Healthcare-seeking Behaviour for Common Infectious Disease-related Illnesses in Rural Kenya: A Community-based House-to-house Survey

Authors

  • Deron C Burton Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA
  • Brendan Flannery Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA
  • Bernard Onyango Kenya Medical Research Institute/CDC Research and Public Health Collaboration, Kisumu
  • Charles Larson McGill Medical School, Montreal
  • Jane Alaii Kenya Medical Research Institute, Kisumu
  • Xingyou Zhang Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA
  • Mary J Hamel Kenya Medical Research Institute/CDC Research and Public Health Collaboration, Kisumu
  • Robert F Breiman CDC International Emerging Infections Program, Nairobi,
  • Daniel R Freikin CDC International Emerging Infections Program, Nairobi,

DOI:

https://doi.org/10.3329/jhpn.v29i1.7567

Keywords:

Community health services, Delivery of healthcare, Diarrhoea, Fever, Healthcare-seeking behaviour, Pneumonia, Rural health, Rural health services, Kenya

Abstract

Community surveys of healthcare-use determine the proportion of illness episodes not captured by health facility-based surveillance, the methodology used most commonly to estimate the burden of disease in Africa. A cross-sectional survey of households with children aged less than five years was conducted in 35 of 686 census enumeration areas in rural Bondo district, western Kenya. Healthcare sought for acute episodes of diarrhoea or fever in the past two weeks or pneumonia in the past year was evaluated. Factors associated with healthcare-seeking were analyzed by logistic regression accounting for sample design. In total, 6,223 residents of 981 households were interviewed. Of 1,679 children aged less than five years, 233 (14%) had diarrhoea, and 736 (44%) had fever during the past two weeks; care at health facilities was sought for one-third of these episodes. Pneumonia in the past year was reported for 64 (4%) children aged less than five years; 88% sought healthcare at any health facility and 48% at hospitals. Seeking healthcare at health facilities was more likely for children from households with higher socioeconomic status and with more symptoms of severe illness. Health facility and hospital-based surveillance would underestimate the burden of disease substantially in rural western Kenya. Seeking healthcare at health facilities and hospitals varied by syndrome, severity of illness, and characteristics of the patient.

Key words: Community health services; Delivery of healthcare; Diarrhoea; Fever; Healthcare-seeking behaviour; Pneumonia; Rural health; Rural health services; Kenya

DOI: 10.3329/jhpn.v29i1.7567

J HEALTH POPUL NUTR 2011 Feb;29(1):61-70

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How to Cite

Burton, D. C., Flannery, B., Onyango, B., Larson, C., Alaii, J., Zhang, X., Hamel, M. J., Breiman, R. F., & Freikin, D. R. (2011). Healthcare-seeking Behaviour for Common Infectious Disease-related Illnesses in Rural Kenya: A Community-based House-to-house Survey. Journal of Health, Population and Nutrition, 29(1), 61–70. https://doi.org/10.3329/jhpn.v29i1.7567

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Original Papers