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Caregiver Decision-Making: Household Response to Child Illness in sub-Saharan Africa
Hayley Pierce1, Ashley Larsen Gibby2, Renata Forste3
1Department of Demography and Sociology, 2232 Piedmont Ave, University of California, Berkeley, Berkeley, CA 94720, hayleyp@berkeley.edu.
Insights
Women
Area of Science:
- Global Health
- Pediatric Health
- Health Services Research
Background:
- Child illness in sub-Saharan Africa remains a significant public health concern.
- Understanding household decision-making processes for seeking child healthcare is crucial for effective interventions.
Purpose of the Study:
- To identify factors influencing treatment-seeking behavior for common childhood illnesses (diarrhea, fever, cough) in sub-Saharan Africa.
- To examine the role of household recognition and response frameworks in child illness management.
Main Methods:
- Multinomial, multilevel analyses were conducted using Demographic and Health Surveys from 19 sub-Saharan African countries.
- The study modeled choices between no treatment, middle-layer treatment, and biomedical treatment for child illness episodes.
Main Results:
- Women's autonomy in healthcare decisions is strongly associated with seeking treatment for child illness.
- Access to biomedical treatment requires healthcare knowledge, decision-making power, and resources for cost and travel negotiation.
- Prior positive experiences with healthcare services, such as prenatal care, increase the likelihood of seeking biomedical treatment.
Conclusions:
- Caregiver decision-making power within households is a critical determinant of child health outcomes in sub-Saharan Africa.
- Empowering women and improving their access to healthcare resources are essential strategies for reducing child morbidity and mortality.
Abstract:
We draw upon a framework outlining household recognition and response to child illness proposed by Colvin and colleagues (2013) to examine factors predictive of treatment sought for a recent child illness. In particular, we model whether no treatment, middle layer treatment (traditional healer, pharmacy, community health worker, etc.), or biomedical treatment was sought for recent episodes of diarrhea, fever, or cough. Based on multinomial, multilevel analyses of Demographic and Health Surveys from 19 countries in sub-Saharan Africa, we determine that if women have no say in their own healthcare, they are unlikely to seek treatment in response to child illness. We find that women in sub-Saharan Africa need healthcare knowledge, the ability to make healthcare decisions, as well as resources to negotiate cost and travel, in order to access biomedical treatment. Past experience with medical services such as prenatal care and a skilled birth attendant also increase the odds that biomedical treatment for child illness is sought. We conclude that caregiver decision-making in response to child illness within households is critical to reducing child morbidity and mortality in sub-Saharan Africa.
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