Health-care seeking for childhood diseases by parental age in Western and Central Africa between 1995 and 2017: A descriptive analysis using DHS and MICS from 23 low- and middle-income countries

Abstract

Background: Globally, health care seeking for childhood diseases seems to be on the rise. However, progress is slow and still, many cases of infectious diseases in children remain untreated, leading to preventable child mortality. A better understanding of care seeking behaviour may help to further increase the probability that a sick child is taken to a health facility for care.

Methods: We investigated whether mother's and father's age at birth of the child is associated with health care seeking behaviour for childhood diseases and how this association changed over time. For this observational study, we used repeated cross-sectional data, namely all available Demographic and Health Surveys as well as Multi-Indicator Cluster Surveys from Western and Central Africa, 1995 to 2017. We analysed care seeking behaviour for diarrhoea, acute respiratory infections (ARI), and treatment of diarrhoea with oral rehydration solution (ORS). We estimated ordinary least squares regressions, controlling for socioeconomic characteristics of the household and adding survey year- and country-fixed effects. Estimated associations are presented for the entire region and for each country separately to highlight heterogeneity.

Results: Overall, the likelihood that care is sought for a child suffering from diarrhoea or ARI is low in Western and Central Africa. Probability of care seeking for diarrhoea ranges between 49% for mothers above 40 years and 53% for mothers between 25 and 29 years. For ARI, the rates are 60% and 62%, respectively. Treatment of diarrhoea with ORS is even lower, ranging between 23% and 26%. The probability that parents seek health care for their child does not seem to be associated with parents' age at birth. Mother's level of education and household's wealth status seem to be more important factors. There is evidence of the relationship between parents' age and care seeking changing over time, suggesting a stronger association in the past.

Conclusions: Parents' age at child birth does not seem to have a relevant association with care seeking for common childhood diseases. Identifying relevant factors may help in improving health care seeking behaviour of parents in low- and middle-income countries leading to reductions in child morbidity and mortality.

Figure 1

Sample selection.

Figure 2

Prevalence of care seeking across age groups of parents. Panel A. Prevalence of Care seeking for diarrhoea across age groups of mother. Panel B. Prevalence of Care seeking for diarrhoea across age groups of father. Panel C. Prevalence of Care seeking for ARI across age groups of mother. Panel D. Prevalence of Care seeking for ARI across age groups of father. Panel E. Prevalence of Treatment with ORS across age groups of mother. Panel F. Prevalence of Treatment with ORS across age groups of father. Note: Prevalence of care seeking by age group of mother and father, across all countries, weighted by each country’s female population aged 15 to 49 years in 2017, means and 95% confidence intervals. ARI – acute respiratory infections. ORS – oral rehydration solution.

Figure 3

Coefficients of parents’ age from model 3 (with father’s age) by country. Panel A. Coefficients of mother’s age, outcome variable: Care seeking for diarrhoea. Panel B. Coefficients of father’s age, outcome variable: Care seeking for diarrhoea. Panel C. Coefficients of mother’s age, outcome variable: Care seeking for ARI. Panel D. Coefficients of father’s age, outcome variable: Care seeking for ARI. Panel E. Coefficients of mother’s age, outcome variable: Treatment with ORS. Panel F. Coefficients of father’s age, outcome variable: Treatment with ORS. Note: Coefficients and confidence intervals of mother’s age, age categories <20 and 40+, and father’s age, age categories <25 and 45+, based on country-specific regressions following column (7) in Table 1, Table 2, Table 3, respectively. ARI – acute respiratory infections. ORS – oral rehydration solution.