The socio-demographic determinants of health care seeking behaviour by carers of children with diarrhoea in rural communities in Enugu state, Nigeria

Background: Diarrhoeal illness is a global leading cause of death in children under five years old worldwide but especially in developing countries. In Nigeria, it is the major cause of childhood mortality after malaria. Published extant literature reveals that the severest impact of diarrhoea is concentrated in rural areas where sanitation and hygiene practices are historically poor. Death due to diarrhoeal illness entirely preventable via timely health seeking behaviour and practices. Aim: This study aimed to examine the effect of socio-demographic factors on the health seeking behaviours of carers for children with diarrhoeal illness in rural communities in Nkanu West LGA of Enugu state, Nigeria. Methods: A cross sectional survey of caregivers in rural communities was undertaken in Nkanu West LGA of those caring for children aged under five years old that have had diarrhoea in the last three months. Data on their health seeking behaviour and socio-demographic characteristics were collected using a semi-structured self-administered questionnaire. Statistical Package for Social Sciences was used to analyse the data using Chi-Square to determine inferential statistics on the established relationship between socio-demographic characteristics and health seeking behaviour. Results: Of the 140 caregivers interviewed, most were aged between 26-30 years (42.1%), traders (30.0%), had at least secondary education (35.0%). The majority of their children were aged between 0-12 years (40.7%) and male (52.1%). 74.3% sought medical care beyond the context of their home during episodic diarrhoea and the majority reported first visiting primary health centres (36.2%). Alternative medical institutions that people accessed were hospitals (14.3%), Traditional Birth Attendants (23.8%), chemists (16.2%), and traditional healer (9.5%). The major reason for the choice of institution visited was accessibility (37.1%). However, not seeking care outside the home was due to perceived severity [not serious (45.7%). Oral rehydration solution use was high (86.4%). Factors associated with the medical care context visited were education (p=0.010), occupation (p=0.002), affordability (p=0.005), accessibility (p=0.002), significant others (p=0.005). Conclusion: Results of this study reveal a significant level of appropriate health seeking behaviour amongst the caregivers in the geographical area. Instead, social, economic and demographic factors were found to be the major determinants of health seeking behaviours. These findings suggest a potential need to improve awareness of the necessity of appropriate health seeking behaviours as well as increasing access to affordable health care in the context of rural Nigerian communities.