Determinants of Timely Healthcare-Seeking Behaviour and Knowledge of Childhood Danger Signs in Caregivers of Children Below Five Years Attending Gita Sub-County Hospital, Kisumu, Kenya
Abstract
Morbidity and mortality in children below five years are still relatively high even after many interventions, especially and low and middle-income countries. Many of the deaths are due to preventable causes. Timely seeking of healthcare from qualified personnel as soon as the child shows signs and symptoms of disease is a game changer, especially to the treatment outcomes. However, this is determined by various factors including the caregiver’s age and knowledge about childhood illnesses, including danger signs. This cross-sectional study aimed to investigate the determinants of timely healthcare-seeking behaviour and knowledge of danger signs in caregivers of children below five years attending Gita Sub-County Hospital in Kisumu, Kenya. Systematic sampling was used to include 324 caregivers in the study. Using structured pretested interview-guided questionnaires, data was collected, cleaned and analysed using into GraphPad Prism 10.2.0 (392). The mean age of the participants was 28.38 years. Knowledge about childhood danger signs in children by their caregivers was poor (35%). Age (31-40 and 41-50 years at [AOR=1.32(95%CI: 0.77-1.87) and AOR=1.29(95%CI: 0.76-1.82)] respectively), secondary [AOR=1.34(95%CI: 1.14-1.54)] and tertiary education [AOR=2.07(95%CI: 0.8-3.33)]), formal employment [AOR=1.62(95%CI: 1.31-1.92)] and no source of income [AOR=1.75(95%CI: 0.61-2.89)] improved caregivers’ knowledge about danger signs in children. Timely healthcare seeking for sick children was low (25%). Age (≤ 20 years [ AOR=3.89 (95%CI: 2.43-5.34)]), marital status (divorced/separated, single and widowed caregivers [AOR=2.55(95%CI: 0.91-4.18), AOR=2.46(95%CI: 1.67-3.24) and AOR=2.41(95%CI: 1.92-2.89) respectively]), source of income (formally employed and self-employed [(AOR=2.9(95%CI: 2.45-3.34) and AOR=2.42(95%CI: 1.89-2.92)] were promotors of timely healthcare seeking. Caregivers need to be sensitized about danger signs in their children and the need to seek timely healthcare once their children present with any one of the danger signs
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Abegaz, N. T., Berhe, H., & Gebretekle, G. B. (2019). Mothers/caregivers healthcare seeking behavior towards childhood illness in selected health centers in Addis Ababa, Ethiopia: A facility-based cross-sectional study. BMC Pediatrics, 19(1). https://doi.org/10.1186/s12887-019-1588-2
Adeoti, I. G., & Cavallaro, F. L. (2022). Determinants of care-seeking behaviour for fever, acute respiratory infection and diarrhoea among children under five in Nigeria. PLoS ONE, 17(9 September). https://doi.org/10.1371/journal.pone.0273901
Burton, D. C., Flannery, B., Onyango, B., Larson, C., Alaii, J., Zhang, X., Hamel, M. J., Breiman, R. F., & Feikin, D. R. (2011). No Title. Journal of Health, Population and Nutrition, 29(1), 61–70. https://doi.org/doi: 10.3329/jhpn.v29i1.7567
Degefa, G., Gebreslassie, M., Meles, K. G., & Jackson, R. (2018). Determinants of delay in timely treatment seeking for diarrheal diseases among mothers with under-five children in central Ethiopia: A case control study. PLoS ONE, 13(3). https://doi.org/10.1371/journal.pone.0193035
Duke, E. S., Ezenwa, B. N., Roberts, A., & Ekanem, E. E. (2020). Mothers’ knowledge of danger signs in childhood illnesses: the integrated management of childhood illness (IMCI) strategy in Alimosho area of Lagos State, Nigeria. Pan African Medical Journal One Health, 2. https://doi.org/10.11604/pamj-oh.2020.2.8.23512
