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The Impact of Socio-Economic Conditions and Clinical Characteristics on Improving Childhood Care Seeking Behaviors for Families Living far from the Health Facility

Received: 5 May 2013     Published: 30 May 2013
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Abstract

Background: Lack of proper transportation and poor road infrastructure to the health facility act as a strong barrier for the adequate accessibility to healthcare services. There is lack of evidence based information particularly in Bangladesh examining the relationship between health care seeking behavior of mothers for their children with diarrhea and barriers such as distance to be travelled in reaching health facility. Objective: This study explored the factors that determine improving care seeking behaviors by the caregivers of under-5 children with diarrhea and also measured its impact due to living too far from a tertiary health facility in rural Bangladesh. Methodology: From January 2010 to December 2011, a total of 2,324 under-five children with diarrhea received treatment at Kumudini Womens’ Medical College and Hospital, Mirzapur, Tangail. Among them, 1,919 (83%) received treatment at home before coming to the health facility. Based on median value of 4 miles needed to travel, we divided distance into two groups: (i) >4 miles, (ii)≤4 miles. Results: Forty nine percent (n=1,144) of the diarrheal children presented to the facility from a distance of >4 miles and 86% of them received treatment at home before reporting to the hospital. Multivariate analysis revealed that age [aOR=0.72 (95% confidence interval;0.53, 0.99) p-value=0.042], longer distance [1.46 ( 1.15, 1.86) 0.002], onset of diarrhea (≥3days) [3.19 (2.37, 4.30) <0.001], stool frequency (>10 times/24 hours) [2.72 (2.05, 3.60) <0.001], presence of blood in stool [0.41 (0.31, 0.54) <0.001], vomiting [1.78 (1.38, 2.30) <0.001] and rotavirus infection [2.08 (1.49, 2.91) <0.001] were significantly associated with prior healthcare seeking behavior of children after controlling for other confounders. On the other hand, longer distance of the facility from home for children who received prior treatment was associated with children aged <2 years old [1.62 (1.26, 2.09) <0.001], electricity in the household [1.59 (1.23, 2.05) <0.001], vomiting [1.26 (1.03, 1.54) 0.028] and fever [1.42 (1.10, 1.83) 0.007] after adjusting for other co-variates. Conclusions: Longer distance of health facility delays seeking appropriate medical care from the facility rather parent seeks care from facilities to the next door of the locality. Clinical features such as fever, vomiting, and more stool frequency influence parents to get prior treatment before reporting to health facility, whether, presence of blood in stool influence parents in reporting directly to the health facility.

Published in Science Journal of Public Health (Volume 1, Issue 2)
DOI 10.11648/j.sjph.20130102.14
Page(s) 69-76
Creative Commons

This is an Open Access article, 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 or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2013. Published by Science Publishing Group

