Mother’s Healthcare Response to Child Illness: A Slum-Based Cross-Sectional Study in Dhaka City, Bangladesh

Abstract

Background: With the burgeoning slum population in Dhaka, the fastest growing megacity in the world, slum population health is a real concern due to overcrowded, unhygienic living conditions and lack of health care facilities. Mortality of children under the age of five is higher in urban populations than in urban non-slum and rural areas, largely because of the mothers’ inability to seek care promptly and appropriately. The present study assesses the behavioral patterns of slum mothers seeking treatment during their children’s illness and determines important predictors of visiting medical doctors.

Methods: A community-based, cross-sectional study was carried out in two selected slums of Dhaka city. A total of 406 mothers were interviewed using a pretested, structured questionnaire to collect data on their socio-demographic backgrounds and care-seeking practices.

Results: Mothers received treatment from drug sellers (56%) as the predominant source for child recovery, whereas only 27% of mothers sought treatment from medical doctors. Only 25.6% mothers visited any providers within 24 hours. Mothers reported that low cost is the most influential factor for visiting drug sellers frequently, and the high cost of medical doctors is the most influential factor for not visiting drug sellers. Younger children (AOR 0.982, 95% CI 0.965-1.000), male children (OR 1.599, 95% CI 1.002-2.552), and unemployed children (OR 0.581, 95% CI 0.346-.976) were more likely to seek treatment from doctors. In addition, perceived illness severity (OR 1.821, 95% CI 1.118-2.965) and longer illness persistence (OR 1.041, 95% CI 1.01-1.066) were found to be significant predictors for seeking treatment from doctors.

Conclusion: Mothers were pushed to go through informal healthcare providers, mainly drug sellers, due to cheaper treatment, easy access to them, and unavailability of the skilled care providers in slum areas. Thus, training and logistic support for drug sellers are essential to deliver better treatment and referral if needed to the slum children, since they are so convenient to mothers.