Garcia, G. E., Igunza, K. A., Madewell, Z. J., Akelo, V., Onyango, D., El Arifeen, S., Gurley, E. S., Hossain, M. Z., Chowdhury, M. A. I., Islam, K. M., Assefa, N., Scott, J. A. G., Madrid, L., Tilahun, Y., Orlien, S., Kotloff, K. L., Tapia, M. D., Keita, A. M., Mehta, A., … Rees, C. A. (2024). Identifying delays in healthcare seeking and provision: The Three Delays-in-Healthcare and mortality among infants and children aged 1–59 months. PLOS Global Public Health, 4(2), e0002494. https://doi.org/10.1371/journal.pgph.0002494
Gebreslasie, S., Welu, G., Berhane, B., Gebresilassie, B., Fseha, B., Tsegay, T., & Negash, H. (2020). Exploring knowledge on danger signs of common childhood illnesses and associated factors among mothers of under-five children in Central Tigrai, Ethiopia: a cross-sectional study. https://doi.org/10.18683/germs.2019.1175
Goodwin, P. Y., Garrett, D. A., Galal, O., & Garrett, D. A. ; (2005). Women and Family Health: The Role of Mothers in Promoting Family and Child Health. In International Journal of Global Health and Health Disparities (Vol. 4, Issue 1). https://scholarworks.uni.edu/ijghhd/vol4/iss1/4
Gyaase, P., Aduse-Poku, E., Lanquaye, M. O., Acheampong, E. B., & Sampson, D. Ben. (2024). Health seeking behaviour and knowledge on neonatal danger signs among neonatal caregivers in Upper Denkyira East Municipality, Ghana. BMC Pediatrics, 24(1). https://doi.org/10.1186/s12887-023-04430-2
Hatch, M., & Posel, D. (2018). Who cares for children? A quantitative study of childcare in South Africa. Development Southern Africa, 35(2), 267– 282. https://doi.org/10.1080/0376835X.2018.1452716
Kajungu, D., Nabukeera, B., Muhoozi, M., Ndyomugyenyi, D. B., Akello, M. C., Gyezaho, C., Waako, J., & Kasirye, R. (2023). Factors associated with caretakers’ knowledge, attitude, and practices in the management of pneumonia for children aged five years and below in rural Uganda. BMC Health Services Research, 23(1). https://doi.org/10.1186/s12913-023-09713-z
Kraft, A. D., Quimbo, S. A., Solon, O., Shimkhada, R., Florentino, J., & Peabody, J. W. (2009). The Health and Cost Impact of Care Delay and the Experimental Impact of Insurance on Reducing Delays. Journal of Pediatrics, 155(2), 281–285. https://doi.org/10.1016/j.jpeds.2009.02.035
Kumar, C., Piyasa, & Saikia, N. (2022). An update on explaining the rural-urban gap in under-five mortality in India. BMC Public Health, 22(1). https://doi.org/10.1186/s12889-022-14436-7
Lungu, E. A., Darker, C., & Biesma, R. (2020). Determinants of healthcare seeking for childhood illnesses among caregivers of under-five children in urban slums in Malawi: A population-based cross-sectional study. BMC Pediatrics, 20(1). https://doi.org/10.1186/s12887-020-1913-9
Ministry of Health. (2021). Integrated Community Case Management (iCCM) in Kenya Gap Analysis and Investment Case. www.childhealthtaskforce.org
Ministry of Health [Kenya]. (2016). Maternal and Child Health handbook. https://www.mchhandbook.com/mchhandbooks/
Mudiyanselage, S. B., Dona, S. W. A., Angeles, M. R., Majmudar, I., Marembo, M., Tan, E. J., Price, A., Watts, J. J., Gold, L., & Abimanyi-Ochom, J. (2024). The impact of maternal health on child’s health outcomes during the first five years of child’s life in countries with health systems similar to Australia: A systematic review. In PLoS ONE (Vol. 19, Issue 3 March). Public Library of Science. https://doi.org/10.1371/journal.pone.0295295
