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Metrics details. Seeking healthcare in children is unique since parents decide upon the type and frequency of healthcare services accessed. Ten health centers were selected using simple random sampling technique and proportionate of participants were included from each health centers. A pre-tested, semi-structured questionnaire was used to collect data. Data were analyzed using SPSS version Descriptive statistics was used to summarize socio-demographic characteristics and multivariable logistic regression was employed to identify factors associated with of healthcare seeking behavior.
In case of illnesses, Among the common childhood illnesses, acute respiratory tract infection and diarrhea ed for The common under-five childhood illnesses were acute respiratory tract infection and diarrhea. Peer Review reports. Children are the most vulnerable age group in any community; hence, the under-five mortality rate U5MR is a widely used demographic measure and an important indicator of the level of welfare in countries [ 1 ]. In the face of these gains, however, half a million children are dying each year from easily preventable diseases [ 4 ].
Globally, more than half of early childhood complications and deaths are due to ill health that can be prevented or treated with simple and affordable interventions [ 5 , 6 ]. In sub-Saharan Africa, 1 in 12 child dies before celebrating the fifth birthday [ 2 , 7 ] and 1 in 11 Ethiopian child dies before the fifth birthday [ 8 ].
Infectious diseases turn out to be the most common causes of child morbidity and mortality in most developing countries; Ethiopia being the forefront [ 5 , 7 ]. Furthermore, they are major causes of under-five mortality as well as inpatient admissions [ 9 ]. Studies suggest that common causes of under-five morbidity and mortality in developing countries could substantially be reduced with timely healthcare seeking behavior HCSB of their families [ 10 ]. On the contrary, studies substantiate that a large of sick children do not visit health facilities [ 11 ].
This means that most children die without ever reaching a health facility and due to delays in seeking healthcare [ 5 ]. Healthcare seeking behavior is not only because of availability of health facilities and other sources of healthcare but also motivation and ability of individuals to seek medical care.
Seeking healthcare in children is unique as parents decide upon the type and frequency of healthcare service accessed [ 12 ]. Poor socio-economic status, attitude to modern treatment, low literacy level of the parents, large family size, and of symptoms, experience of child illness and death, and perceived severity of illness were the most commonly mentioned factors affecting HCSB [ 5 ].
First and foremost, mothers in developing countries usually do not have sufficient knowledge to recognize danger s or what appropriate treatment should be to their child health [ 10 ]. Secondly, millions of mothers and their children live in remote areas, where the social environment is against seeking healthcare [ 6 ]. Thirdly, parental belief and anticipation about the outcome of therapy was identified as a barrier or early termination in seeking treatment for their children [ 5 ].
Improving families HCSBs for their children can contribute to ificantly reduce morbidity and mortality of under-five children. In addition, effective management of childhood illness necessitates a partnership between families and health workers.
Maternal practices regarding child healthcare have been recognized as the main factor behind preventing morbidities and mortality among children [ 14 ]. A facility-based cross-sectional study was conducted in Addis Ababa, Ethiopia between April 18 to May 11, Administratively Addis Ababa is divided into 10 sub-cities and it has a total of 56 hospitals 14 of which are public and 96 health centers [ 16 ]. The city administration has a total population of 3,,; where 7. The sample size was determined by using single proportion formula [ 17 ].
A total of five sub-cities and ten health centers; two health centers from each sub-city Kotebe, Yeka, Shiromeda, Hidasse, Lomimeda, Keranio, Arada, Churchill, Woreda amest and Woreda hulet health centers were selected using simple random sampling method by employing lottery method. Data were collected using a pre-tested, semi-structured questionnaire consisting of 33 questions Additional file 1.
It was developed by reviewing works of literature [ 1 , 12 , 18 ] and modified to the study context. It was initially prepared in English and then translated into local language, Amharic and then re-translated into English to check its consistency. Two health officers and five clinical nurses were recruited as supervisors and data collectors, respectively. To avoid potential bias, it was ensured that data collectors were not working in the under-five outpatient department as well as in the sampled health centers.
They attended a one-day training focused on the aim of the study and detailed review of the tools. Besides the practical training, adequate supervision and follow up were done by the supervisors to maximize the quality of the data collected.
