Determinants of Health Care Service Utilization for Common Childhood Illness in Nepal: Results from the Nationally Representative Sample

Background:

The United Nations’ Sustainable Development Goals (SDGs) Goad 3 suggests for ‘ensuring healthy lives and promoting well-being for all of all ages,’ including children. SDG Goal 3 emphasizes reducing common illness associated with child mortality.  Child mortality has been decreased worldwide; however, child mortality and morbidity remain a significant public health and child welfare issue in developing countries of South Asia such as Nepal.

Method:

The current study attempts to examine the factors that are associated with healthcare service utilization against common child illness (e.g., diarrhea, fever, and fever/cough) using Anderson’s Health Behavioral Model. A nationally representative sample of Nepal (the 2016 NDHS) was used. Mothers of children under five year were asked about child’s illness and asked whether they sought any treatment for diarrhea and fever/cough. Multivariate logistic regressions were conducted considering the sampling weight for complex sampling design.

Results:

We found that around 7% of the children had diarrhea last 24 hours before the survey. Among them, approximately 85% of children received any form of treatment. Approximately 20% of the children got a fever two weeks before the survey. Among them, 51% of the children received treatment. Around 20% of children had got both fever and cough two weeks before the survey. Among them, only 52 % of children sought for treatment. Results from multivariate logistic regression (after controlling for all factors) suggest that household wealth and mother’ higher level of education had higher Odd Ratios (ORs) for the likelihood of health care service utilization.

Conclusion

Low economic status and mother's lower level of educational attainment were risk factors for health care service non-utilization against common childhood illness in Nepal. The current study suggests that policies should be developed for educating mothers as well as developing practical economic policies to enhance the economic status of lowest wealth quantile mothers. We conclude that women’s educational and economic empowerment is the way to reduce child morbidity and mortality in developing countries.