Keywords

Diarrhea, Distance, Healthcare Seeking Behavior, Rural, Under-Five Children

References
[1] Dekate P, Jayashree M, Singhi SC, Management of acute diarrhea in emergency room. Indian J Pediatr, 2013, 80(3): 235-46.DOI: 10.1007/s12098-012-0909-3
[2] Peruzzo M, Milani GP, Garzoni L, et al., Body fluids and salt metabolism - part II. Italian Journal of Pediatrics, 2010, 36(1): 78.DOI: 1824-7288-36-78 [pii]10.1186/1824-7288-36-78
[3] Colvin CJ, Smith HJ, Swartz A, et al., 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 & Medicine, 2013, 86: 66-78.DOI: S0277-9536(13)00113-5 [pii] 10.1016/j.socscimed.2013.02.031
[4] Prohmmo A, Cook LA, Murdoch DR, Childhood diarrhoea in a district in northeast Thailand: incidence and treatment choices. Asia-Pacific Journal of Public Health, 2006, 18(2): 26-32.DOI:10.1177/10105395060180020501
[5] Nyamongo IK, Health care switching behaviour of malaria patients in a Kenyan rural community. Soc Sci Med, 2002, 54(3): 377-86
[6] Yamasaki-Nakagawa M, Ozasa K, Yamada N, et al., Gender difference in delays to diagnosis and health care seeking behaviour in a rural area of Nepal. International Journal of Tuberculosis and Lung Disease, 2001, 5(1): 24-31
[7] Rahman A ,Chowdhury S, Determinants of chronic malnutrition among preschool children in Bangladesh. J Biosoc Sci, 2007, 39(2): 161-73.DOI: 10.1017/S0021932006001295
[8] Alom J, Quddus MA, Islam MA, Nutritional status of under-five children in Bangladesh: a multilevel analysis. J Biosoc Sci, 2012, 44(5): 525-35.DOI: 10.1017/S0021932012000181
[9] Bhuiya A, Bhuiya I, Chowdhury M, Factors affecting acceptance of immunization among children in rural Bangladesh. Health Policy Plan, 1995, 10(3): 304-12
[10] Bentley ME, Elder J, Fukumoto M, et al., Acute childhood diarrhoea and maternal time allocation in the northern central Sierra of Peru. Health Policy Plan, 1995, 10(1): 60-70
[11] World Health Organization, Department of Child and Adolescent Health and Development, The Treatment of Diarrhea: A Manual for Physicians and Other Senior Health Workers. Geneva: World Health Organization. 1995.
[12] Qadri F, Khan AI, Faruque AS, et al., Enterotoxigenic Escherichia coli and Vibrio cholerae diarrhea, Bangladesh, 2004. Emerging Infectious Diseases, 2005, 11(7): 1104-1107.DOI: 10.3201/eid1107.041266
[13] Wold Health Organization, Manual for laboratory investigations of acute enteric infections. 1987: Programme for control of diarrhoeal disease, Geneva. (CDD/83.3 Rev. 1, 1987).
[14] Rahman M, De Leener K, Goegebuer T, et al., Genetic characterization of a novel, naturally occurring recombinant human G6P[6] rotavirus. Journal of Clinical Microbiology, 2003, 41(5): 2088-2095.DOI: 10.1128/JCM.41.5.2088-2095.2003
[15] Ahmed SM, Tomson G, Petzold M, et al., Socioeconomic status overrides age and gender in determining health-seeking behaviour in rural Bangladesh. Bull World Health Organ, 2005, 83(2): 109-17.DOI: /S0042-96862005000200011
[16] Amin R, Chowdhury SA, Kamal GM, et al., Community health services and health care utilization in rural Bangladesh. Soc Sci Med, 1989, 29(12): 1343-9
[17] Ashraf A, Chowdhury S, Streefland P, Health, disease and health-care in rural Bangladesh. Soc Sci Med, 1982, 16(23): 2041-54
[18] Rahman SA, Kielmann T, McPake B, et al., Healthcare-seeking behaviour among the tribal people of Bangladesh: Can the current health system really meet their needs? J Health Popul Nutr, 2012, 30(3): 353-65
[19] Rahman SA, Kielmann T, McPake B, et al., Healthcare-seeking behaviour among the tribal people of Bangladesh: Can the current health system really meet their needs? Journal of Health, Population and Nutrition, 2012, 30(3): 353-365
[20] Ahmed SM, Adams AM, Chowdhury M, et al., Gender, socioeconomic development and health-seeking behaviour in Bangladesh. Soc Sci Med, 2000, 51(3): 361-71
[21] Ahmed SM, Adams AM, Chowdhury M, et al., Changing health-seeking behaviour in Matlab, Bangladesh: do development interventions matter? Health Policy Plan, 2003, 18(3): 306-15
[22] Goldman N ,Heuveline P, Health-seeking behaviour for child illness in Guatemala. Tropical Medicine and International Health, 2000, 5(2): 145-155.DOI: tmi527 [pii]
[23] Yoder P ,Hornik R, Symptoms and perceived severity of illness as predictive of treatment for diarrhea in six Asian and African sites. Social Science & Medicine, 1996, 43(4): 429-439.DOI: 10.1016/0277-9536(95)00408-4
[24] Mahmood SS, Iqbal M, Hanifi SM, et al., Are 'Village Doctors' in Bangladesh a curse or a blessing? BMC Int Health Hum Rights, 2010, 10: 18.DOI: 10.1186/1472-698X-10-18
[25] Barros FC, Victora CG, Forsberg B, et al., Management of childhood diarrhoea at the household level: a population-based survey in north-east Brazil. Bull World Health Organ, 1991, 69(1): 59-65
[26] Ellis AA, Winch P, Daou Z, et al., Home management of childhood diarrhoea in southern Mali--implications for the introduction of zinc treatment. Soc Sci Med, 2007, 64(3): 701-12.DOI: 10.1016/j.socscimed.2006.10.011
[27] Bucher A, Rivara G, Briceno D, et al., [Use of a rapid rotavirus test in prescription of antibiotics in acute diarrhea in pediatrics: an observational, randomized, controlled study]. Rev Gastroenterol Peru, 2012, 32(1): 11-5
[28] Diniz-Santos DR, Silva LR, Silva N, Antibiotics for the empirical treatment of acute infectious diarrhea in children. Brazilian Journal of Infectious Diseases, 2006, 10(3): 217-227.DOI: S1413-86702006000300011 [pii]
[29] Hasan B, Sandegren L, Melhus A, et al., Antimicrobial drug-resistant Escherichia coli in wild birds and free-range poultry, Bangladesh. Emerging Infectious Diseases, 2012, 18(12): 2055-2058.DOI: 10.3201/eid1812.120513
[30] Mahmood SS, Iqbal M, Hanifi SM, et al., Are 'Village Doctors' in Bangladesh a curse or a blessing? BMC International Health and Human Rights, 2010, 10: 18.DOI: 1472-698X-10-18 [pii]10.1186/1472-698X-10-18
[31] Das SK, Nasrin D, Ahmed S, et al., Health Care-Seeking Behavior for Childhood Diarrhea in Mirzapur, Rural Bangladesh. Am J Trop Med Hyg, 2013.DOI: 10.4269/ajtmh.13-0107
[32] Konde-Lule JK, Elasu S, Musonge DL, Knowledge, attitudes, and practices and their policy implications in childhood diarrhoea in Uganda. Journal of Diarrhoeal Diseases Research, 1992, 10(1): 25-30
[33] Annis S, Physical access and utilization of health services in rural Guatemala. Soc Sci Med D, 1981, 15(4): 515-23
[34] Van der Stuyft P, Sorensen SC, Delgado E, et al., Health seeking behaviour for child illness in rural Guatemala. Tropical Medicine & International Health, 1996, 1(2): 161-170
[35] Rahman M ,Huq SS, Biodemographic and health seeking behaviour factors influencing neonatal and postneonatal mortality in Bangladesh: evidence from DHS data. East Afr J Public Health, 2009, 6(1): 77-84
[36] Mturi AJ ,Curtis SL, The determinants of infant and child mortality in Tanzania. Health Policy Plan, 1995, 10(4): 384-94
Cite This Article
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    Farzana Ferdous, Sumon Kumar Das, Shahnawaz Ahmed, Fahmida Dil Farzana, Guddu Kaur, et al. (2013). The Impact of Socio-Economic Conditions and Clinical Characteristics on Improving Childhood Care Seeking Behaviors for Families Living far from the Health Facility. Science Journal of Public Health, 1(2), 69-76. https://doi.org/10.11648/j.sjph.20130102.14

