The prevalence and root causes of delay in seeking healthcare among mothers of under five children with pneumonia in hospitals of Bahir Dar city, North West Ethiopia

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Abstract

Background

Globally pneumonia is the leading cause of under-five child mortality. Several risk factors for pneumonia mortality have been identified, including delay in seeking health care. For successful reduction of delay in seeking healthcare, further evidence is crucial on its magnitude and factors associated with it in the country particularly in the study area. Therefore, this study aimed to determine the prevalence and root causes of delay in seeking health care among mothers of under-five children with pneumonia in hospitals of the Bahir Dar city, 2019.

Methods

A hospital-based cross-sectional study was conducted from March 15 to May 15, 2019 among 356 mothers of under-five children with pneumonia in hospitals of the Bahir Dar city. The study participants were selected by using a stratified sampling technique and data was collected through face to face interview. Binary logistic regression was used to identify the associated factors of delay in seeking healthcare. The P - value < 0.05 was considered statistically significant. Associations between outcome and exposure variables were expressed by the adjusted odds ratio with a 95% confidence interval (CI).

Results

A total of 356 mothers participated in the study yielded a response of 89.4%. The proportion of delay in seeking health care was 48.6%. Rural residence (AOR = 2. 3, 95% CI: 1.1, 4.9, seek healthcare in a governmental hospital (AOR = 3. 3, 95% CI: 1.8, 6.1), health care decision by mothers (AOR = 2. 9, 95% CI: 1.6, 5.4), poorest household (AOR = 2. 8, 95% CI: 1.1, 7.2), using self-medication (AOR = 7. 5, 95% CI: 3.8, 14.7), using traditional medicine before healthcare-seeking (AOR = 2. 7, 95% CI: 1.4, 5.1), and no information about early healthcare-seeking for childhood pneumonia treatment (AOR = 5. 1, 95% CI: 2.8, 9.1) were the identified determinants significantly associated with delay in seeking healthcare among mothers of under-five children with pneumonia.

Conclusion

This study showed that nearly half of the mothers delayed in seeking healthcare. Rural residence, healthcare seeking at government hospitals, healthcare decision by mothers, poorest household, using self-medication, using traditional medicine before health care seeking, and lack of information about early healthcare-seeking were factors associated with a delay in seeking healthcare for under-five children with pneumonia. Hence, the government and other concerned stakeholders should give due emphasis to tackle on the identified causes of delay in seeking health care for the under five children with pneumonia.

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Most cited references 8

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Delayed care seeking for fatal pneumonia in children aged under five years in Uganda: a case-series study.

George Pariyo, Karin Källander, Helena Hildenwall … (2008)

To review individual case histories of children who had died of pneumonia in rural Uganda and to investigate why these children did not survive. This case-series study was done in the Iganga/Mayuge demographic surveillance site, Uganda, where 67 000 people were visited once every 3 months for population-based data and vital events. Children aged 1-59 months from November 2005 to August 2007 were included. Verbal and social autopsies were done to determine likely cause of death and care-seeking actions. Cause of death was assigned for 164 children, 27% with pneumonia. Of the pneumonia deaths, half occurred in hospital and one-third at home. Median duration of pneumonia illness was 7 days, and median time taken to seek care outside the home was 2 days. Most first received drugs at home: 52% antimalarials and 27% antibiotics. Most were taken for care outside the home, 36% of whom first went to public hospitals. One-third of those reaching the district hospital were referred to the regional hospital, and 19% reportedly improved after hospital treatment. The median treatment cost for a child with fatal pneumonia was US$ 5.8. There was mistreatment with antimalarials, delays in seeking care and likely low quality of care for children with fatal pneumonia. To improve access to and quality of care, the feasibility and effect on mortality of training community health workers and drug vendors in pneumonia and malaria management with prepacked drugs should be tested.

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Determinants of delay in care seeking among children under five with fever in Dodoma region, central Tanzania: a cross-sectional study

Telemu Kassile, Razack Lokina, Phares GM Mujinja … (2014)

Background Early diagnosis and timely treatment of malaria is recognized as a fundamental element to the control of the disease. Although access to health services in Tanzania is improved, still many people seek medical care when it is too late or not at all. This study aimed to determine factors associated with delay in seeking treatment for fever among children under five in Tanzania. Methods A three-stage cluster sampling design was used to sample households with children under five in Dodoma region, central Tanzania between October 2010 and January 2011. Information on illness and health-seeking behaviours in the previous four weeks was collected using a structured questionnaire. A multivariable logistic regression was used to investigate determinants of delay in treatment-seeking behaviour while accounting for sample design. Results A total of 287 under-five children with fever whose caretakers sought medical care were involved in the study. Of these, 55.4% were taken for medical care after 24 hours of onset of fever. The median time of delay in fever care seeking was two days. Children who lived with both biological parents were less likely to be delayed for medical care compared to those with either one or both of their biological parents absent from home (OR = 0.42, 95% CI: 0.24, 0.74). Children from households with two to three under-five children were more likely to be delayed for medical care compared to children from households with only one child (OR = 1.54, 95% CI: 1.04, 2.26). Also, children living in a distance ≥5 kilometres from the nearest health facility were about twice (95% CI: 1.11, 2.72) as likely to delay to be taken for medical care than those in the shorter distances. Conclusion Living with non-biological parents, high number of under-fives in household, and long distance to the nearest health facility were important factors for delay in seeking healthcare. Programmes to improve education on equity in social services, family planning, and access to health facilities are required for better healthcare and development of children.

