Abstract

IntroductionThis paper identifies factors influencing differences in the prevalence of diarrhea, fever and acute respiratory infection (ARI), and health seeking behavior among caregivers of children under age five in rural Tanzania.MethodsUsing cross-sectional survey data collected in Kilombero, Ulanga, and Rufiji districts, the analysis included 1,643 caregivers who lived with 2,077 children under five years old. Logistic multivariate and multinomial regressions were used to analyze factors related to disease prevalence and to health seeking behavior.ResultsOne quarter of the children had experienced fever in the past two weeks, 12.0 % had diarrhea and 6.7 % experienced ARI. Children two years of age and older were less likely to experience morbidity than children under one year [ORfever = 0.77, 95 % CI 0.61-0.96; ORdiarrhea = 0.26, 95 % CI 0.18-0.37; ORARI = 0.60 95 % CI 0.41-0.89]. Children aged two and older were more likely than children under one to receive no care or to receive care at home, rather than to receive care at a facility [RRRdiarrhea = 3.47, 95 % CI 1.19-10.17 for “No care”]. Children living with an educated caregiver were less likely to receive no care or home care rather than care at a facility as compared to those who lived with an uneducated caregiver [RRRdiarrhea = 0.28, 95 % CI 1.10-0.79 for “No care”]. Children living in the wealthiest households were less likely to receive no care or home care for fever as compared to those who lived poorest households. Children living more than 1 km from health facility were more likely to receive no care or to receive home care for diarrhea rather than care at a facility as compared to those living less than 1 km from a facility [RRRdiarrhea = 3.50, 95 % CI 1.13-10.82 for “No care”]. Finally, caregivers who lived with more than one child under age five were more likely to provide no care or home care rather than to seek treatment at a facility as compared to those living with only one child under five.ConclusionsOur results suggest that child age, caregiver education attainment, and household wealth and location may be associated with childhood illness and care seeking behavior patterns. Interventions should be explored that target children and caregivers according to these factors, thereby better addressing barriers and optimizing health outcomes especially for children at risk of dying before the age of five.

Highlights

  • This paper identifies factors influencing differences in the prevalence of diarrhea, fever and acute respiratory infection (ARI), and health seeking behavior among caregivers of children under age five in rural Tanzania

  • This study aims to assess the prevalence of fever, diarrhea, and acute respiratory infections (ARI) for children under-five years of age and to identify the determinants of health seeking behavior on their behalf among caregivers in rural Tanzania

  • About 29.2 % of children lived within 1 km from a health facility while 24.6 % lived more than 4 km from a health facility (Table 1)

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Summary

Introduction

This paper identifies factors influencing differences in the prevalence of diarrhea, fever and acute respiratory infection (ARI), and health seeking behavior among caregivers of children under age five in rural Tanzania. A large proportion of these deaths are due to Health system strengthening initiatives in Tanzania have contributed to the country’s achievement of the highest density of primary health care facilities in Africa [3]. These efforts have played a major role in reducing child mortality in Tanzania, placing the country on a trajectory to achieve the Millennium Development Goal 4 of reducing of under-five mortality rate by twothirds between 1990 and 2015 [4, 5]. Fostered children may be less likely to receive health care than their peers, based on evidence for higher mortality among children with a lower degree of biological relatedness to their caregiver in Uganda [18]

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