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    Farzana Ferdous; Sumon Kumar Das; Shahnawaz Ahmed; Fahmida Dil Farzana; Guddu Kaur, et al. The Impact of Socio-Economic Conditions and Clinical Characteristics on Improving Childhood Care Seeking Behaviors for Families Living far from the Health Facility. Sci. J. Public Health 2013, 1(2), 69-76. doi: 10.11648/j.sjph.20130102.14

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    AMA Style

    Farzana Ferdous, Sumon Kumar Das, Shahnawaz Ahmed, Fahmida Dil Farzana, Guddu Kaur, et al. The Impact of Socio-Economic Conditions and Clinical Characteristics on Improving Childhood Care Seeking Behaviors for Families Living far from the Health Facility. Sci J Public Health. 2013;1(2):69-76. doi: 10.11648/j.sjph.20130102.14

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  • @article{10.11648/j.sjph.20130102.14,
      author = {Farzana Ferdous and Sumon Kumar Das and Shahnawaz Ahmed and Fahmida Dil Farzana and Guddu Kaur and Mohammod Jobayer Chisti and Abu Syed Golam Faruque},
      title = {The Impact of Socio-Economic Conditions and Clinical Characteristics on Improving Childhood Care Seeking Behaviors for Families Living far from the Health Facility},
      journal = {Science Journal of Public Health},
      volume = {1},
      number = {2},
      pages = {69-76},
      doi = {10.11648/j.sjph.20130102.14},
      url = {https://doi.org/10.11648/j.sjph.20130102.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20130102.14},
      abstract = {Background: Lack of proper transportation and poor road infrastructure to the health facility act as a strong barrier for the adequate accessibility to healthcare services. There is lack of evidence based information particularly in Bangladesh examining the relationship between health care seeking behavior of mothers for their children with diarrhea and barriers such as distance to be travelled in reaching health facility. Objective: This study explored the factors that determine improving care seeking behaviors by the caregivers of under-5 children with diarrhea and also measured its impact due to living too far from a tertiary health facility in rural Bangladesh. Methodology: From January 2010 to December 2011, a total of 2,324 under-five children with diarrhea received treatment at Kumudini Womens’ Medical College and Hospital, Mirzapur, Tangail. Among them, 1,919 (83%) received treatment at home before coming to the health facility. Based on median value of 4 miles needed to travel, we divided distance into two groups: (i) >4 miles, (ii)≤4 miles. Results: Forty nine percent (n=1,144) of the diarrheal children presented to the facility from a distance of >4 miles and 86% of them received treatment at home before reporting to the hospital. Multivariate analysis revealed that  age [aOR=0.72 (95% confidence interval;0.53, 0.99) p-value=0.042], longer distance [1.46 ( 1.15, 1.86) 0.002], onset of diarrhea (≥3days) [3.19 (2.37, 4.30) 10 times/24 hours) [2.72 (2.05, 3.60) <0.001], presence of blood in stool [0.41 (0.31, 0.54) <0.001], vomiting [1.78 (1.38, 2.30) <0.001] and rotavirus infection [2.08 (1.49, 2.91) <0.001] were significantly associated with prior healthcare seeking behavior of children after controlling for  other confounders. On the other hand, longer distance of the facility from home for children who received prior treatment was associated with children aged <2 years old [1.62 (1.26, 2.09) <0.001], electricity in the household [1.59 (1.23, 2.05) <0.001], vomiting [1.26 (1.03, 1.54) 0.028] and fever [1.42 (1.10, 1.83) 0.007] after adjusting for other co-variates.  Conclusions: Longer distance of health facility delays seeking appropriate medical care from the facility rather parent seeks care from facilities to the next door of the locality. Clinical features such as fever, vomiting, and more stool frequency influence parents to get prior treatment before reporting to health facility, whether, presence of blood in stool influence parents in reporting directly to the health facility.},
     year = {2013}
    }
    

