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Why are there delays in seeking treatment for childhood diarrhoea in India?
Nisha Malhotra1, Ravi Prakash Upadhyay
1Vancouver School of Economics, Faculty of Arts, University of British Columbia, Vancouver, BC, Canada.
Insights
Seeking timely treatment for childhood diarrhea in India is crucial. Factors like mother's education and wealth improve care-seeking, while distance to facilities and gender bias create delays.
Area of Science:
- Public Health
- Pediatrics
- Health Services Research
Background:
- Childhood diarrhea remains a significant health concern in India.
- Understanding barriers to timely treatment is essential for improving child survival rates.
Purpose of the Study:
- To identify factors influencing treatment-seeking for childhood diarrhea.
- To determine reasons for delays in seeking medical care for pediatric diarrhea.
Main Methods:
- Analysis of data from the Indian Demographic and Health Survey (NFHS-III, 2005-06).
- Inclusion of mothers' reports on children under 5 years with diarrhea.
- Multivariate logistic regression to identify determinants of seeking treatment and delays.
Main Results:
- Higher maternal education, higher wealth index, and health card possession increased odds of seeking treatment.
- Male children had lower odds of delayed treatment compared to female children.
- Distance to health facilities significantly delayed treatment seeking.
Conclusions:
- Access to healthcare facilities and public health system strengthening are critical for improving care-seeking.
- Educating caregivers, particularly mothers, on timely treatment and oral rehydration solution (ORS) is vital.
Aim:
To examine the barriers and facilitating factors for seeking treatment for childhood diarrhoea and to determine the main causes for delay in seeking treatment.
Methods:
Data from Indian Demographic and Health survey 2005-06 (NFHS-III) were used. Mothers were asked whether their children (<5-years) had suffered from diarrhoea during the 2 weeks preceding the survey. Data were collected on the time of seeking treatment after start of the illness and days waited to seek treatment after the diarrhoea started. Multivariate logistic regression analysis was performed to find the determinants of seeking treatment at the health facility and the factors responsible for the 'delay' in seeking advice/treatment.
Results:
Of a sample of 41 287 children, 3890 (9.4%) reportedly had diarrhoea. Sixty percentage of children with diarrhoea were taken to a health facility. Mother's education till higher secondary and above (OR 1.65; 95% CI, 1.08-2.54), richest (OR 1.76; 95% CI, 1.24-2.48) wealth index, and possession of a health card by the mother (OR 1.35; 95% CI, 1.12-1.62) increased the odds of seeking treatment. There was a strong gender bias; a male child had lower odds of experiencing a 'delay' in seeking treatment, compared with a female child (OR 0.71; 95% CI, 0.55-0.92). Access to a health facility still remains a major issue: treatment seeking was delayed when distance to a health facility was reported as a 'major problem' (OR 1.33; 95% CI, 1.01-1.76).
Conclusion(S):
Improved care seeking for childhood diarrhoea in India is still constrained by access to a health facility and requires expansion and strengthening of the public health system. The caregivers, especially the mothers need to be educated about the importance of seeking timely treatment and the benefits of oral rehydration solution.
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