Household relationships and healthcare seeking behaviour for common childhood illnesses in sub-Saharan Africa: a cross-national mixed effects analysis
Household relationships and healthcare seeking behaviour for common childhood illnesses in sub-Saharan Africa: a cross-national mixed effects analysis
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DOI：
10.1186/s12913-019-4142-x
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发表时间：
2019-05-14
影响因子：
2.8
通讯作者：
Odimegwu, Clifford O.
中科院分区：
文献类型：
--
作者：
Akinyemi, Joshua O.;Banda, Pamela;Odimegwu, Clifford O.
家庭内部的动态在儿童医疗服务的利用中起着至关重要的作用。我们调查了家庭关系对寻求医疗保健行为的影响，常见的儿童疾病在四个撒哈拉以南非洲regions.MethodsData 247,061五岁以下的儿童从最近的人口与健康调查2012年和2016年之间在25个国家进行提取。对每个次区域的数据进行了合并和分析。因变量（DV）为腹泻和急性呼吸道感染（ARI）症状的卫生设施护理。主要自变量（IV）是家庭关系，由母亲的婚姻状况（婚姻状况，家庭类型和婚姻数量）和母亲与户主的关系表示。混合效应logit模型进行拟合，以评估独立的IV和DV之间的关系，调整相关的人口和社会经济特征在5%的显着性level.ResultsThe百分比的儿童谁收到照顾腹泻和ARI症状从卫生设施跨次区域是：西非（WA）42.4，44.1%;中非（CA）32.6，33.9%;东非41.5，48.7%，南部非洲58.9，62.7%。在任何一个次区域，母亲的婚姻状况与腹泻和ARI症状的就医行为无关。在东非，母亲是女儿/儿媳到户主的儿童被带到卫生机构接受腹泻治疗的可能性显著降低（AOR=0.81，CI：0.51-0.95）。有一个母亲谁是户主是显着相关的设施照顾更高的几率为ARI症状的儿童从西方（AOR=1.20，CI：1.02-1.43）和南部非洲（AOR=1.49，CI：结论未成年人的母亲与子女的关系类型不同，母亲与子女的关系类型也不同。在东部、西部和南部非洲，五岁以下的儿童和户主对寻求治疗腹泻和急性呼吸道感染症状的行为产生了影响。这些地区的国家需要采用最佳做法，促进儿童利用医疗保健，使家庭关系不构成障碍。
BackgroundIntra-household dynamics play crucial roles in utilisation of healthcare services for children. We investigated the influence of household relationships on healthcare seeking behaviour for common childhood illnesses in four sub-Sahara African regions.MethodsData on 247,061 under-five children were extracted from recent Demographic and Health Surveys conducted between 2012 and 2016 in 25 countries. Data were combined and analysed per sub-region. Dependent variables (DVs) were uptake of health facility care for diarrhea and Acute Respiratory Tract Infection (ARI) symptoms. The main independent variable (IV) was household relationship which was represented by maternal marital profile (marital status, family type and number of marriages) and maternal relationship to household head. Mixed effects logit models were fitted to assess independent relationship between the IVs and DVs with adjustment for relevant demographic and socio-economic characteristics at 5% significance level.ResultsThe percentage of children who received care for diarrhea and ARI symptoms from health facilities across sub-regions was: Western Africa (WA) 42.4, 44.1%; Central Africa (CA) 32.6, 33.9%; Eastern Africa (EA) 41.5, 48.7% and Southern Africa (SA) 58.9, 62.7%. Maternal marital profile was not associated with healthcare seeking behaviour for diarrhea and ARI symptoms in any of the sub-regions. Children whose mothers were daughter/daughter-in-law to household head were significantly less likely to be taken to health facility for diarrhea treatment in Eastern Africa (AOR=0.81, CI: 0.51-0.95). Having a mother who is the head of household was significantly associated with higher odds of facility care for ARI symptoms for children from Western (AOR=1.20, CI: 1.02-1.43) and Southern Africa (AOR=1.49, CI: 1.20-1.85).ConclusionThe type of relationship between mother of under-fives and head of households affect health seeking behaviour for treatment of diarrhea and ARI symptoms in Eastern, Western and Southern Africa. Countries in these regions need to adapt best practices for promoting healthcare utilisation for children such that household relationship does not constitute barriers.