Data were checked for completeness, coded and entered into EPI-info version 3. Descriptive statistics like graphs, tables, frequency, percentage and standard deviation were computed to describe the events. The presence and strength of association of outcome variable were assessed using multivariable logistic regression. Prior to data collection, the data collectors explained the purpose of the study in Amharic local language and read to them an informed consent script which was approved by the ethics committee.
Participants were also assured of the confidentiality and anonymity of the information obtained. Permission to conduct the study was also sought from the selected health facilities. Collected questionnaires were coded and locked in a lockable cabinet in order to maintain confidentiality of the information obtained. Of these, Three hundred sixty three Three hundred seventy two The mean of family size was 3. More than half From the result, the commonest childhood diseases that were confirmed by health professionals for under-five children were ARI and diarrhea, which s for Thirty eight 9.
One hundred twelve On the other hand, A quarter The likelihood of seeking healthcare among children was 3. Almost half of the under-five children in this study had ARI and The high prevalence of diarrhea could be attributed to the short term rainy season during the data collection period which might have degraded surface and ground water microbial quality.
In this result, families that have less than or equal to five members were four times more likely to seek healthcare for the sick child when compared to those having greater than five members. This shows that children born from larger family size are also less likely to get immediate care from health facilities. Likewise, in Tanzania showed that children from households having two to three under-five children were more likely to receive medical care late than those from households which had only one under-five child [ 21 ].
Furthermore, financial restraints of large family members to visiting health facilities was related to family size [ 6 , 22 ]. This implies that the higher the level of education, the better the HCSB. This might be due to the fact that educated mothers are more likely to be able to read thereby, understand better and adopt practices for a preventive and curative child as promoted through health education in outreach programs or by healthcare providers. This result showed that This means that healthcare seeking in a health facility is delayed. Their tendency to try home remedies; lack of money; and their thought that the illness was mild or will resolve by its self were mentioned as some of the reasons for a delay in seeking healthcare [ 1 , 25 ].
Alike this, result in South Africa found that, treatment by home remedies was the most common first action by caretakers for children [ 26 ]. In many areas, modern pharmaceutical agents are a commonly misused as a first-line therapy for the home treatment of childhood illnesses or they serve as an alternative when traditional remedies fail [ 28 ]. Comparably in Nepal, Similarly, a study in Yemen reported that most frequent first response was purchasing over-the-counter medicines [ 1 ].
Unless regulated, this irrational use of medicines will contribute to increasing undesirable consequences of medicines like the development of antibiotic resistance [ 30 ]. Hence, strong regulatory enforcement should be in place to prohibit over-the-counter sales of prescription-only-medicines from the community pharmacies and efforts should be made to encourage families to promptly visit health facilities. It is also true that people use first what is most easily available to them, but when the illnesses is serious, they start to make a greater effort in order to try something better [ 1 ].
This implies that perceived risk and severity of the illness as well as, prior bad experience can influence the initiation of HCSB. Acute Respiratory Infection and diarrhea were the most common childhood illnesses in under-five children. The study also showed that there was a delay in seeking healthcare to the sick children. Factors affecting health seeking behavior for common childhood illnesses in Yemen. Patient Preference and Adherence. Article Google Scholar. Ethiopia Demographic and Health Survey Key Indicators Report. Determinants of mothers health seeking behaviour for their children in a Nigerian teaching hospital.
Ethiopia J Health Sci. Google Scholar. Commiting to child survival: A promised Renewed: Progress Repor Morbidity profile of preschool children from below poverty line families of Lucknow district, North India. Int J Adv Res. State of inequalty: Reproductive, maternal,newborn and child health. WHO, Geneva, Switzerland, Awoke W. Open Journal of Preventive Medicine. MacKian S. Health Systems Development Programme: a review of health seeking behavior -problems and prospects.
Estimating child mortality due to diarrhoea in developing countries. Bulletin World Health Organization. Diarrhea: Why children are still dying and what can be done. The Lancet. Available at: [ whqlibdoc. Lwanga SK, Lemeshow S. Sample size determination for health studies: a practical manual. Geneva, Switzerland: World Health Organization.
Socio-cultural determinants of health-seeking behaviour on the Kenyan coast: a qualitative study. PLoS One.Seeking more or less
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Health care seeking behaviour of mothers towards diarrheal disease of children less than 5 years in Mekelle city, North Ethiopia