The present study was conducted to determine the differential prevalence of fever and to identify the factors associated with appropriate health care-seeking behaviours for childhood fever in Burkina Faso.
The results of this study show that 79.11% and 57.27% of children had a fever in the four weeks before the survey in 2013 and 2017, respectively. We noted a decrease in the prevalence of self-reported fever between 2013 and 2017. This may be explained by the PBF and interventions in the field of malaria. Our finding is higher than previous studies conducted in Burkina Faso [12, 29, 35, 36]. This may be due to the four-week reference period chosen to collect the data for this study as compared to the two-week reference period of other studies.,
Our finding showed an increase in health care-seeking behaviours for childhood fever between 2013 and 2017. This could be explained by the PBF and interventions in the field of malaria and the policy of free care for children under five and for pregnant women for whom the financial barriers to access to health care have been removed. The study also showed that health care-seeking behaviours for childhood fever in Burkina Faso was higher than that showed in studies conducted in Nigeria [17] and Ethiopia [37]. However, it was lower than the level of health care-seeking for childhood fever in Tanzania [6] and in Gabon [38]. Because a population’s standard of living is a vital factor in health and disease [37, 39], the above inconsistent results could be due to the difference in the socio-economic status of the study participants [37, 40].
The child’s age, wealth of the household, household composition, mother’s educational level, use of antenatal and postnatal care and safety in health facilities were factors significantly associated with appropriate health care-seeking behaviours for childhood fever.
In the present study, mothers were less likely to seek appropriate healthcare for children one year and older with fever. This is consistent with similar studies in Ethiopia, Tanzania and Kenya that assessed health-seeking behaviours in children under five with fever [18, 37, 41, 42].
Mothers from the richest households were more likely to seek appropriate health care for children's fever than mothers from households with the poorest wealth status. This finding is consistent with previous studies reported in Nepal, Ethiopia, Tanzania and Nigeria [6, 37, 38, 43–45].
Mothers who had formal education (secondary and above) were more likely to seek appropriate health care for children with fever than mothers who had no formal education. This finding is consistent with previous studies conducted in Ethiopia, Bangladesh and Tanzania [6, 37, 43, 46]. It is known that education influences health care-seeking behaviours in communities. Educated mothers can better understand the symptoms and severity of fever and thus seek health care in a shorter period than those mothers who are less-educated.
Our study also found that children residing in households with two or more children under the age of five were more likely to receive appropriate health care for fever than children residing in households with only one child under five. This fact is probably explained by the experiences acquired with the other children of the household. However, this finding is not consistent with another study in Tanzania [6]. These inconsistent results could be due to the difference in the socio-cultural context of study participants.
Limitations of the study
As the study was cross-sectional and data were collected in a short period, we could not capture changes in the health care-seeking behaviours of mothers between seasons. Moreover, in this study, we did not analyse the health care-seeking behaviours of mothers in terms of the duration and severity of the fever.
Furthermore, although our study’s focus was a sample of randomly selected households in the regions, the generalizability of our results may be limited given that study regions and districts of the study were purposely selected.
The construction of the results in this study depended on women's self-report of childhood fever and care-seeking behaviours. Perception and accurate recall of fever in young children pose many problems of reliability and validity. The accurate recall of symptoms depends largely on the respondent's knowledge of these symptoms and the subjective perception of the disease by the respondent and / or other household members.