title: Why are there delays in seeking treatment for childhood diarrhoea in India?
abstract: OBJECTIVE
  To examine the barriers and facilitating factors for seeking treatment for childhood diarrhoea and to determine the main causes for delay in seeking treatment.
  
  
  METHODS
  Data from Indian Demographic and Health survey 2005-06 (NFHS-III) were used. Mothers were asked whether their children (<5-years) had suffered from diarrhoea during the 2 weeks preceding the survey. Data were collected on the time of seeking treatment after start of the illness and days waited to seek treatment after the diarrhoea started. Multivariate logistic regression analysis was performed to find the determinants of seeking treatment at the health facility and the factors responsible for the 'delay' in seeking advice/treatment.
  
  
  RESULTS
  Of a sample of 41 287 children, 3890 (9.4%) reportedly had diarrhoea. Sixty percentage of children with diarrhoea were taken to a health facility. Mother's education till higher secondary and above (OR 1.65; 95% CI, 1.08-2.54), richest (OR 1.76; 95% CI, 1.24-2.48) wealth index, and possession of a health card by the mother (OR 1.35; 95% CI, 1.12-1.62) increased the odds of seeking treatment. There was a strong gender bias; a male child had lower odds of experiencing a 'delay' in seeking treatment, compared with a female child (OR 0.71; 95% CI, 0.55-0.92). Access to a health facility still remains a major issue: treatment seeking was delayed when distance to a health facility was reported as a 'major problem' (OR 1.33; 95% CI, 1.01-1.76).
  
  
  CONCLUSIONS
  Improved care seeking for childhood diarrhoea in India is still constrained by access to a health facility and requires expansion and strengthening of the public health system. The caregivers, especially the mothers need to be educated about the importance of seeking timely treatment and the benefits of oral rehydration solution.
authors.affiliation: Vancouver School of Economics, Faculty of Arts, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Nisha
authors.initials: N
authors.lastname: Malhotra
authors.forename: Ravi Prakash
authors.initials: RP
authors.lastname: Upadhyay
mesh_terms: D000328:Adult; D016001:Confidence Intervals; D057210:Delayed Diagnosis / Q000706:statistics & numerical data*; D003906:Developing Countries; D003967:Diarrhea / Q000175:diagnosis / Q000628:therapy*; D004522:Educational Status; D005260:Female; D005440:Fluid Therapy / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D020380:Needs Assessment; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013997:Time Factors
keywords: Childhood diarrhoea; Delay; Gender Bias; ORS knowledge; Treatment seeking