, A. Djibo, M. L. Manzo and R. F. Grais, “Health care seeking behavior for diarrhea in children under 5 in rural Niger: results of a cross-sectional survey,” BMC Public Health, Vol. 11, 2011, pp. 389-397.
W. Gao, S. Dang, H. Yan and D. Wang, “Care-seeking pattern for diarrhea among children under 36 months old in rural western China” PLoS ONE, Vol. 7, No. 8, 2012, e43103.
M. Azage and D. Haile, “Factors affecting healthcare service utilization of mothers who had children with diarrhea in Ethiopia: evidence from a population based national survey,” Journal of rural and remote health research, Vol. 15, 2015, pp. 3493-401.
M. Ansari, M. I. M. Ibrahim, M. A. Hassali, P. R. Shankar, A. Koirala and N. J. Thapa, “Mothers’ beliefs and barriers about childhood diarrhea and its management in Morang district, Nepal,” BMC research notes, Vol. 5, 2012, 576-588.
S. E. Wilson, C. T. Ouédraogo, P. Lea, A. Ouédraogo, S. Y. Hess and N. Rouamba, “Caregiver recognition of childhood diarrhea, care seeking behaviors and home treatment practices in rural Burkina Faso: A cross-sectional survey,” PLoS ONE, Vol. 7, 2012, pp. 33273-33286.
G. Gregorio, L. Dans, C. Cordero and C. Panelo, “Zinc supplementation reduced cost and duration of acute diarrhea in children,” Journal of Clinical Epidemiology, Vol. 60, No. 6, 2007, pp. 560-566.
D. Collins, Z. Jarrah, K. D. Wright and A. C. Lee, “The cost of integrated community health services for treating child pneumonia, diarrhoea, and malaria in three African countries: economic research using systematic sampling”. The Lancet, Vol. 381, 2013, S31.
N. Taffa and G. Chepngeno, “Determinants of health care seeking for childhood illnesses in Nairobi slums,” Tropical Medicine and International Health, Vol. 10, No. 3, 2005, pp. 240-245.
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