Does free of charge policy increase care-seeking for children under five in Sierra Leone? Evidence from population-based studies from 2008-2016

Résumé

Abstract Background In 2010, the Government of Sierra Leone has implemented the Free Health Care Initiative (FHCI) in the country with the objective to reduce under five mortality. The biggest share of this mortality in the country is attributable to infectious diseases. Care-seeking for children under five is a key point to reduce mortality due to infectious diseases as it permits early diagnosis and prompt and correct treatment. The objective of this study was therefore to assess the trend in the prevalence of care-seeking as well as to identify determinants of utilization of healthcare services by under-five (U5) caregivers under the policy initiative. Methods The analysis of care-seeking behavior was done using data from three population-based studies in Sierra Leone (2008-before FHCI and 2013, and 2016-After FHCI). Care-seeking behavior was assessed through care-seeking of caregivers of children U5 with a history of fever in the 2 weeks prior to the survey. We compared the percentages of care-seeking and performed modified Poisson modeling to evaluate the determinants of care-seeking during the period of FHCI (2013–2016). Results In 2008, a total of 1,208 feverish children were identified, as compared with 2,823 children in 2013, and 1,633 in 2016. Fewer children had seeking care for fever in 2008 (51% [95% CI (46.4–55.5)]) than in 2013 (71.5% [95% CI (68.4–74.5)]) and in 2016 (70.3% [95% CI (66.6–73.8)] (p < 0.001)). Care-seeking was low when the household head was a man, when the head of the household was 15–24 years old, when the child was living in a poorest household, in north or west region and when the child was more than one year old. Conclusions The increase of care-seeking in children under five with fever coincided with the initiation of the FHCI in Sierra Leone. Effective interventions to improve the health facilities’ visitation of the children under five should target the identified factors.

Citer ce document

Accès au document

Ce document est hébergé sur son dépôt institutionnel d'origine.

Auteur(s)

Statistiques

Consultations : 1

Téléchargements : 0