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'I also take part in caring for the sick child': a qualitative study on fathers' roles and responsibilities in seeking care for children in Southwest Ethiopia.

ABSTRACT: OBJECTIVES:Fathers play an important role in household decision-making processes and child health development. Nevertheless, they are under-represented in child health research, especially in low-income settings. Little is known about what roles fathers play in the care-seeking processes or how they interact with the health system when their child is sick. This study aimed to understand Ethiopian fathers' roles and responsibilities in caring for their children when they are or become ill. DESIGN:Qualitative study using semistructured interviews with fathers. SETTING:This study was conducted in three rural districts of the Southern Nations, Nationalities and People's Region of Ethiopia. PARTICIPANTS:Twenty-four fathers who had at least one child between 2 and 59 months who visited a health extension worker with fever. RESULTS:The overarching theme of this study was 'changing perceptions of paternal responsibilities during children's ill health'. It constituted three subthemes, namely, 'fathers' burden of earning money for care', 'fatherhood entails advocating children's healthcare needs' and 'investing in children's health can benefit the family in the future'. Fathers described that they were the ones mainly responsible for the financial arrangement of care and that this financial responsibility can involve stress when resources are scarce. Fathers knew what health services were available and accessible to them and were involved in different ways in the care seeking of the child. Changes in the importance ascribed to child health were expressed by fathers who described being more alert to children's ill-health. CONCLUSION:Fathers play various roles in the care-seeking process during children's illness episodes. This included, for instance, arranging resources to seek care, (co)-deciding where to seek care as well as accompanying the child to the health facility. The inability to organise necessary resources for care can lead to involuntary delays in care seeking for the child. This demonstrates the importance of including fathers in future interventions on maternal and child health.

SUBMITTER: Funk T

PROVIDER: S-EPMC7440706 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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'I also take part in caring for the sick child': a qualitative study on fathers' roles and responsibilities in seeking care for children in Southwest Ethiopia.

Funk Tjede T Källander Karin K Abebe Ayalkibet A Alfvén Tobias T Alvesson Helle Mølsted HM

BMJ open 20200820 8

<h4>Objectives</h4>Fathers play an important role in household decision-making processes and child health development. Nevertheless, they are under-represented in child health research, especially in low-income settings. Little is known about what roles fathers play in the care-seeking processes or how they interact with the health system when their child is sick. This study aimed to understand Ethiopian fathers' roles and responsibilities in caring for their children when they are or become ill ...[more]

PMID: 32819953

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Project description:BackgroundAlthough the number of children living with complex care needs (CCN) is increasing worldwide, there is limited data on the experience of fathers caring for children with CCN. This paper reports on findings specific to fathers' experiences of caring for their child with CCN and highlights recommendations provided for parents of children with CCN, service providers, and policymakers. The findings emerged from a larger study designed to examine how Canadian families of children with CCN participate in society.MethodsWe used the qualitative research approach of ethnography and arts-based methodologies (ecomaps and photovoice) as well as purposive and snowball sampling techniques. Four parents were engaged as advisors and twenty-nine fathers participated in interviews (all were married or in a relationship; age range of 28 to 55 years). In line with an ethnographic approach, data analysis involved several iterative steps including comparing data from the first, second, and third set of interviews and refining themes.ResultsOne overarching theme, striving to be there for the child with CCN, was identified. Five supporting themes further exemplified how fathers strived to be there for their child: 1) contributing to the parental team through various roles; 2) building accessibility through adaptation; 3) engaging in activities with the child; 4) expressing admiration and pride in their children; and 5) meaning making. Recommendations for parents included making and nurturing connections and asking for help while recommendations for healthcare and social service providers included communicating authentically with families and listening to parents. Fathers also indicated that leadership and funding for programs of families of children with CCN should be priorities for policymakers.ConclusionsIn addition to documenting fathers' active involvement in their child's care and development, our findings provide new insights into how fathers make participation in everyday life accessible and inclusive for their children. Study findings also point to 1) priority areas for policymakers (e.g., accessible physical environments); 2) factors that are critical for fostering collaborative care teams with fathers; and 3) the need for complex care teams in the adult health care system. Implications for those providing psychosocial support for these families are noted as well as knowledge gaps worthy of future exploration such as the role of diversity or intersectionality in fathering children with CCN.

