Background
Methods
Study area
Population
Eligibility criteria
Sample size determination and sampling procedure
Study variables
Dependent variable
Independent variables
Operational definitions and measurements
Delay in seeking health care
Promptness in seeking health care
Self-medication
Traditional medicine
A scoring system for knowledge assessment
Wealth index
Data collection process and quality control
Data processing and analysis
Ethical consideration
Results
Socio-demographic characteristics of the respondents
Variable | Category | Frequency | Percent |
---|---|---|---|
Sex of the child | Male | 192 | 53.9 |
Females | 164 | 46.1 | |
Age of the child in months | 0–12 | 133 | 37.4 |
13–24 | 93 | 26.1 | |
25–36 | 58 | 16.3 | |
37–48 | 55 | 15.4 | |
49–59 | 17 | 4.8 | |
Age of caregiver | 16–24 | 47 | 13.2 |
25–34 | 231 | 64.9 | |
35–44 | 74 | 20.8 | |
> 45 | 4 | 1.1 | |
Residence | Urban | 284 | 79.8 |
Rural | 72 | 20.2 | |
Marital status of caregivers | Married | 350 | 98.4 |
Divorced | 3 | 0.8 | |
Single | 3 | 0.8 | |
Religion of caregiver | Orthodox | 300 | 84.3 |
Muslim | 39 | 11.0 | |
Protestant | 16 | 4.5 | |
Educational status | Unable to read and write | 72 | 20.8 |
Primary education | 62 | 17.4 | |
Secondary education | 85 | 23.9 | |
Diploma and above | 135 | 37.9 | |
The child lives with whom | With a single parent | 26 | 7.3 |
With both parents | 330 | 92.7 | |
Number of under-five children in the Household | 1 | 131 | 36.8 |
> 1 | 243 | 63.2 | |
Family size | 2–5 | 254 | 71.3 |
> 5 | 102 | 28.7 | |
Occupation | Housewives | 143 | 40.2 |
Merchants | 49 | 13.8 | |
Students | 9 | 2.5 | |
Government employees | 71 | 19.9 | |
NGO employees | 17 | 4.8 | |
Farmers | 59 | 16.6 | |
Unemployed | 4 | 1.1 | |
Others | 4 | 1.1 | |
Wealth index | Poorest | 68 | 19.1 |
Poor | 71 | 19.9 | |
Medium | 74 | 20.8 | |
Rich | 63 | 17.7 | |
Richest | 80 | 22.5 |
Health facility, behavioral and clinical related factors
Variable | Category | Health seeking | X2 at 95% CI | |
---|---|---|---|---|
Prompt | Delay | |||
Type of hospital closer to you | Government | 91 | 130 | X2 = 24.40 |
Private | 121 | 43 | ||
Type of hospital, mothers prefer to seek healthcare | Government | 62 | 110 | X2 = 31.42 |
Private | 121 | 63 | ||
Reasons to prefer private hospitals | Comprehensive examination | 57 | 21 | X2 = 7.10 |
Low waiting time | 37 | 12 | ||
Treatment is effective | 19 | 9 | ||
Because they are near | 4 | 6 | ||
Because they are respectful | 7 | 3 | ||
Necessary medications are available | 3 | 3 | ||
Always open/early open | ||||
Reasons to prefer government hospitals | Because they are near | 23 | 48 | |
They don’t charge too much | 10 | 37 | ||
Because they are respectful | 2 | 14 | ||
Comprehensive examination | 7 | 8 | ||
Always open/early open | 8 | 7 | ||
Treatment is effective | 0 | 3 | ||
Necessary medication availability | 1 | 1 | ||
Time taken to arrive to the nearest health facility on foot | < 60 min | 171 | 167 | X2 = 1.76 |
> 60 min | 12 | 6 | ||
The severity of pneumonia (diagnosed at Pediatric OPD) | Severe pneumonia | 21 | 51 | X2 = 17.86 |
Non-severe pneumonia | 162 | 122 | ||
Mothers reasons for a delay in seeking healthcare | The disease is resolved by itself | 0 | 53 | |
Self-medication | 0 | 32 | ||
Transportation difficulties | 0 | 13 | ||
Use of holy water at home | 0 | 15 | ||
Use of traditional medicine | 0 | 17 | ||
Lack of money | 0 | 16 | ||
The illness was mild | 0 | 28 | ||
Information on healthcare seeking for pneumonia | No | 37 | 105 | X2 = 60.76 |
Yes | 146 | 68 | ||
