Effect of community integrated management of childhood illness on mothers' healthcare-seeking behaviour and home management of childhood illness in Ile-Ife, South-West Nigeria: A household survey

Background. Care-seeking interventions, as part of community integrated management of childhood illness (CIMCI), have the potential to substantially reduce child mortality in countries where common childhood illnesses are a major problem. Prompt and appropriate care-seeking practices are important to avoid many deaths attributed to delays in or not seeking care, particularly in developing countries such as Nigeria. Objective. To assess the effect of community-level intervention on mothers' care-seeking behaviour for common childhood illnesses and related influencing factors. Methods. The study had a comparative cross-sectional design and was conducted in two local government areas (LGAs) of Osun State, South-West Nigeria. A total of 722 mothers of index children aged <5 years were selected through a multistage cluster sampling technique. Data were collected and analysed using SPSS version 16.0. Descriptive, bivariate and multivariate analyses were performed. Results. Care-seeking for children who reported illness was higher in the CIMCI-implementing LGA (90.2%) compared with 74.8% in the non-implementing LGA (p=0.002). Care was sought within the first 48 hours of perceived onset of illness for 83.2% and 57.9% of sick children in the CIMCI-implementing and non-implementing LGAs, respectively. Residing in a CIMCI-implementing area ( odds ratio (OR) 2.54, 95% confidence interval (CI) 1.24 - 5.45) and maternal education level (OR 1.50, 95% CI 1.06 - 3.03) were identified as predictors of healthcare-seeking practices among mothers. Conclusion. The study concluded that a high level of care-seeking behaviour exists where community-level intervention was operating. Therefore the CIMCI programme should be strengthened further and also scaled up to include non-implementing communities.