Childhood morbidity and health services utilization: cross-national comparisons of user-related factors from DHS data

The purpose of this study was to examine user-related factors that influence the utilization of medical care facilities for treating childhood morbidity in sub-Saharan Africa. Data from six African countries which participated in the Demographic and Health Surveys (DHS) program were examined using a modified version of the Andersen Behavioral model as a conceptual framework. The results indicate that while the prevalence of childhood morbidity is high in all the countries, between 23-68% of sick children were not taken for a medical visit. This is a major concern since the diseases examined here account for a high proportion of deaths among children. Logistic regression analyses show that factors which account for differentials in health service use include the age of the mother, the mother's education, family resources, rural-urban residence and the number of reported diseases. The implications for improved health care delivery in sub-Saharan African countries are discussed.