MOTHERS’ TWO – WEEK RECALL OF COMMON MANIFESTATIONS OF ILLNESS IN UNDER – FIVE CHILDREN AND HEALTH SEEKING PRACTICES IN KEFFI, NASARAWA STATE

Abstract

Under – five mortality has remained unacceptably high in developing countries like Nigeria despite a number of strategies aimed at improving child survival. An understanding of the pattern of diseases among this population and the factors influencing care seeking by parents for children is an invaluable tool in increasing access to health care. Two – thirds of under – five deaths can be prevented by extending access to mothers and children with interventions available today.
The study was undertaken to determine the common manifestations of illness and health seeking practices for under – five children in Keffi, Nasarawa State. It was a community – based, cross – sectional survey carried out in three of the six districts of Keffi Local Government area of Nasarawa State within the month of July 2008. Four hundred and fifty mothers who had children less than five years old were selected through a stratified, multi – stage cluster sampling technique based on a modification of the framework provided by the National Population Commission. Data was obtained by household interviews based on pre – tested, semi – structured questionnaires.
The ages of respondents ranged from 14 – 45 (mean 29.93 + 6.57) years and about three – quarters of them had four children or less. Two hundred and fifteen (47.8%) of the mothers had secondary school education while 261 (58.0%) were gainfully employed. Almost 80% of the families belonged to either social class III or IV.
Altogether, the respondents had 623 under – five children of whom 152 (24.4%) had disease symptoms in the two – week period preceding the survey. More than 90% of the symptoms were attributable to largely preventable diseases such as malaria and other febrile illnesses (70%), acute respiratory infections (25%), diarrhoea (22%) and measles (16%).
Although the mothers were the first to recognize the symptoms of illness in children in 432 (96%) households, the fathers single – handedly determined where care was sought for in 331 (74%) households. Medicine bought from patent medicine vendors (PMV) were used as the first resort for 84 (55%) ill children, followed by hospital consultations for 28 (18%) children and home care for 16 (11%) children. No treatment had been given to 24 (16%) of the symptomatic children within the period and the administration of traditional medication was not mentioned as an initial intervention in response to illnesses. However, this did not exclude the use of traditional medication as a subsequent measure. There were no statistically significant differences in the treatment modality sought for ill children based on the gender of the children or the income – earning capacity of the mothers.
Maternal knowledge on common childhood illnesses was significantly associated with the measures taken during the course of children’s illnesses. Mothers with formal education relied more on drugs bought from PMV while un – educated women took their children to the hospital more often as a first resort (x2 = 8.27, df = 1, p = 0.004). Maternal formal education also showed significant association with a
better knowledge of common childhood diseases, use of preventive health services and decision making on care seeking for children. Other factors which also demonstrated significant associations with a better knowledge of illnesses and appropriate use of preventive health facilities include maternal employment and higher social class. Some of these factors were likewise found to be significantly associated with healthy home practices such as exclusive breastfeeding.
Hindrances to the utilization of health care services for children in Keffi were linked to poor attitude of hospital staff, financial constraint, delayed attention and preference for alternative medicine.
It is concluded that although the rate of health service utilization in Keffi was higher than the average rates given for the North Central zone of the country, it could be improved upon. Several deficiencies were identified in the knowledge of mothers on common childhood diseases, how to identify such diseases and appropriate preventive and curative measures.
There is a need for health education of parents, especially the mothers in Keffi, on common childhood ailments, the importance of health care services in the prevention and treatment of these diseases as well as breastfeeding.

MOTHERS’ TWO – WEEK RECALL OF COMMON MANIFESTATIONS OF ILLNESS IN UNDER – FIVE CHILDREN AND HEALTH SEEKING PRACTICES IN KEFFI, NASARAWA STATE