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Care-seeking behaviour among febrile children under five in Togo
Gountante Kombate1, Gbènonminvo Enoch Cakpo2, Komi Ameko Azianu2
1Society for Study and Research in Public Health, Ouagadougou, Burkina Faso. gountanto@gmail.com.
Insights
Care-seeking for febrile children under five is low in Togo. Mothers with higher education and closer health access were more likely to seek care, unlike those with traditionalist beliefs.
Area of Science:
- Pediatrics
- Public Health
- Global Health
Background:
- Fever is a critical indicator of childhood illness, necessitating timely care-seeking to reduce mortality and morbidity.
- Care-seeking behaviors for febrile children in sub-Saharan Africa, including Togo, are often suboptimal.
- Understanding caregiver behavior and modifiable risk factors is crucial for improving pediatric care access.
Purpose of the Study:
- To investigate caregiver decision-making processes for seeking medical attention for febrile children under five in Togo.
- To identify demographic, socioeconomic, and geographic factors associated with care-seeking for childhood fever.
- To pinpoint modifiable risk factors influencing formal care-seeking behaviors.
Main Methods:
- Utilized data from a 2013-2014 nationally representative malaria indicator survey in Togo.
- Defined care-seeking as obtaining advice or treatment for a febrile child under five within two weeks of interview from various sources.
- Employed univariate and multivariate logistic regression analyses using Generalized Linear Models to identify risk factors.
Main Results:
- Out of 6529 children, 1359 presented with fever; formal care was sought in 38.9% of cases.
- Independent predictors for formal care-seeking included proximity to health centers (aOR=1.52) and secondary or higher maternal education (aOR=1.85).
- Mothers adhering to animist/traditionalist religions showed higher odds of seeking formal care (aORs ranging from 1.9 to 2.41) compared to those in formal religions; the Maritime region showed lower odds (aOR=0.49).
Conclusions:
- Care-seeking for febrile children is influenced by maternal education, religious affiliation, and geographic accessibility to healthcare facilities.
- Interventions should prioritize mothers with limited education and those not affiliated with formal religious institutions.
- Improving access to healthcare facilities is essential, particularly for populations residing farther from health centers.
Background:
Fever is one of the warning signs of poor health in children. Care-seeking in febrile children is importance in reducing child deaths and morbidity. This care-seeking by parents in children with fever is however relatively low in sub-Sahara Africa. The aim of this study is to improve understanding of the behaviour of caregivers in seeking care for children under five with fever and to identify associated modifiable risk factors in Togo.
Methods:
Data from a 2013-2014 cross-sectional nationally representative malaria indicator survey was used. Advice or care-seeking is defined as any child under 5 years of age with fever in the two weeks prior to the interview for whom advice or treatment was sought in a public medical area, private medical area, store, market, or from an itinerant medicine seller. Univariate and multivariate logistic regression analysis were performed using Generalized Linear Models.
Results:
A total of 1359 febrile children out of 6529 children under five were enrolled. Care had been sought in 38.9% of cases. In multivariate analysis, independent risk factors associated with formal care seeking were accessibility to the nearest health center (aOR = 1.52, 95% CI [1.18-1.95], mother's education level secondary and above (aOR = 1.85, 95% [1.32-2.59]), mothers who identified as belonging to animist/traditionalist religions compared to mothers who belonged to a formal religion (catholic (aOR = 2. 28, 95% [1.55-3.37]), Muslim (aOR = 2.41, 95% [1.67-3.47]), and Protestant (aOR = 1.9, 95% [1.37-2.65]), Maritime region (aOR = 0.49, 95% [0.29-0.82]) compared to Lome commune.
Conclusion:
Interventions should specifically target women with limited education, not identifying as part of an official church and at longer distance from health center.
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