Urban-Rural Differences in Care-Seeking for Childhood Febrile Illnesses Among Mothers of Under-Fives in Anambra State, Nigeria

C. Ezenyeaku, C. Nnebue, N. Ezeama, C. C. Ezenyeaku, I. Njelita, C. C. Nwachukwu
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Abstract

Background: Despite inroads in treatment and prevention, childhood febrile illnesses remain global public health issues. Optimal care-seeking by mothers could influence health outcomes. Objective: To assess the differences in care-seeking patterns and practices for childhood febrile illnesses among mothers of under–fives in urban and rural areas of Anambra state, Nigeria. Methods: This was a comparative cross-sectional analytical mixed-method study. Multistage sampling technique was used to enrol 600 mothers of under-five children accessing child welfare clinics at the Primary Health Care facilities in Anambra state. Analysis of data was carried out using SPSS version 22; with alpha set at p-value ≤ 0.05.Triangulation of findings of the survey and thematic content analysis of the Focus Group Discussion was done. Results: Appropriate care was sought by 134 (44.7%) of the urban and 125 (43.2%) of the rural respondents (p = 0.458). Prompt appropriate care was sought by 122 (40.7%) of the urban and 98 (36.7%) of the rural respondents (p = 0.042). Distance to the health facility, determinant of place of care-seeking and possession of health insurance were significantly associated with appropriate and prompt care-seeking patterns among the mothers. Conclusions: Appropriate and prompt care-seeking is generally poor among the respondents in both localities. A reorientation of mothers on appropriate and prompt care-seeking practices through continuous health education and other awareness creation processes is needed.
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尼日利亚阿南布拉州五岁以下母亲儿童发热性疾病求诊的城乡差异
背景:尽管在治疗和预防方面取得了进展,儿童发热性疾病仍然是全球性的公共卫生问题。母亲的最佳求诊可能会影响健康结果。目的:评估尼日利亚阿南布拉州城市和农村地区五岁以下儿童发热性疾病母亲的求医模式和做法的差异。方法:采用比较横断面分析混合方法进行研究。采用多阶段抽样技术,在阿南布拉州初级保健设施的儿童福利诊所登记了600名5岁以下儿童的母亲。数据分析使用SPSS version 22;alpha集p值≤0.05。对调查结果进行了三角测量,并对焦点小组讨论的主题内容进行了分析。结果:城市和农村分别有134人(44.7%)和125人(43.2%)寻求适当护理(p = 0.458)。城市受访者中有122人(40.7%)和农村受访者中有98人(36.7%)寻求及时适当的治疗(p = 0.042)。与保健设施的距离、求医地点的决定因素和是否拥有医疗保险与母亲适当和及时的求医模式显著相关。结论:两地被调查者普遍缺乏适当、及时的就医服务。需要通过持续的保健教育和其他提高认识的进程,使母亲重新认识到适当和迅速的求医做法。
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