TY - JOUR
T1 - Factors affecting decisions to seek treatment for sick children in Kerala, India
AU - Pillai, Rajamohanan K.
AU - Williams, Sankey V.
AU - Glick, Henry A.
AU - Polsky, Daniel
AU - Berlin, Jesse A.
AU - Lowe, Robert A.
N1 - Funding Information:
We thank the Director, International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Bombay-400088, India for authorizing use of the NFHS data set for the study. This study was done as a part of the INCLEN training program, funded by United States Agency for International Development.
PY - 2003/9
Y1 - 2003/9
N2 - The purpose of this study was to measure the effects of social and economic variables, disease-related variables, and child gender on the decisions of parents in Kerala, India, to seek care for their children and on their choice of providers in the allopathic vs. the alternative system. A case-control analysis was done using data from the Kerala section of the 1996 Indian National Family Health Survey, a cross-sectional survey of a probability sample of households conducted by trained interviewers with a close-ended questionnaire. Of the 469 children who were eligible for this study because they had at least one common symptom suggestive of acute respiratory illness or diarrhea during the 2 weeks before the interview, 78 (17%) did not receive medical care, while the remaining 391 (83%) received medical care. Of the 391 children who received medical care, 342 (88%) received allopathic medical care, and 48 (12%) received alternative medical care. In multivariable analyses, parents chose not to seek medical care for their children significantly more often when the illness was mild, the child had a specific diagnosis, the mother had previously made fewer antenatal visits, and the family had a higher economic status. When parents sought medical care for their children, care was sought significantly more often in the alternative provider system when the child was a boy, the family lived in a rural area, and the family had a lower social class. We conclude that, in Kerala, disease severity and economic status predict whether children with acute respiratory infection or diarrhea are taken to medical providers. In contrast, most studies of this issue carried out in other populations have identified economic status as the primary predictor of medical system utilization. Also in Kerala, the gender of the child did not influence whether or not the child was taken for treatment but did influence whether care was sought in the alternative or the allopathic system.
AB - The purpose of this study was to measure the effects of social and economic variables, disease-related variables, and child gender on the decisions of parents in Kerala, India, to seek care for their children and on their choice of providers in the allopathic vs. the alternative system. A case-control analysis was done using data from the Kerala section of the 1996 Indian National Family Health Survey, a cross-sectional survey of a probability sample of households conducted by trained interviewers with a close-ended questionnaire. Of the 469 children who were eligible for this study because they had at least one common symptom suggestive of acute respiratory illness or diarrhea during the 2 weeks before the interview, 78 (17%) did not receive medical care, while the remaining 391 (83%) received medical care. Of the 391 children who received medical care, 342 (88%) received allopathic medical care, and 48 (12%) received alternative medical care. In multivariable analyses, parents chose not to seek medical care for their children significantly more often when the illness was mild, the child had a specific diagnosis, the mother had previously made fewer antenatal visits, and the family had a higher economic status. When parents sought medical care for their children, care was sought significantly more often in the alternative provider system when the child was a boy, the family lived in a rural area, and the family had a lower social class. We conclude that, in Kerala, disease severity and economic status predict whether children with acute respiratory infection or diarrhea are taken to medical providers. In contrast, most studies of this issue carried out in other populations have identified economic status as the primary predictor of medical system utilization. Also in Kerala, the gender of the child did not influence whether or not the child was taken for treatment but did influence whether care was sought in the alternative or the allopathic system.
KW - Acute respiratory infections
KW - Alternative systems of medicine
KW - Disease severity
KW - Health-seeking behavior
KW - Household economic status
KW - Kerala
KW - Maternal education
UR - http://www.scopus.com/inward/record.url?scp=0037824765&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037824765&partnerID=8YFLogxK
U2 - 10.1016/S0277-9536(02)00448-3
DO - 10.1016/S0277-9536(02)00448-3
M3 - Article
C2 - 12850106
AN - SCOPUS:0037824765
SN - 0277-9536
VL - 57
SP - 783
EP - 790
JO - Ethics in Science and Medicine
JF - Ethics in Science and Medicine
IS - 5
ER -