Nafista, U. F., Nurhaeni, N., & Waluyanti, F. T. (2023). Improvement in maternal knowledge, attitudes, and children’s weight with education on World Health Organization feeding recommendations. Pediatria Medica e Chirurgica, 45(S1). https://doi.org/10.4081/pmc.2023.314
Negatou, M., Ouedraogo, M., Donnen, P., Paul, E., Samadoulougou, S., & Kirakoya-Samadoulougou, F. (2021). Care-seeking for fever for children under the age of five before and after the free healthcare initiative in burkina faso: Evidence from three population-based surveys. Risk Management and Healthcare Policy, 14, 2065– 2077. https://doi.org/10.2147/RMHP.S297983
Ogunlesi, T. A., & Olanrewaju, D. M. (2010). Socio-demographic factors and appropriate health care-seeking behavior for childhood illnesses. Journal of Tropical Pediatrics, 56(6), 379– 385. https://doi.org/10.1093/tropej/fmq009
Okolo, E. A., & Mwachukwu, C. C. (2022). Gender issues in African Culture: an evaluation. Journal of Applied Philosophy, 20(1), 194–205. https://doi.org/10.13140/RG.2.2.34138.62405
Rutebemberwa, E., Kallander, K., Tomson, G., Peterson, S., & Pariyo, G. (2009). Determinants of delay in care-seeking for febrile children in eastern Uganda. Tropical Medicine and International Health, 14(4), 472–479. https://doi.org/10.1111/j.1365-3156.2009.02237.x
Saikia, N., Singh, A., Jasilionis, D., & Ram, F. (2013). Explaining the rural-urban gap in infant mortality in India. In Demographic Research (Vol. 29, Issue 18). http://www.demographic-research.org473http//www.demographic-research.org
UN. (2022). World Population Prospects 2022. In World Population Prospects 2022. www.un.org/development/ desa/pd/.
UNICEF. (2016). A fair chance for every child. www.soapbox.co.uk
UNICEF Kenya. (2024). Reducing maternal, neonatal and childhood deaths. Health. https://www.unicef.org/kenya/health
Van Poel, E. DE, & Van Doorslaer, E. (2009). What explains the rural-urban gap in infant mortality: household or community characteristics? In Cai and Chongsuvivatwong (Vol. 46, Issue 4). https://doi.org/https://doi.org/10.1353/dem.0.0074
Wambui, W. M., Kimani, S., & Odhiambo, E. (2018). Determinants of Health Seeking Behavior among Caregivers of Infants Admitted with Acute Childhood Illnesses at Kenyatta National Hospital, Nairobi, Kenya. International Journal of Pediatrics, 2018, 1–11. https://doi.org/10.1155/2018/5190287
WHO. (2024). The Global Health Observatory; Explore a world of health data. Child Mortality and Causes of Death 2023. https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/child-mortality-and-causes-of-death
WHO, & UNICEF. (2005). Handbook IMCI Integrated Management of Childhood Illness. https://www.who.int/publications/i/item/9241546441
Yaya, S., Odusina, E. K., & Adjei, N. K. (2021). Health care seeking behaviour for children with acute childhood illnesses and its relating factors in sub-Saharan Africa: evidence from 24 countries. Tropical Medicine and Health, 49(1). https://doi.org/10.1186/s41182-021-00385-1
Yaya, S., Uthman, O. A., Okonofua, F., & Bishwajit, G. (2019). Decomposing the rural-urban gap in the factors of under-five mortality in sub-Saharan Africa? Evidence from 35 countries. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-6940-9
Zhou, J., Hua, W., Zheng, Q., Cai, Q., Zhang, X., & Jiang, L. (2022). Knowledge about neonatal danger signs and associated factors among mothers of children aged 0–12 months in a rural county, Southwest of China: a cross-sectional study. BMC Pregnancy and Childbirth, 22(1). https://doi.org/10.1186/s12884-022-04592-4
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