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Health Care Seeking Behavior for Common Childhood Illnesses in Jeldu District, Oromia Regional State, Ethiopia

Tufa Kolola, Takele Gezahegn, Mesfin Addisie (2016)

Background Even though health care seeking interventions potentially reduce child mortality from easily treatable diseases, significant numbers of children die without ever reaching a health facility or due to delays in seeking care in Ethiopia. This study aimed to assess health care seeking behavior for common childhood illnesses and associated factors. Methods A community-based cross-sectional study was conducted in Jeldu District from January to February 2011. A systematic sampling method was used for sample selection. Data were collected from 422 caregivers with under-five children who experienced diseases within six weeks before the survey. Interviewer administered structured and pre-tested questionnaire which were used to collect data. Data entry and cleaning were carried out using Epi Info version 3.5.1 and analyzed using SPSS version 16. Descriptive analysis was done to determine the magnitude of health care seeking behavior. Multivariate logistic regression analyses were performed to identify associated factors. Results A total of 422 caregivers of under-five children were participated in the study giving an overall response rate of 97.5%. Three hundred fifteen (74.6%) children sought care from health facilities for all conditions. However, only 55.4% of them were taken to health facilities as first source treatment during their illness and prompt care was also very low (13.7%). Marital status of the caregivers (AOR = 2.84; 95%CI: 1.62–4.98), number of symptoms experienced by the child (AOR = 2.04; 95%CI: 1.24–3.36) and perceived severity of the illness (AOR = 3.20; 95%CI: 1.96–5.22) were predictors of health care seeking behavior. Conclusion Health care seeking behavior for childhood illnesses was delayed and decision to seek care from health facilities was influenced by worsening of the illnesses. Thus, community level promotion of prompt health care seeking is essential to enhance the health care seeking behavior for child hood illnesses in the locality.

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Author and article information

Contributors

Getasew Mulat Bantie:

ORCID: http://orcid.org/0000-0002-5073-6767

getasewmulat@gmail.com

Zemene Meseret: zemeneepid@gmail.com

Melkamu Bedimo: melkamubb@gmail.com

Abebayehu Bitew: abebayehubitew@gmail.com

Journal

Journal ID (nlm-ta): BMC Pediatr

Journal ID (iso-abbrev): BMC Pediatr

Title: BMC Pediatrics

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2431

Publication date (Electronic): 9 December 2019

Publication date PMC-release: 9 December 2019

Publication date Collection: 2019

Volume: 19

Electronic Location Identifier: 482

Affiliations

[1 ]GAMBY Medical and Business College, department of Public Health, Bahir Dar, Ethiopia

[2 ]Felegehiwot comprehensive specialized hospital, Bahir Dar, Ethiopia

[3 ]ISNI 0000 0004 0439 5951, GRID grid.442845.b, Department of Biostatistics and Epidemiology, , Bahir Dar university, ; Bahir Dar, Ethiopia

Author information

Getasew Mulat Bantie http://orcid.org/0000-0002-5073-6767

Article

Publisher ID: 1869

DOI: 10.1186/s12887-019-1869-9

PMC ID: 6900847

PubMed ID: 31815630

SO-VID: e8a8c9e6-c0a7-4111-9101-a724e85706c2

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 31 July 2019

Date accepted : 3 December 2019

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ScienceOpen disciplines: Pediatrics

Keywords: pneumonia,delay in seeking healthcare,associated factor,children,ethiopia

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ScienceOpen disciplines: Pediatrics

Keywords: pneumonia, delay in seeking healthcare, associated factor, children, ethiopia

The prevalence and root causes of delay in seeking healthcare among mothers of under five children with pneumonia in hospitals of Bahir Dar city, North West Ethiopia

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Chinese Journal of School Health

Most cited references 8

Delayed care seeking for fatal pneumonia in children aged under five years in Uganda: a case-series study.

Determinants of delay in care seeking among children under five with fever in Dodoma region, central Tanzania: a cross-sectional study

Health Care Seeking Behavior for Common Childhood Illnesses in Jeldu District, Oromia Regional State, Ethiopia

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