Determinants of the type of health care sought for symptoms of Acute respiratory infection in children: analysis of Ghana demographic and health surveys

Leslie Danquah,Prince Michael Amegbor,Dawit Getnet Ayele

doi:10.1186/s12887-021-02990-9

Abstract

BackgroundGlobally, acute respiratory infection (ARI) is a leading cause of infant and childhood morbidity and mortality. Currently, it is estimated that 50 million cases of childhood ARI are untreated. In this study, we identified determinants of the type of treatment sought for symptoms of childhood acute respiratory infection (ARI), including non-treatment, amongst a nationally representative sample of children under five years in Ghana.MethodsIn total, 1 544 children were studied by a secondary analysis of pooled survey data from the 1993, 1998, 2003, 2008, and 2014 Ghana Demographic and Health Surveys (GDHS). Cross-tabulations, chi-square, multinomial logistic regression, and Bayesian hierarchical spatial logistic regression analyses were used to identify relationships between the type of treatment sought and maternal socio-economic and household characteristics.ResultsSeeking medical care was significantly associated with child age (RRR= 1.928, 95 % CI 1.276 – 2.915), maternal employment status (RRR = 1.815, 95 % CI 1.202 – 2.740), maternal health insurance status, (RRR = 2.618, 95 % CI 1.801 – 3.989), children belonging to middle (RRR = 2.186, 95 % CI 1.473 – 3.243), richer (RRR = 1.908, 95 % CI 1.145 – 3.180) and richest households (RRR = 2.456, 95 % CI 1.363 – 4.424) and the 1998 survey period (RRR = 0.426, 95 % CI 0.240 – 7.58). Seeking self-care or visiting a traditional healer was significantly associated with maternal educational status (RRR = 0.000, 95 % CI 0.000 – 0.000), and the 1998 (RRR= 0.330, 95 % CI 0.142 – 0.765), 2003 (RRR= 0.195, 95 % CI 0.071 – 0.535), 2008 (RRR= 0.216, 95 % CI 0.068 – 0.685) and 2014 (RRR= 0.230, 95 % CI 0.081 – 0.657) GDHS periods. The probability that the odds ratio of using medical care exceeded 1 was higher for mothers/caregivers in the Western, Ashanti, Upper West, and Volta regions.ConclusionsGovernment policies that are aimed at encouraging medical care-seeking for children with ARI may yield positive results by focusing on improving maternal incomes, maternal NHIS enrolment, and maternal household characteristics. Improving maternal education could be a positive step towards addressing challenges with self-care or traditional healing amongst children with ARI.

Highlights

Acute respiratory infection (ARI) is a leading cause of infant and childhood morbidity and mortality
Our study found that the type of health care sought for symptoms of childhood acute respiratory infection (ARI) was determined by maternal socioeconomic and household characteristics
We identified the child’s age, maternal employment status, household wealth, maternal health insurance status and the Ghana Demographic and Health Surveys (GDHS) period as significant determinants of choosing medical care

Summary

Introduction

Acute respiratory infection (ARI) is a leading cause of infant and childhood morbidity and mortality. Acute respiratory infections (ARIs) mortality [1], with the annual untreated cases of childhood ARI estimated to be over 50 million [2]. It is Danquah et al BMC Pediatrics (2021) 21:514 estimated that 80 % of all ARI-related deaths among children under 5 years of age occur in developing countries, making it a leading cause of infant mortality in these countries [3]. Children under five years are not usually able to seek health care themselves; they must rely on adults for this This responsibility usually falls to the mother or other female caregivers in the family [5]. With differing sociocultural roles in the home, males are often regarded as breadwinners whereas females are seen as homemakers, which includes taking care of the children [5]

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