A cross-sectional survey of parental care-seeking behavior for febrile illness among under-five children in Nigeria

Abstract

Background: Infections are a common cause of childhood morbidity and mortality in developing countries. Proper management of these conditions in appropriate health facilities provides the best opportunity for survival and reducing disability.
Aims: To evaluate the care-seeking behavior by parents of under-five children with fever in Nigeria and determine household characteristics associated with appropriate care-seeking.
Material and methods: The study is a secondary analysis of 2013 Demographic and Health Survey data for Nigeria, which was a cross-sectional survey conducted nationwide to obtain demographic and health characteristics of the population among 40,680 households selected using a multistage cluster sampling method. Under-five children with fever in the preceding two weeks were selected alongside their mothers. Selected sociodemographic parameters were related to parents seeking care from appropriate health facilities or otherwise. Logistic regression analysis was employed to evaluate the association of these parameters with appropriate care-seeking.
Results: There were 3632 (12.6%) under-five children with fever in the preceding two weeks. Of these, 1142 (31.4%) had been taken to an appropriate health facility for care. Factors associated with appropriate care-seeking were paternal secondary (OR, 95% CI; 1.49, 1.16–1.90), paternal tertiary education (OR, 95% CI; 2.03, 1.49–2.76) and belonging to the Muslim faith (OR, 95% CI; 2.31, 1.86–2.87). Others were age of child <36 months, being married and working mother.
Conclusion: There is poor care-seeking for fever in under-five children by parents in Nigeria. Improved literacy, women empowerment and health education are strategies that may improve care-seeking behavior. Highlighted regional differences are additional considerations for such interventions.