Assessment of caretaker factors associated with disease outcomes in children at Kenyatta National Hospital, Nairobi, Kenya

Abstract

Globally, 10.5 million children under five years die annually. Approximately 6 million of Kenya’s population are children under five years with a child mortality rate of 74 per 1000 live births. The morbidity pattern of children attending Kenyatta National Hospital (KNH) are mainly gastro enteritis, respiratory diseases, neonatal sepsis and meningitis accounting for 44 % of all the deaths, which occur in the first 48 hours, post admission. The objective of this study was to assess care taker factors associated with disease outcome among children at KNH. A cross sectional study was conducted where questionnaires were administered to the caretakers of the 156 children recruited into the study. Data entry was done in Microsoft Access and analyzed using Statistical Package for Social Science (SPSS). Data from the study revealed that there was a significant association between diseases outcome and length of exclusive breast-feeding (P < 0.025), occupation of both fathers and mothers (P< 0.026 and P <0.001, respectively) in the priority disease outcomes. There was a statistically significant association between duration of illness and that of seeking treatment before visiting KNH, (P < 0.001). A child that was not breast-fed exclusively for more than 4 months had a 3-fold risk of being a priority case. Children who stayed more than 2 months before seeking health care at KNH had a 3-fold risk of becoming priority cases. Using formal education as the reference category for mother occupation, the odds of priority outcome for unemployed compared to formal education was 10.4 and informal education compared to formal education was 7.6. A majority of caretakers delayed in seeking care in the health xv facilities as they sought care in the peripheral health facilities. Majority of the children attended other public health facilities prior to admission, private clinics or traditional medical practitioners before attending KNH. Results from this study suggest that occupation of parents was a major determinant in regard to disease outcome. Families and communities need to be empowered to obtain and access basic health care services. More studies need to be done to identify specific caretaker factors associated with childhood illnesses. This will enable to evaluate further the possible interventions in the health care delivery among children.