Abstract

Background: Although the under-5 mortality has declined in Ethiopia, the utilization of health service remains low. This objective of this study wasto measure the incidence of common childhood illness and their health seeking behaviour among children under the age of five in rural parts of Gedeo in Ethiopia.

Methods: A community based cohort study was conducted on 903 children aged 0-59 months from July 2017 to January 2018. Every second week we visited the households of 903 children to ask about illnesses and their use of health services. We randomly selected households from three kebeles of Wonago district. Survival and Poisson regression analysis were used.

Results: The total incidence of illness was 12.1 episodes per 100child-weeks (95% CI; 11.6-12.5). From the total incidence of illness there were 3.3 episodes of diarrhoea, 4.1 episodes of acute respiratory infection and 5.4 episodes of fever per 100 child-weeks.Only 12.1% of those who reported illness sought care from health facilities, and the incidence rate of utilization of health service was 1.4 per 100 any illness per week (95% CI; 1.3-1.6). Health service utilization for diarrhoeawas 29.7%,22.1% for ARI and 21 % for fever associated diseases.The most common option for childcare was from private clinics and pharmacies (58.2%) followed bypublic health care facilities (41.8%). The main reasons for not using health care services werethatmothers thought thatthe illness would heal by itself, lack of money, and that the illness was not severe. Lower wealth index ARR=1.23, 95 % CI 1.08-1.41), children in the age group of 12-23 months (ARR=1.26, 95% CI; 1.12-1.42), children who were under-weight (ARR= 1.26, 95% CI; 1.12-1.42) and who used unprotected drinking water source (ARR=1.12, 95% CI 1.01-1.25) were the main risk factor for illness. Older mothers (ARR=0.81, 95 % CI 0.61-1.05), younger children (ARR=1.75, 95 % CI 1.13-2.71) and exclusive breast feeding (ARR=0.122, 95 % CI 0.21-0.68) were the factors for the use of health service.

Conclusions: The incidence of common childhood illness was high in the densely populatedGedeo area of Ethiopia, and low health care utilization for illness was observed.