ABSTRACT
Introduction: In developing countries like Nigeria, treatable and preventable diseases such as malaria, Upper Respiratory Tract Infections (URTIs) and diarrhea accounts for high levels of child morbidity and mortality. Despite the availability of medicines and interventions to alleviate this huge public health concern, poor health-seeking behaviours and irrational use of medicines still complicates the burden of these diseases in Nigerian communities. Aim/Objectives: The main objective of this study was to understand disease prevalence, health-seeking behavior and medication utilization among under-5 children in a rural community. Methods: Three approaches were utilised. Firstly, a cross-sectional community-based study was adopted, involving parents/caregivers of children aged 5years and below, who had been ill within the last 4 weeks prior to the study. Data were collected through house-to-house survey and in-depth interviews using questionnaire. Secondly, past hospital records of children 5years and below, from January 2022 to December 2022, were also reviewed using WHO core prescribing indicator proforma for medication utilization studies. Lastly, focused group discussion with caregivers of children aged under 5years was done and audio records were transcribed to document and textual discussion carried out. Data analyses were done using SPSS version 17. Descriptive statistics were computed using frequencies and percentages. Results: A total of 272 caregivers in the community were interviewed, 1300 patients’ files were reviewed for retrospective records and 6 discussants were engaged in focused group discussion. From caregivers’ interviews, 51(42.5%) children were 6 months and below. Most caregivers used high fever 113(93.4%), looking unwell and not playing 92(76.0%) as symptoms signaling the illness of a child. The most common symptom that led to health seeking for under 5 children were cough 86(71.1%) and fever 63(52.1%). Onset of symptoms led caregivers to seek care, making their first point of call mostly at hospitals 56(46.7%) and chemists (PPMVs) 29(24.2%). If symptoms were unresolved, the second point of call by the caregivers were mostly hospitals 30(25%) and pharmacies 29(24.2%). Ninety-eight (98, 81.7%) respondents were the ones who decided where to seek healthcare, while 19(15.8%) reported that their partners made the decision. Cost of service 54(45%), severity of illness 34(28.3%), and quality of service 17(14.2%) were all factors influencing health-seeking behaviour. Malaria was found to be the most prevalent illness 57(47.5%) among young children in the community. For hospital investigations, records showed that 104(34.9%) children were below 6months and malaria was the most common illness for which care was sought at the hospital. All prescribing indicators deviated significantly from WHO recommendations. From the focused group discussions, some sub-themes that emerged were unhygienic practices, health threatening environment and disease-causing pathogens. Conclusion: The health-seeking behavior and medication utilization of parents/caregivers of children aged 0 to 5 years in the rural community was not uniform. Most of them used licensed sources and obtained their medications from places such as hospitals, proprietary patent medicine vendors (PPMVs), and pharmacies. There is the need for behavioral change interventions as some caregivers still turn to unregulated herbal medicines and unlicensed sources for healthcare, which is considered detrimental to the health of the child. Key words: health-seeking behavior, medication utilization, healthcare utilization, children, illness.
