Predictors of Health-Care Utilization Among Children 6-59 Months of Age in Zambézia Province, Mozambique.
Globally, approximately 5.9 million children under 5 years of age died in 2015, a reduction of over 50% since 1990. Millennium Development Goal 4 established the goal of reducing child mortality by two-thirds by 2015. Multiple countries have surpassed this goal; however, regional and within-country inequities exist. We sought to study determinants of health-care utilization among children 6-59 months of age with fever, diarrhea, and respiratory symptoms in Zambézia Province, Mozambique. We conducted a population-based cross-sectional survey of female heads of household between April and May 2014. Mobile teams conducted interviews in 262 enumeration areas, with three distinct districts being oversampled for improved precision. Descriptive statistics and logistic regression using Stata 13.1 and R 3.2.2 were used to examine factors associated with health-care utilization. A total of 2,317 children were evaluated in this study. Mothers' median age was 26 years, whereas child median age was 24 months. The proportion of children reporting fever, diarrhea, or respiratory illness in the prior 30 days was 44%, 22%, and 22%, respectively. Health-care utilization varied with 65% seeking health care for fever, compared with 57% for diarrhea and 25% for respiratory illness. In multivariable logistic regression, the characteristics most associated with health-care utilization across illnesses were delivery of last child at a facility, higher maternal education, and household ownership of a radio. The decision or ability to use health care is a multifaceted behavior swayed by societal norms, values, socioeconomics, and perceived need. Recognizing the predictors of a particular population may offer useful information to increase uptake in health-care services.
Vanderbilt Institute for Global Health, Nashville, Tennessee.
Mary
M
Bayham
Department of Biostatistics, Vanderbilt University, Nashville, Tennessee.|Friends in Global Health, Maputo, Mozambique.|Vanderbilt Institute for Global Health, Nashville, Tennessee.
Meridith
M
Blevins
World Vision United States, Federal Way, Washington.
Melanie
M
Lopez
World Vision International, Maputo, Mozambique.
Omo
O
Olupona
Friends in Global Health, Maputo, Mozambique.|Vanderbilt Institute for Global Health, Nashville, Tennessee.
Lazaro
L
González-Calvo
Friends in Global Health, Maputo, Mozambique.
Elisée
E
Ndatimana
Friends in Global Health, Maputo, Mozambique.|Vanderbilt Institute for Global Health, Nashville, Tennessee.
Ann F
AF
Green
Vanderbilt Institute for Global Health, Nashville, Tennessee.|Division of Infectious Diseases, Department of Pediatrics, Vanderbilt University, Nashville, Tennessee.|Friends in Global Health, Maputo, Mozambique.
Troy D
TD
Moon
D000067576:Child Health / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005544:Forecasting; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D009073:Mozambique; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires