Effect of residence on mothers’ health care seeking behavior for common childhood illness in Northwest Ethiopia: a community based comparative cross – sectional study

Gelaw et al. BMC Research Notes 2014, 7:705 http://www.biomedcentral.com/1756-0500/7/705 RESEARCH ARTICLE Open Access Effect of residence on mothers’ health care seeking behavior for common childhood illness in Northwest Ethiopia: a community based comparative cross – sectional study Yalemzewod Assefa Gelaw*, Gashaw Andargie Biks and Kefyalew Addis Alene Abstract Background: Children are at higher risk of acquiring infections and developing severe disease. This study assessed the health care seeking behavior and associated factors of urban and rural mothers for common childhood illness in Northwest Ethiopia. Methods: A comparative community based cross-sectional study was conducted among urban and rural mothers living in the district. A multistage sampling technique was used to select the study participants. A pre-tested and structured questioner via interview was used to collect the data. Binary logistic regression analysis was used to identify associated factors. Odds ratio with 95% CI was computed to assess the strength of the associations. Result: A total of 827 (274 urban and 553 rural) mothers were interviewed. Among these, 79.3% (95% CI: (76.5%, 82.06%)) of the mothers were sought health care in the district. Health care seeking behavior was higher among urban mothers (84.6%) than rural mothers (76.7%). Marital status, completion health extension package, and sex of child were significantly associated with health care seeking behavior of urban mothers. Whereas age of child, age and occupation of mothers, educational level of fathers, wealth quintile, and type of reported illness were significantly associated with rural mothers. Perceived severity of illness was significantly associated with both urban and rural mothers for health care seeking behavior. Conclusion: The overall health seeking behaviors of mothers for common childhood illness was high. However, urban mothers seek health care more than rural. Socio Economic position and types of reported illness has an effect for health seeking behavior of rural mothers. Whereas child sex preference and graduation status for health extension package has an effect for health care seeking behavior of urban mothers. Work on strengthen accessibility of health care services in the rural mothers and increase awareness of mothers about the disadvantage of sex preferences will improve the health care seek behavior of families regardless of the severity of illness and types of illnesses. Keywords: Health care seeking behavior, Mothers, Urban and rural communities, Northwest Ethiopia * Correspondence: Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia © 2014 Gelaw et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Gelaw et al. BMC Research Notes 2014, 7:705 http://www.biomedcentral.com/1756-0500/7/705 Background Millions of mothers and their children through the world are living in a social environment that doesn’t encourage health care seeking behavior [1]. Reduction of childhood mortality is a worldwide health priority and one of the Millennium Developmental Goals (MDG). According to the United Nations Children’s Fund (UNICEF) 2012 report globally 6.9 million children die before the age of five years annually. The majority of these death occurred in Sub-Saharan Africa. Ethiopia is one of the countries with a consistently high under- five mortality rate. It is ranked 36th among Sub- Saharan Africa countries [2]. Rural and urban populations have differences in sociodemographic, socio-economic and cultural compositions which have an effect on their health care seeking behavior. In sub Saharan Africa, child mortality is higher among rural, poor and less educated families [3]. Early health care seeking behavior of mothers has a potential to reduce child mortality particularly in developing countries like Ethiopia [4]. However, different studies showed that mothers health care seeking behavior for common childhood illness are influenced by socio-demographic and cultural, educational factors. Studies also indicated that timely decision to seek remedies, and times of health seeking after the onset of illness are influenced by residence [5-7]. Children from rural communities often have the highest risk of infection and severe disease especially for diarrhea, fever and acute respiratory illness (ARI), mothers are less likely to seek appropriate health care for them as compared to urban mothers [8]. Little is known about the magnitude and determinants of health care seeking behaviors of mothers’ for their children when they ill in Ethiopia especially in the study area. However, recent evidence indicates that health care seeking behaviors of mothers are increasing because of it considers only the urban dwellers. Thus, this study aimed to identify the prevalence of health care seeking behaviors and associated factors of health care seeking behaviors among mothers for their children living in urban and rural areas. Methods A community based comparative cross – sectional study was conducted in Bure district from April to June, 2103. It is about 419 km away from Northwest of Addis Ababa, the capital city of Ethiopia. According to the 2007 census projection, the district has a total population of 161,480. It has five urban and twenty three rural kebeles [9]. Multistage sampling technique was used to select the study participants. The district was classified into two strata; urban and rural. Then three urban and six rural kebeles were randomly selected. For the purpose of this study, census was conducted in the selected kebele to estimate the approximate number of eligible mothers. Mothers who had under – five children with common Page 2 of 8 childhood illnesses two weeks preceding the data collection period were included. Whenever there was more than one mother having under - five children in the household, one of them were selected using lottery method. The sample size was calculated using a two population proportion formula; considering 37.2% proportion of urban mothers and 22.4% rural mothers seeking health care for fever according to EDHS report [10], a 5% significance level, power of 80%,1:2 urban to rural ratio, design effect 2 and 10% possible non – response rate. The sample size was estimated to be 786 (274 urban and 553 rural). While a sample size was regionally computed to be 786, a preliminary survey prior to a data collection shows that 886 mothers were eligible. Data were collected via interview with a pre-tested and structur (...truncated)