Socio-demographic characteristics
In this study 373 care takers with children less than five year were participate making the response rate of 94.7 %. Three hundred twenty seven 327 (87.7%) care takers were female. The age of care takers ranged from 15 years to 54 years with a mean of 30.04 years and standard deviation 10.134 years. Regarding to age categories of the respondents 107(28.7%) were 15-24 years, 134(35.9%) were 25-34 years, 80(21.4%) were 35-44 years and 52(13.9%) were 45-54 years. Two hundred ninety four (78.8%) care takers were live in rural. Three hundred twenty (85.8%) care takers were married.
As to the educational background 101(27.1%) were illiterate, 57(15.3%) were read and write, 47(12.6%) were primary school, 78(20.9%) were secondary school and 90(24.1%) were post-secondary school. Among care takers in this study 215(57.6%) were housewife, 42(11.3%) were Government employee, 39(10.5%) were private/NGO employee, 28(7.5%) were farmer, 12(3.2%) were merchant, and the rest 37(9.9%) were others.
The monthly household income of the respondents ranges between 200 to 2245 Birr with a media of 550 Birr, standard deviation 484.082 Birr. Regarding to monthly income 99(26.5%) have monthly income less than 345 birr, 100(26.8%) have monthly income between 346-550 birr, 83(22.3%) have monthly income between 551-890 and the rest 91(24.4%) have monthly income above 891 birr. (Table 1)
Two hundred sixty two (70.2%) care takers have only one under five year child, 107(28.7%) have two under five child and 4(1.1%) have three under five year child. Three hundred seven (82.3%) of children were brought to health center by their mothers. (Table 1)
Table 1:-Socio-demographic characteristics of care takers in Enebse Sarmider woreda, in 2014.
Variable Number (%)
|
Sex
|
Male 46(12.3)
|
Female 327(87.7)
|
Age
|
15-24 years 107(28.7)
|
25-34 years 134(35.9)
|
35-44 years 80(21.4)
|
45-54 years 52(13.9)
|
Residence
|
Urban 79(21.2)
|
Rural 294(78.8)
|
Marital status
|
Married 320(85.8)
|
Divorced 36(9.7)
|
Windowed 17(4.5)
|
Educational
|
Illiterate 101(27.1)
|
Read and write 57(15.3)
|
Primary school (1-8 grade) 47(12.6)
|
Secondary school 78(20.9)
|
Post-secondary school 90(24.1)
|
Occupation
|
House wife 215(57.6)
|
Government employee 42(11.3)
|
Private /NGO employee 39(10.5)
|
Farmer 28(7.5)
|
Merchant 12(3.2)
|
Others 37(9.9)
|
Monthly income
|
< 345 birr 99(26.5)
|
346-550 birr 100(26.8)
|
551-890 birr 83(22.3)
|
> 891 birr 91(24.4)
|
Number of under 5 year children
|
one child 262(70.2)
|
two child 107(28.7)
|
three child 4(1.1)
|
Relationship of respondent to child
|
Mothers 307(82.3)
|
Fathers 50(13.4)
|
Grandmother 71(0.9)
|
Grandfather 41(0.1)
|
Co mother 20(0.5)
|
Others 30(0.8)
|
Table 2:-Knowledge, believe on severity of illness and number of days first noticed in health center in Enebse Sarmider Woreda in 2014.
Variable Categories N (%)
|
|
Knowledge
|
Knowledgeable 169(45.3)
No knowledgeable 45.3(54.7)
|
|
Believe on severity of illness
|
Yes 285(76.4)
|
|
No 88(23.6)
|
|
Number of days sick before attending health center.
|
One day 132(35.4%)
|
|
Two days 111(29.8%)
|
|
Three days 80(21.4%)
|
|
Greater than or equal to four days 50(15.5%)
|
|
Time taken to reach health center from their residence were ranged from 5 minutes to 360 minutes with median 65 minutes and standard deviation 62.376 minutes. Regarding to waiting time at health center 173(46.4%) was said that take long time. Regarding to trust on health worker 107(28.7%) were satisfied by the service delivered by health worker during visit.
Table 3:- Time taken to travel from home to health center, in Enebse Sarmider Woreda in 2014.
Variable Categories Frequency (%)
|
Total time taken 0-60 minutes 176(47.2)
> 60 minutes 197(52.8)
|
Waiting time at health center
|
Too long time 15(4)
Long time 173(46.4)
Acceptable time 142(38.1)
Short time 43(11.5)
|
Satisfaction with service
|
Satisfied with the service 107(28.7)
Not satisfied with the service 266(71.3)
|
Before attending the health centre 351 (94.1%) had treated their child at home, of these 200 (57%) gave homemade food or fluid, 65(18.5) gave holly water, 58(16.5%) gave traditional drug, 13(3.7%) give modern drug, 8(2.3%) give ORS and the rest 7(2%) give others (Figure 1).
Treatment
Oral or topical drugs were prescribed for 373 children. Three hundred sixty nine (98.9%) children's were prescribed antibiotic. Out of 369 children treated with antibiotic Cotrimaxazole, amoxicillin, TTC eye ointment and Metrindazole were prescribed for 206(55.8%), 83(22.5%), 42(11.4%) and 40(10.8%) children respectively.
