Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia.
Front Public Health. 2021 May 19;9:569569. doi: 10.3389/fpubh.2021.569569. eCollection 2021.
Developing countries, including Zambia, account for larger share of child morbidities and mortalities due to common childhood illnesses. Studies on wider determinants of behaviour pertaining to treatment seeking for childhood febrile illnesses in poor resource settings are limited. This study investigated health seeking behaviours of mothers in poor resource settings of Zambia and identified associated factors. Secondary data from a community cross sectional study design from the Health for the Poorest Population (HPP) Project was analysed between March and May 2019. Data was collected between May and August, 2013. It was collected by means of administering a structured questionnaire from the mothers of under-five children. The survey took place in Samfya and Chiengi of Luapula province while in Northern Province, Luwingu and Mungwi were settled for. A total of 1 653 mothers of under 5 years who had an episode of diarrhoea, malaria, pneumonia or a combination of any of them not more than 14 days before the interview were included in the study. A sample size was arrived at using A Lot Quality Assurance Sampling (LQAS) method. In order to determine the associations between respondent's demographic characteristics and health seeking behaviour, chi square test of independence was carried out. Multivariable logistic regression was also done to identify predictors of health seeking behaviours for common childhood illnesses in children aged <5 years old in poor resource settings. Among the mothers interviewed, 64.6% were married while 35.4% were unmarried. Their mean age was 32 years. Mothers who took their sick children to the health facilities for the purpose of seeking health care for their child for either of the illnesses accounted for 75.2%, [95% CI: 0.62-0.96], while 24.8% did not seek health care for their sick child. Factors typically associated with health seeking behaviours were mothers' marital status [aOR = 0.74; 95% CI: 0.58-0.94], and mothers 'education level [aOR = 1.47; 95% CI: 1.13-1.92]. It was established in this study that health care seeking behaviours for these common childhood illnesses in poor resource settings was relatively high and could be predicted by mother's education level and mothers' marital status. Integrating interventions targeted at increasing utilisation of maternal and child health services with basic education to women and moral support counselling to families may potentially maximise health seeking behaviours in marginalised communities.
发展中国家，包括赞比亚，在儿童发病率和死亡率方面占比较大，这是由于常见的儿童疾病。关于在资源匮乏环境下寻求治疗儿童发热疾病的更广泛行为决定因素的研究有限。本研究调查了赞比亚资源匮乏地区母亲的卫生保健寻求行为，并确定了相关因素。
本研究使用横断面研究设计，对健康最贫困人群项目（HPP）的二次数据进行了分析，数据收集时间为 2019 年 3 月至 5 月。数据于 2013 年 5 月至 8 月间收集，通过向 5 岁以下儿童的母亲发放结构化问卷进行收集。调查在卢阿普拉省的 Samfya 和 Chiengi 进行，而在北部省，选择了 Luwingu 和 Mungwi 进行调查。共有 1653 名在接受采访前 14 天内经历过腹泻、疟疾、肺炎或三者组合的 5 岁以下儿童的母亲参与了研究。使用大量质量保证抽样（LQAS）方法确定样本量。为了确定受访者的人口统计学特征与卫生保健寻求行为之间的关联，进行了独立性卡方检验。还进行了多变量逻辑回归分析，以确定资源匮乏环境中 5 岁以下儿童常见儿童疾病的卫生保健寻求行为的预测因素。
在接受采访的母亲中，64.6%已婚，35.4%未婚。她们的平均年龄为 32 岁。为了给孩子治疗疾病而将生病的孩子带到医疗机构的母亲占 75.2%[95%CI：0.62-0.96]，而 24.8%的母亲没有带生病的孩子去寻求医疗服务。与卫生保健寻求行为相关的典型因素是母亲的婚姻状况[aOR=0.74；95%CI：0.58-0.94]和母亲的教育水平[aOR=1.47；95%CI：1.13-1.92]。
本研究表明，在资源匮乏环境中治疗这些常见儿童疾病的卫生保健寻求行为相对较高，可以通过母亲的教育水平和母亲的婚姻状况来预测。将针对增加孕产妇和儿童卫生服务利用的干预措施与妇女基本教育以及家庭道德支持咨询相结合，可能会最大限度地提高边缘化社区的卫生保健寻求行为。
