Health care seeking behavior for diarrhea in children under 5 in rural Niger: results of a cross-sectional survey

BMC Public Health

Research Article

Mahamane Laouali Manzo¹  Francisco J Luquero²  Anne-Laure Page²  Sarah Hustache²  Rebecca F Grais²  Ali Djibo³ 

[1] Direction Régionale de la Santé Publique, Maradi, Niger;Epicentre, Paris, France;Ministère de la Santé, Niamey, Niger;

关键词: Diarrhea;    Recall Period;    Health Post;    Severe Diarrhea;    Oral Rehydration Solution;   

DOI  :  10.1186/1471-2458-11-389

 received in 2010-11-26, accepted in 2011-05-25,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundDiarrhea remains the second leading cause of death in children under 5 years of age in sub-Saharan Africa. Health care seeking behavior for diarrhea varies by context and has important implications for developing appropriate care strategies and estimating burden of disease. The objective of this study was to determine the proportion of children under five with diarrhea who consulted at a health structure in order to identify the appropriate health care levels to set up surveillance of severe diarrheal diseases.MethodsA cluster survey was done on 35 clusters of 21 children under 5 years of age in each of four districts of the Maradi Region, Niger. Caretakers were asked about diarrhea of the child during the recall period and their health seeking behavior in case of diarrhea. A weighted cluster analysis was conducted to determine the prevalence of diarrhea, as well as the proportion of consultations and types of health structures consulted.ResultsIn total, the period prevalence of diarrhea and severe diarrhea between April 24th and May 21st 2009 were 36.8% (95% CI: 33.7 - 40.0) and 3.4% (95% CI: 2.2-4.6), respectively. Of those reporting an episode of diarrhea during the recall period, 70.4% (95% CI: 66.6-74.1) reported seeking care at a health structure. The main health structures visited were health centers, followed by health posts both for simple or severe diarrhea. Less than 10% of the children were brought to the hospital. The proportion of consultations was not associated with the level of education of the caretaker, but increased with the number of children in the household.ConclusionsThe proportion of consultations for diarrhea cases in children under 5 years old was higher than those reported in previous surveys in Niger and elsewhere. Free health care for under 5 years old might have participated in this improvement. In this type of decentralized health systems, the WHO recommended hospital-based surveillance of severe diarrheal diseases would capture only a fraction of severe diarrhea. Lower levels of health structures should be considered to obtain informative data to ensure appropriate care and burden estimates.

【 授权许可】

CC BY   
© Page et al; licensee BioMed Central Ltd. 2011