Healthcare-seeking practices of caregivers of under-five children with diarrheal diseases in two informal settlements in Nairobi, Kenya

Abstract

Background Diarrhea is among the leading causes of childhood mortality in developing countries. In Kenya, it is the second highest cause of death among children. Despite diarrhea being a disease that is easy to prevent and treat, it causes about 1.5 million under-five deaths every year. The mortality due to diarrheal diseases is worse in slums which are characterized by poor hygiene and sanitation. Mortality due to diarrhea is preventable and appropriate and prompt healthcare-seeking is one of the ways of prevention. Objectives The study aimed at exploring the healthcare-seeking practices of caregivers with under-five children with diarrhea in two slum settlements – Korogocho and Viwandani in Nairobi city, Kenya. Specifically the study will: 1) Describe the socio-demographic characteristics of the study population; 2) Identify the healthcare-seeking practices of caregivers of under-five children with diarrhea; 3) Determine the prevalence of appropriate healthcare-seeking practices in the two slums; 4) Identify the socio-demographic factors associated with healthcare-seeking practices of caregivers of under-five children with diarrheal diseases. Methods The study used data from a project nested into the Nairobi Urban Health and Demographic Surveillance System, which collected data on morbidity for children reported to be ill over the last 2 weeks preceding the survey. The study was conducted between 2006 and 2010 in two informal settlements in Nairobi. There were a total of 11,677 interviews with caregivers who had children below five years, of which 1,656 had children who had diarrhea two weeks preceding IX the study. Appropriate multivariate statistical techniques were used to examine the factors associated with healthcare-seeking practices. Results The study shows that healthcare-seeking practices for diarrhea remains a great challenge among the urban poor with more than half (55%) of the caregivers seeking inappropriate health care. A significant proportion of caregivers (35%) are taking no action regarding the child illness. The use of ORS and Zinc supplements which have been widely recommended for the management of diarrhea by the UNICEF and WHO is very low. The critical predictors of healthcare-seeking identified by the study are duration of illness, place of residence and the child’s age.