Data from: Determinants of appropriate health-seeking behavior for febrile illness among caregivers of children under 5 years in Busia county, Kenya

Background of the study: Globally, about 75% of under-five deaths are
still caused by febrile illnesses such as pneumonia, malaria, and typhoid
fever. In Kenya, more than 10 million episodes of acute febrile illness
are treated annually among under-five-children. According to the Kenya
Demographic and Health Survey, during the two weeks before the survey, 2%
of children under age 5 showed symptoms of an ARI, 17% exhibited fever,
and 14% experienced diarrhea. Therefore, this study ascertained the
proportion and determinants of health-seeking behavior (HSB) for febrile
illness and generated information that informs the efforts towards timely
seeking care for febrile illness among caregivers under under-five.
Objective: To determine the proportion and the determinants of
health-seeking behavior (HSB) for febrile illness among caregivers of
children under five years in Butula Sub- County, Busia County, Kenya.
Methods and Materials: The study was conducted in Busia County using a
cross-sectional design, which utilized a mixed method approach. The study
population was caregivers for the under five years old children in the
Butula sub-county. The participants were selected using systematic random
sampling with the guide from Butula sub-county register. Quantitative data
was to be gathered from caregivers using questionnaires, and data from
health facility staff (key informants) and community health volunteers
(focus group discussion) was used for qualitative data. Qualitative data
was transcribed, entered, coded, and analyzed thematically. For
quantitative data, categorical variables were analyzed using frequencies,
percentages, and mean and standard deviations in Statistical Package for
Social Scientists (SPSS). To test association, chi-squire was used while
multivariable analysis was done using binominal regression with a p
< 0.05 as statistically significant at a 95% confidence level.
Results: The quantitative data was gathered from 271 caregivers,
while qualitative data was obtained from two focused groups, each
involving five community health volunteers and interviews from 6 key
informants. A majority of the participants were aged between 21-30 years
(42.1%, n = 114), were females (84.1%, n = 228), had secondary education
(44.6%, n = 121), were farmers by occupation (39.9%, n = 108), earned less
than KES. 5000 (75.3%, n = 204), were from nuclear households (79.3%, n =
215), and had at most two children at home (48.7%, n = 132). The
proportion of children under five years old with febrile illness was 64.6%
(n = 175), with 70.1% (n = 190) of the participants indicating they sought
care for a child's fever within 24 hours. Individual factors
influencing good health-seeking behavior 24 hours after controlling
confounders were unemployment (adjusted odds ratio (aOR) = 0.49, 95% CI:
0.217 – 0.593, p = 0.018), preferring self-medication over profession care
(aOR = 0.14, 95% CI: 0.054 – 0.363, p < 0.001), had two or more
children (aOR = 0.63, 95% CI: 0.425 – 0.937, p = 0.042), and being
confident in identifying fever (aOR = 7.0, 95% CI: 2.200 – 22.439, p =
0.001). The health system-related factors with statistically significant
association to health-seeking behavior were caregivers who felt a facility
was far (aOR = 0.86, 95% CI: 0.526 – 0.914, p = 0.027), those who received
health education from the staffs' olds (aOR = 1.8, 95%CI:
1.201-4.122, p=0.015), and the level of facility (aOR = 4.4, 95% CI: 2.015
– 9.750, p < 0.001). Qualitatively, patient ignorance, stock-outs,
facility distance, staff workload, and poverty among caregivers were
identified as factors influencing health-seeking behavior.
Conclusion: In our study, many caregivers take more than 24 hours
to seek care for fever. Among the identified individual factors associated
with health-seeking behavior were unemployment, those who preferred
self-medication for their child's fever, having two or more children,
and being comfortable identifying fever in children under five. The health
system factors that were identified to have a negative impact on
health-seeking behavior within 24 hours were a facility being too far,
staff workload, drug stock out, and inadequate sensitization due to a
shortage of community outreach programs.