Factors associated with healthcare seeking behaviour for children in Malawi:2016

OBJECTIVE: To characterize health seeking behavior (HSB) and determine its predictors amongst children in Malawi in 2016. METHODS: We used the 2016 Malawi Integrated Household Survey dataset. The outcome of interest was HSB, defined as seeking care at a health facility amongst people who reported one or more of a list of possible symptoms given on the questionnaire in the past two weeks. We fitted a multivariate logistic regression model of HSB using a forward step-wise selection method, with age, sex and symptoms entered as a priori variables. RESULTS: Of 5350 children, 1666 (32%) had symptoms in the past two weeks. Of the 1666, 1008 (61%) sought care at health facility. The children aged 5 to 14 years were less likely to be taken to health facilities for healthcare than those aged 0 to 4 years. Having fever vs. not having fever and having a skin problem vs. not having skin problem were associated with increased likelihood of HSB. Having a headache vs. not having a headache was associated with lower likelihood of accessing care at health facilities (AOR= 0.50,95%CI: 0.26-0.96, P=0.04). Children from urban areas were more likely to be taken to health facilities for healthcare (AOR= 1.81, 95%CI: 1.17-2.85, P=0.008), as were children from households with a higher socioeconomic position (AOR= 1.96, 95%CI: 1.13-3.40, P=0.02). CONCLUSION: There is a need to understand and address individual, socioeconomic and geographical barriers to health seeking to increase access and use of healthcare and fast-track progress towards Universal Health Coverage.