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  • TY  - JOUR
    T1  - The Impact of Socio-Economic Conditions and Clinical Characteristics on Improving Childhood Care Seeking Behaviors for Families Living far from the Health Facility
    AU  - Farzana Ferdous
    AU  - Sumon Kumar Das
    AU  - Shahnawaz Ahmed
    AU  - Fahmida Dil Farzana
    AU  - Guddu Kaur
    AU  - Mohammod Jobayer Chisti
    AU  - Abu Syed Golam Faruque
    Y1  - 2013/05/30
    PY  - 2013
    N1  - https://doi.org/10.11648/j.sjph.20130102.14
    DO  - 10.11648/j.sjph.20130102.14
    T2  - Science Journal of Public Health
    JF  - Science Journal of Public Health
    JO  - Science Journal of Public Health
    SP  - 69
    EP  - 76
    PB  - Science Publishing Group
    SN  - 2328-7950
    UR  - https://doi.org/10.11648/j.sjph.20130102.14
    AB  - Background: Lack of proper transportation and poor road infrastructure to the health facility act as a strong barrier for the adequate accessibility to healthcare services. There is lack of evidence based information particularly in Bangladesh examining the relationship between health care seeking behavior of mothers for their children with diarrhea and barriers such as distance to be travelled in reaching health facility. Objective: This study explored the factors that determine improving care seeking behaviors by the caregivers of under-5 children with diarrhea and also measured its impact due to living too far from a tertiary health facility in rural Bangladesh. Methodology: From January 2010 to December 2011, a total of 2,324 under-five children with diarrhea received treatment at Kumudini Womens’ Medical College and Hospital, Mirzapur, Tangail. Among them, 1,919 (83%) received treatment at home before coming to the health facility. Based on median value of 4 miles needed to travel, we divided distance into two groups: (i) >4 miles, (ii)≤4 miles. Results: Forty nine percent (n=1,144) of the diarrheal children presented to the facility from a distance of >4 miles and 86% of them received treatment at home before reporting to the hospital. Multivariate analysis revealed that  age [aOR=0.72 (95% confidence interval;0.53, 0.99) p-value=0.042], longer distance [1.46 ( 1.15, 1.86) 0.002], onset of diarrhea (≥3days) [3.19 (2.37, 4.30) 10 times/24 hours) [2.72 (2.05, 3.60) <0.001], presence of blood in stool [0.41 (0.31, 0.54) <0.001], vomiting [1.78 (1.38, 2.30) <0.001] and rotavirus infection [2.08 (1.49, 2.91) <0.001] were significantly associated with prior healthcare seeking behavior of children after controlling for  other confounders. On the other hand, longer distance of the facility from home for children who received prior treatment was associated with children aged <2 years old [1.62 (1.26, 2.09) <0.001], electricity in the household [1.59 (1.23, 2.05) <0.001], vomiting [1.26 (1.03, 1.54) 0.028] and fever [1.42 (1.10, 1.83) 0.007] after adjusting for other co-variates.  Conclusions: Longer distance of health facility delays seeking appropriate medical care from the facility rather parent seeks care from facilities to the next door of the locality. Clinical features such as fever, vomiting, and more stool frequency influence parents to get prior treatment before reporting to health facility, whether, presence of blood in stool influence parents in reporting directly to the health facility.
    VL  - 1
    IS  - 2
    ER  - 

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Author Information
  • International Centre for Diarrhoeal Disease Research, Bangladesh

  • International Centre for Diarrhoeal Disease Research, Bangladesh

  • International Centre for Diarrhoeal Disease Research, Bangladesh

  • International Centre for Diarrhoeal Disease Research, Bangladesh

  • University of Sydney, Sydney, Australia

  • International Centre for Diarrhoeal Disease Research, Bangladesh

  • International Centre for Diarrhoeal Disease Research, Bangladesh

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