Factors Associated with Appropriate Care-Seeking for Fever in under-5 Children: Comparative Multilevel Analysis of National Data in Three West African Countries.

Stella Babalola, Johns Hopkins University
Angela Acosta, Johns Hopkins University

Introduction: Malaria continues to be a major source of morbidity and mortality in Africa. Appropriate care for febrile children under five years remains suboptimal in Burkina Faso, Guinea, and Nigeria. Theory: This study is grounded in the ideation model that posits that the decision to adopt a health-protective behavior is influenced by a set of psychosocial variables. Data: The analyses used data from national surveys (Burkina Faso: DHS; Guinea and Nigeria: MIS) conducted in 2021 and that included the Social and Behavior Change (SBC) module. We analyzed datasets that include 12,343 under-5 children in Burkina Faso, 4,133 in Guinea, and 10,988 in Nigeria. Methods: Using mixed effects logistic regression with QR decomposition, the study examined the correlated of appropriate care-seeking for a child with fever in the past two weeks. Findings: Both the incidence of fever and the prevalence of appropriate care-seeking varied across countries. In all three countries, significant correlates include attitudes towards self-medication and the belief that prompt care-seeking for fever was a community norm. There was significant clustering of the behavior at the cluster level. Conclusion: The ideation model appears useful for understanding the important factors for promoting appropriate care-seeking for fever in children.

Keywords: Children, Adolescents, and Youth, Health and Morbidity

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