Contextual factors associated with health care service utilization for children with acute childhood illnesses in Nigeria.
<h4>Objective</h4>To examine the independent contribution of individual, community and state-level factors to health care service utilization for children with acute childhood illnesses in Nigeria.<h4>Materials and methods</h4>The study was based on secondary analyses of cros...
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Public Library of Science (PLoS)
2017-01-01
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| author | Sulaimon T Adedokun Victor T Adekanmbi Olalekan A Uthman Richard J Lilford |
| author_facet | Sulaimon T Adedokun Victor T Adekanmbi Olalekan A Uthman Richard J Lilford |
| author_sort | Sulaimon T Adedokun |
| collection | DOAJ |
| description | <h4>Objective</h4>To examine the independent contribution of individual, community and state-level factors to health care service utilization for children with acute childhood illnesses in Nigeria.<h4>Materials and methods</h4>The study was based on secondary analyses of cross-sectional population-based data from the 2013 Nigeria Demographic and Health Survey (DHS). Multilevel logistic regression models were applied to the data on 6,427 under-five children who used or did not use health care service when they were sick (level 1), nested within 896 communities (level 2) from 37 states (level 3).<h4>Results</h4>About one-quarter of the mothers were between 15 and 24 years old and almost half of them did not have formal education (47%). While only 30% of the children utilized health service when they were sick, close to 67% lived in the rural area. In the fully adjusted model, mothers with higher education attainment (Adjusted odds ratio [aOR] = 1.63; 95% credible interval [CrI] = 1.31-2.03), from rich households (aOR = 1.76; 95% CrI = 1.35-2.25), with access to media (radio, television or magazine) (aOR = 1.18; 95% CrI = 1.08-1.29), and engaging in employment (aOR = 1.18; 95% CrI = 1.02-1.37) were significantly more likely to have used healthcare services for acute childhood illnesses. On the other hand, women who experienced difficulty getting to health facilities (aOR = 0.87; 95% CrI = 0.75-0.99) were less likely to have used health service for their children.<h4>Conclusions</h4>Our findings highlight that utilization of healthcare service for acute childhood illnesses was influenced by not only maternal factors but also community-level factors, suggesting that public health strategies should recognise this complex web of individual composition and contextual composition factors to guide provision of healthcare services. Such interventions could include: increase in female school enrolment, provision of interest-free loans for small and medium scale enterprises, introduction of mobile clinics and establishment of more primary health care centres. |
| format | Article |
| id | doaj-art-278d6a65eb7347ef98b2dc8a8f762e4e |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-278d6a65eb7347ef98b2dc8a8f762e4e2025-08-20T03:24:27ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01123e017357810.1371/journal.pone.0173578Contextual factors associated with health care service utilization for children with acute childhood illnesses in Nigeria.Sulaimon T AdedokunVictor T AdekanmbiOlalekan A UthmanRichard J Lilford<h4>Objective</h4>To examine the independent contribution of individual, community and state-level factors to health care service utilization for children with acute childhood illnesses in Nigeria.<h4>Materials and methods</h4>The study was based on secondary analyses of cross-sectional population-based data from the 2013 Nigeria Demographic and Health Survey (DHS). Multilevel logistic regression models were applied to the data on 6,427 under-five children who used or did not use health care service when they were sick (level 1), nested within 896 communities (level 2) from 37 states (level 3).<h4>Results</h4>About one-quarter of the mothers were between 15 and 24 years old and almost half of them did not have formal education (47%). While only 30% of the children utilized health service when they were sick, close to 67% lived in the rural area. In the fully adjusted model, mothers with higher education attainment (Adjusted odds ratio [aOR] = 1.63; 95% credible interval [CrI] = 1.31-2.03), from rich households (aOR = 1.76; 95% CrI = 1.35-2.25), with access to media (radio, television or magazine) (aOR = 1.18; 95% CrI = 1.08-1.29), and engaging in employment (aOR = 1.18; 95% CrI = 1.02-1.37) were significantly more likely to have used healthcare services for acute childhood illnesses. On the other hand, women who experienced difficulty getting to health facilities (aOR = 0.87; 95% CrI = 0.75-0.99) were less likely to have used health service for their children.<h4>Conclusions</h4>Our findings highlight that utilization of healthcare service for acute childhood illnesses was influenced by not only maternal factors but also community-level factors, suggesting that public health strategies should recognise this complex web of individual composition and contextual composition factors to guide provision of healthcare services. Such interventions could include: increase in female school enrolment, provision of interest-free loans for small and medium scale enterprises, introduction of mobile clinics and establishment of more primary health care centres.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0173578&type=printable |
| spellingShingle | Sulaimon T Adedokun Victor T Adekanmbi Olalekan A Uthman Richard J Lilford Contextual factors associated with health care service utilization for children with acute childhood illnesses in Nigeria. PLoS ONE |
| title | Contextual factors associated with health care service utilization for children with acute childhood illnesses in Nigeria. |
| title_full | Contextual factors associated with health care service utilization for children with acute childhood illnesses in Nigeria. |
| title_fullStr | Contextual factors associated with health care service utilization for children with acute childhood illnesses in Nigeria. |
| title_full_unstemmed | Contextual factors associated with health care service utilization for children with acute childhood illnesses in Nigeria. |
| title_short | Contextual factors associated with health care service utilization for children with acute childhood illnesses in Nigeria. |
| title_sort | contextual factors associated with health care service utilization for children with acute childhood illnesses in nigeria |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0173578&type=printable |
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