Mothers reason to seek healthcare promptly | Previous information on healthcare seeking on childhood pneumonia | 101 | 0 | |
Symptom worsen | 63 | 0 | ||
Previous complication experience of delay | 19 | 0 | ||
The main source of information | At health center/hospital | 83 | 35 | |
Health extension workers | 12 | 10 | ||
During community conversation | 24 | 7 | ||
Neighbor | 0 | 2 | ||
Media TV/Radio | 25 | 11 | ||
Other# | 2 | 3 | ||
Symptoms lead the mother to seek healthcare | Cough/fast breathing | 135 | 121 | X2 = 5.97 |
Fever | 33 | 24 | ||
Chest-in drawing | 2 | 5 | ||
Has a danger sign* | 13 | 23 | ||
Decision-maker to seek healthcare | Mother | 89 | 107 | X2 = 7.37 |
Father | 11 | 11 | ||
Both parents | 72 | 47 | ||
Grandparents | 7 | 6 | ||
Other# | 4 | 2 | ||
Perception of mothers on the cost of childhood pneumonia treatment | Easy to pay | 56 | 91 | X2 = 18.14 |
Difficult to pay | 123 | 78 | ||
Very difficult to pay | 4 | 4 | ||
Community health insurance | Yes | 30 | 39 | X2 = 2.15 |
I don’t have | 153 | 134 | ||
knowledge on prompt health care seeking | Poor knowledge | 131 | 154 | X2 = 16.92 |
Good knowledge | 52 | 19 |
The proportion of delay in seeking healthcare
Factors associated with delay in health care-seeking
Variable | Category | Health seeking | COR (95%CI) | AOR (95% CI) | |
---|---|---|---|---|---|
Prompt | Delay | ||||
Residence | Rural | 26 | 46 | 2.2 (1.3, 3.7) | 2.3 (1.1, 4.9)* |
Urban | 157 | 127 | 1.00 | 1.00 | |
Type of hospital mothers seek | Governmental | 62 | 110 | 3.4 (2.2, 5.3) | 3.3 (1.8, 6.1)*** |
Private | 121 | 63 | 1.00 | 1.00 | |
Decision-maker to seek healthcare | Others | 4 | 2 | 0.8 (0.1, 4.4) | 0.8 (0.1, 6.8) |
Father | 11 | 11 | 1.5 (0.6, 3.8) | 0.9 (0.3, 2.9) | |
Mother | 89 | 107 | 1.8 (1.2, 2.9) | 2.9 (1.6, 5.4)** | |
Grandparents | 7 | 6 | 1.3 (0.4, 4.2) | 0.5 (0.1, 2.6) | |
Both parents | 72 | 47 | 1.00 | 1.00 | |
Wealth index | Poorest | 20 | 48 | 5.9 (2.9, 12.1) | 2.8 (1.1,7.2)* |
Poor | 33 | 38 | 2.8 (1.5, 5.6) | 2.3 (0.9, 5.6) | |
Medium | 34 | 40 | 2.9 (1.5, 5.6) | 1.8 (0.8, 4.2) | |
Rich | 39 | 24 | 1.5 (0.8, 3.1) | 1.4 (0.6, 3.4) | |
Richest | 57 | 23 | 1.00 | 1.00 | |
Using traditional medicine | Yes | 33 | 64 | 2.7 (1.6, 4.3) | 2.7 (1.4, 5.1)** |
No | 150 | 109 | 1.00 | 1.00 | |
Self-medication | Yes | 19 | 70 | 5.9 (3.3, 10.3) | 7.5 (3.8, 14.7)*** |
No | 150 | 109 | 1.00 | 1.00 | |
Information on early healthcare-seeking | No | 37 | 105 | 6.1 (3.8, 9.8) | 5.1 (2.8, 9.1)*** |
Yes | 146 | 68 | 1.00 | 1.00 |
Discussion
Conclusion
Recommendations
The regional health bureau
-
Should better strengthen the regulations of un-prescribed medications and the use of traditional medicine in the region.
-
Should provide exempted health service for under-five children to improve early health care seeking practice of mothers for childhood pneumonia
-
Should better disseminate information via the mass media about the complications of delay in seeking health care.
Health facilities and partners
-
Should better create awareness for mothers about the importance of prompt health care seeking.
-
Should strengthen the health extension program via house to house visits and active surveillance to early detect the pneumonia cases from the community.
-
Government health facilities should improve the quality of the healthcare services to the community for mothers to seek the service.
-
Health facilities should improve healthcare provision approach of childhood pneumonia treatment, especially for governmental health facilities.
The researchers
-
Further studies with strong evidence should be conducted.