Project description:Pneumonia, diarrhea, and malaria are leading causes of under-5 mortality. Accelerated reductions in illness burden are needed to meet childhood Sustainable Development Goals. Understand-ing where parents take sick children for care is key to improving equitable, high-quality treatment for these childhood illnesses and catalyzing reductions in morbidity and mortality. We analyzed the most recent Demographic and Health Survey data in 24 of the United States Agency for International Development's maternal and child health priority countries to examine levels and sources of care for children sick with 3 illness classifications: symptoms of acute respiratory infection, diarrhea, or fever. On average, across countries analyzed, one-third of children had recent experience with at least 1 of the 3 classifications. The majority (68.2%) of caregivers sought external advice or treatment for their sick children, though the level is far higher for the wealthiest (74.3%) than poorest (63.1%) families. Among those who sought out-of-home care, 51.1% used public sources and 42.5% used private-sector sources. Although sources for sick child care varied substantially by region and country, they were consistent across the 3 illness classifications. Urban and wealthier families reported more use of private sources compared with rural and poorer families. Though 35.2% of the poorest families used private sources, most of these (57.2%) were retail outlets like pharmacies and shops, while most wealthier families who sought care in the private sector went to health facilities (62.4%). Efforts to strengthen the quality of integrated management of sick child care must therefore reach both public and private facilities as well as private pharmacies, shops, and other retail outlets. Stakeholders across sectors must collaborate to reach all population groups with high-quality child health services and reduce disparities in care-seeking behaviors. Such cross-sectoral efforts will build clinical and institutional capacity and more efficiently allocate resources, ultimately resulting in stronger, more resilient health systems.

Project description:Background:Although there are low cost and effective interventions to prevent and treat diarrhea, it is one of the leading causes of morbidity and mortality among under-five children in developing countries. Deaths from diarrheal diseases are largely due to lack of prompt seeking of medical care. This study aimed to identify determinants of delayed treatment-seeking for diarrheal diseases among under-five children in Southwest Ethiopia. Methods:Unmatched case-control study was conducted among 324 under-five children paired with their mothers/caregivers from 1st April to 30th May 2019. Cases were under-five children paired with their mothers/caregivers who sought treatment after 24 hours of the onset of signs and symptoms of diarrheal diseases, and controls were under-five children paired their mothers/caregivers who sought treatment within 24 hours of the onset of signs and symptoms of diarrheal diseases. Consecutive sampling was used, and data were collected through interviews and chart reviews. Multivariable binary logistic regression analysis was performed, and variables with a P-value <0.05 were considered statistically significant. Results:A total of 324 (162 cases and 162 controls) under-five children paired with their mothers/caregivers were included in this study. Being rural residents (AOR=1.93, 95% CI: 1.13,3.31), children from households with more than two children (AOR=2.05, 95% CI: 1.15-3.66), preferring traditional healers for the treatment of diarrhea (AOR= 4.78, 95% CI: 1.74,13.12), not having television or radio for the households (AOR=2.05, 95% CI: 1.11-3.66), living in more than 10 km from the nearest health facility (AOR=4.80, 95% CI: 2.61-4.83), and perceiving diarrhea can cure without treatment (AOR=2.11, 95% CI: 1.15-3.87) were significant determinants of delayed treatment-seeking. Conclusion:Being rural residents, larger family size, physical inaccessibility of health facilities, not having access to electronic media (television or radio), preferring traditional healers for the treatment of diarrhea, and having the perception that diarrhea can be cured without treatment were determinants of delayed treatment-seeking for diarrheal diseases among under-five children. Thus, multidimensional approaches that can address accessibility of health facilities and improve caregivers' awareness are necessary to encourage prompt treatment-seeking for diarrheal diseases among under-five children.

Project description:The child mortality rate is an essential measurement of socioeconomic growth and the quality of life in Ethiopia which is one among the six countries that account for half of the global under-five deaths. Therefore, this study aimed to identify the potential risk factors for child mortality in Ethiopia. Data for the study was drawn from the Ethiopian Demographic and Health Survey data conducted in 2016. A two-part random effects regression model was employed to identify the associated predictors of child mortality. The study found that 53.3% of mothers did not face any child death, while 46.7% lost at least one. Vaccinated child (IRR = 0.735, 95%CI: 0.647, 0.834), were currently using contraceptive (IRR = 0.885, 95%CI: 0.814, 0.962), who had antenatal care visit four or more times visit (IRR = 0.841, 95%CI: 0.737,0.960), fathers whose level of education is secondary or above(IRR = 0.695, 95%CI: 0.594, 0.814), mothers who completed their primary school(IRR = 0.785, 95%CI: 0.713, 0.864), mothers who have birth interval greater than 36 months (IRR = 0.728, 95%CI: 0.676, 0.783), where the age of the mother at first birth is greater than 16 years(IRR = 0.711, 95%CI: 0.674, 0.750) associated with the small number of child death. While multiple births (IRR = 1.355, 95%CI: 1.249, 1.471, four and above birth order (IRR = 1.487, 95%CI: 1.373, 1.612) and had working father (IRR = 1.125, 95%CI: 1.049, 1.206) associated with a higher number of child death. The variance components for the random effects showed significant variation of child mortality between enumeration areas. Policies and programs aimed at addressing enumeration area variations in child mortality need to be formulated and their implementation must be strongly pursued. Efforts are also needed to extend educational programmers aimed at educating mothers on the benefits of the antenatal checkup before first birth, spacing their birth interval, having their child vaccinated, and selecting a safe place of delivery to reduce child mortality.

Dataset Information

'I also take part in caring for the sick child': a qualitative study on fathers' roles and responsibilities in seeking care for children in Southwest Ethiopia.

Publications

'I also take part in caring for the sick child': a qualitative study on fathers' roles and responsibilities in seeking care for children in Southwest Ethiopia.

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