Health-seeking behaviour and its determinants of health of Under-5 Children living in urban slums of Chennai, India 2018

Parasuraman Ganeshkumar; Pattabi Kamaraj; S Mageswari; K Gayathri; Srilekha Gajendran; S Karthigai Selvi; H Magesh Rajan; M Balusamy; R Vijayaprabha

doi:10.4103/jfmpc.jfmpc_817_23

Health-seeking behaviour and its determinants of health of Under-5 Children living in urban slums of Chennai, India 2018

J Family Med Prim Care. 2023 Nov;12(11):2934-2941. doi: 10.4103/jfmpc.jfmpc_817_23. Epub 2023 Nov 21.

Authors

Parasuraman Ganeshkumar¹, Pattabi Kamaraj¹, S Mageswari¹, K Gayathri¹, Srilekha Gajendran¹, S Karthigai Selvi¹, H Magesh Rajan¹, M Balusamy¹, R Vijayaprabha¹

Affiliation

¹ Department of Epidemiology and Biostatistics, ICMR -National Institute of Epidemiology, Chennai, Tamil Nadu, India.

Abstract

Background: Appropriate health-seeking behaviour could help in reducing child mortality and morbidity. Information on social factors of mortality and health-seeking behaviours of caregivers of under-5 children from slums of Indian cities is minimal in literature.

Objectives: We estimated the prevalence of health-seeking behaviour for morbidity ofunder-5 children and its determinants in urban slums in Chennai city, India.

Methods: A cross-sectional study was conducted using a mixed-method design among primary caregivers of under-5 children living in Chennai slums, India. Two-stage cluster sampling was adopted to select 40 slums. A total of 233 primary caregivers were interviewed. Nine focus group discussions and 18 in-depth interviews were conducted among the primary caregivers. Prevalence of inappropriate health-seeking behaviour was estimated, and determinants were identified by multivariate binary logistic regression analysis. Thematic analysis was done on qualitative data.

Results: We interviewed 233 primary caregivers. The weighted prevalence of inappropriate health-seeking behaviour for under-five children in urban slums of Chennai was 53.9% (95% CI: 46.9 - 60.8). Primary caregivers educated above secondary school were more likely (AOR of 2.3, 95% CI: 1.3-4.1) to follow inappropriate health-seeking behaviour compared to those educated below. Similarly, caregivers who were unaware of young child feeding practices (AOR of 3.6, 95% CI: 1.9-6.5) and early care-seeking and health practices (AOR of 2.5, 95% CI: 1.3-4.9) were more likely to engage in inappropriate health-seeking behaviour compared to those who were aware and we found that illness symptoms influenced health-seeking behaviour and that early disease detection might prevent severe illness.

Conclusion: Health-seeking behaviour was found to be suboptimal among under-5 children in Chennai's urban slums. We suggest policymakers improve interventions on early care-seeking of common childhood illnesses in the urban health programme.

Keywords: Health-seeking behaviour; health utilization behaviour; slum; under-5 children.