title: Cost and Predictors of Care-Seeking Behaviors Among Caregivers of Febrile Children-Uganda, 2009.
abstract: Fever is a major cause of morbidity and mortality among children under 5 years of age in resource-limited countries. Although prevention and treatment of febrile illnesses have improved, the costs--both financial and nonfinancial--remain barriers to care. Using data from the 2009 Uganda Malaria Indicator Survey, we describe the costs associated with the care of a febrile child and assess predictors of care-seeking behavior. Over 80% of caregivers sought care for their febrile child, however less than half did so on either the day of or the day after the development of fever. The odds of seeking care decreased with each additional month of the child's age. Caregivers living in rural areas were more likely to seek care, however were less likely to seek care promptly. Caregivers with at least a primary school education and those familiar with the protective effect of bed nets and the need to seek care promptly were more likely to seek care. Despite government assistance, the majority of caregivers did incur costs (mean 13,173 Ugandan shilling; $6.84 U.S. dollars) associated with medical care. Continued efforts targeting barriers to seeking care, including the economic burden, are necessary.
authors.affiliation: Malaria Branch, Division of Malaria and Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Medicine, University of Washington, Seattle, Washington; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia mmenon@fhcrc.org.
authors.forename: Manoj P
authors.initials: MP
authors.lastname: Menon
authors.affiliation: Malaria Branch, Division of Malaria and Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Medicine, University of Washington, Seattle, Washington; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Njau
authors.forename: Deborah A
authors.initials: DA
authors.lastname: McFarland
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017028:Caregivers / Q000191:economics / Q000706:statistics & numerical data; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008288:Malaria / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult