Marew Asnakech, Jebero Zaza Zenebe, Birhanu Shiferaw, Belachew Amare, Kasse Tsehaynew
College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar City, Ethiopia.
College of Medicine and Health Sciences, Arba Minch University, P.O. Box, 21, Arba Minch City, Ethiopia.
BMC Public Health. 2025 Jan 13;25(1):138. doi: 10.1186/s12889-025-21300-x.
Approximately 70% of child deaths due to diarrhea are caused by a lack of timely healthcare. However, there was little evidence of factors associated with delays in seeking health care for patients with diarrheal diseases in the study area. Therefore, this study aimed to investigate delays in seeking healthcare for children with diarrhea and identify associated factors among caregivers in health centers of Northwest Ethiopia.
An institution-based mixed study method was conducted from May to June 2022. Quantitative data were collected from 374 participants who were selected by systematic random sampling using a structured interviewer-administered questionnaire and chart review. The data were analyzed using the Statistical Package for Social Science software version 25. Bivariable and multivariable logistic regression models were used to identify associated factors. Variables with a p- value < 0.05 in the multivariable analysis were considered to be significantly associated. Qualitative data were collected from participants in waiting area after receiving treatments via in-depth interviews and analyzed using open-source software. The qualitative data were transcribed, translated, coded, thematized, and interpreted accordingly.
In this study, 53.48% of patients experienced delays in seeking healthcare for diarrhea. A large family size (adjusted odds ratio (AOR) = 2.64, 95% CI: 1.26-5.4), poor knowledge about diarrhea danger signs (AOR = 3.25, 95% CI: 1.6-6.6), difficulty paying for treatment (AOR = 2.95, 95% CI: 1.6-5.3), not visiting health facilities as the first response to diarrhea (AOR = 3.94, 95% CI: 1.96-7.9), only diarrhea (AOR = 2.39, 95% CI: 1.01-5.63), and no information about early healthcare seeking (AOR = 4.88, 95% CI: 1.91-12.43) were identified; moreover, from the qualitative findings, mothers' perceptions of the illness were mild, poor service provision, and economic problems were determinants of delay. Awareness, barriers, compliance, and perception emerged as themes.
The prevalence of delays in seeking healthcare for children with diarrhea was high. This poses a negative health risk to the lives of children and their caregivers. A large family size, poor knowledge about diarrhea danger signs, difficulty paying for treatment, and many others were factors associated with delayed health care seeking. Hence, the government and other concerned stakeholders should give due emphasis to tackling the identified causes of delay in seeking health care for children under five years of age with diarrhea by diverting community focus toward timely care seeking and disease prevention.
约70%的儿童腹泻死亡是由于缺乏及时的医疗保健。然而，在研究地区，几乎没有证据表明腹泻病患者寻求医疗保健延迟的相关因素。因此，本研究旨在调查埃塞俄比亚西北部健康中心腹泻儿童寻求医疗保健的延迟情况，并确定护理人员中的相关因素。
2022年5月至6月采用基于机构的混合研究方法。通过系统随机抽样从374名参与者中收集定量数据，使用结构化访谈问卷和病历审查。数据使用社会科学统计软件包第25版进行分析。采用双变量和多变量逻辑回归模型确定相关因素。多变量分析中p值<0.05的变量被认为具有显著相关性。定性数据通过深入访谈从接受治疗后的候诊区参与者中收集，并使用开源软件进行分析。定性数据进行转录、翻译、编码、主题化并相应解释。
在本研究中，53.48%的患者在寻求腹泻医疗保健方面存在延迟。家庭规模大（调整后的优势比（AOR）=2.64，95%置信区间：1.26 - 5.4）、对腹泻危险信号了解不足（AOR = 3.25，95%置信区间：1.6 - 6.6）、支付治疗费用困难（AOR = 2.95，95%置信区间：1.6 - 5.3）、腹泻时不将前往医疗机构作为首选反应（AOR = 3.94，95%置信区间：1.96 - 7.9）、仅表现为腹泻（AOR = 2.39，95%置信区间：1.01 - 5.63）以及没有关于早期寻求医疗保健的信息（AOR = 4.88，95%置信区间：1.91 - 12.43）被确定；此外，从定性研究结果来看，母亲对疾病的认知较轻、服务提供差和经济问题是延迟的决定因素。意识、障碍、依从性和认知成为主题。
腹泻儿童寻求医疗保健延迟的患病率很高。这对儿童及其护理人员的生命构成负面健康风险。家庭规模大、对腹泻危险信号了解不足、支付治疗费用困难等是与延迟寻求医疗保健相关的因素。因此，政府和其他相关利益攸关方应适当重视解决五岁以下腹泻儿童寻求医疗保健延迟的已确定原因，将社区关注点转向及时寻求护理和疾病预防。