Among respondent compliance towards antibiotic treatment were 144(39%). When asked the reason not to give correct dose of antibiotic treatment, 104(46.2%) of them said that they do not know how to give the drug, 40(17.7%) of them said the child was improved before finishing the drug 20(9%) of them were unable to afford to buy the drug, 23(10.2%) of them said lack of trust in health worker, 20(8.9%) of them said unable to afford to buy a drug, 13(5.8%) of them said the health worker not tell me how use it, 9(4%) of them said fear of side effect, 8(3.6%) of them said shared the drug to another child and 8(3.6%) of them said the child becomes more sick(Table 4).
Table 4:- Care takers reason for not given correct dose of antibiotic treatment, in Enebse sarmider Woreda, in 2014.
Reason Frequency (%)
|
Do not know how to give drug 104(46.2)
|
The child was improved before finishing the drug 40(17.7)
|
Lack of trust in health worker 23(10.2)
|
Unable to afford to buy a drug 20(8.9)
|
The health worker not tell me how use it 13(5.8)
|
Fear of side effect 9(4)
|
Shared the drug to another child 8(3.6)
|
The child becomes more sick 8(3.6)
|
Total 225(100)
|
Analytic Part
Treatment
Result from the statistical analysis table 5 shows care takers with post-secondary educational status were significantly associated with compliance to antibiotic treatment having (AOR=5.33, 95%CI: 2.557, 11.109), care takers with private/NGO employee were significantly associated with compliance to antibiotic treatment having (AOR=5.936, 95%CI: 1.632, 21.582), knowledgeable care takers were significantly associated with compliance to antibiotic treatment having (AOR=1.806, 95%CI: 1.096, 2.976) and those travel less than or equal to one hours from their place of residence to health center were significantly associated with compliance to antibiotic treatment having (AOR=2.366, 95%CI: 1.419, 3.945).
Table 5:- Factors associated with care takers compliance towards IMNCI with respect to antibiotic treatment in Enebse sarmider Woreda in 2014.
Variable
|
Compliance
|
Non compliance
|
Crude OR/95% CI/
|
Adjusted OR /95%CI/
|
P-value
|
|
Sex of care
Takers
|
Female
Male
|
133
11
|
191
34
|
1
2.152(1.053, 4.4)*
|
1
2.24(0.849, 5.911)
|
0.103
|
Age of care takers
|
15-24 years
25-34 years
35-44 years
45-54 years
|
41
37
35
31
|
65
94
45
21
|
1
1.602(0.929, 2.765)
0.811(0.45, 1.463)
0.427(0.217,0.842)**
|
1
1.479(0.786, 2.738)
1.29(0.651, 2.559)
0.532(0.249, 1.137)
|
0.225
0.465
0.104
|
|
Educational status of care takers
|
Illiterate
Read and write
Primary school
Secondary school
Post secondary school
|
58
24
25
20
17
|
43
33
21
56
72
|
1
1.855(0.961, 3.579)
1.133(0.562, 2.285)
3.777(1.981, 7.2)***
5.713(2.954, 11.047)***
|
1
1.885(0.925, 3.844)
0.867(0.373, 2.017)
1.322(0.454, 3.846)
5.33(2.557, 11.109)***
|
0.081
0.74
0.609
< 0.001
|
|
Occupation of care takers
|
House wife
Gov. employee
Private empl/NGO
Farmer
Merchant
Others
|
95
8
5
4
18
14
|
119
33
33
8
9
23
|
1
3.293(1.453, 7.463)***
5.269(1.98, 14.017)***
1.597(0.467, 5.463)
0.399(0.172, 0.929)*
1.312(0.64, 2.686)
|
1
2.445(0.763,7.832 )
5.936(1.632, 21.582)**
1.348(0.26, 6.996)
0.666(0.245, 1.809)
1.97(0.864, 4.493)
|
0.132
0.007
0.723
0.426
0.107
|
|
Knowledge of care taker
|
Knowledgeable
No knowledgeable
|
51
93
|
114
111
|
1.873(1.218, 2.879)***
1
|
1.806(1.096, 2.976)**
1
|
0.02
|
Trust on health worker
|
Those satisfied with the service delivered by health worker.
Those do not satisfied with the service delivered by health worker.
|
27
117
|
78
147
|
2.299(1.394, 3.793 )***
1
|
1.154(0.832, 2.754)
1
|
0.174
|
|
|
Distance
|
Those travel less than or equal to one hour
Those travel more than one hour
|
43
101
|
130
95
|
3.214(2.061, 5.012)***
1
|
2.366(1.419, 3.945)***
1
|
0.001
|
|
|
|
|
|
|
|
|
|
|
*= Significantly associated with compliance towards IMNCI with respect to antibiotic treatment when p value close to 0.05.
**= Significantly associated with compliance towards IMNCI with respect to antibiotic treatment when p value close to 0.01.
***= Significantly associated with compliance towards IMNCI with respect to antibiotic treatment when p value close to 0.001.
CI = Confidence interval and others= include students, daily labors.