In low- and middle-income nations, pneumonia is the primary infectious cause of mortality and morbidity . In children aged less than 59 months, the burden of pneumonia remains high due to the younger age of the child associated with low immunity, pre-existing diseases, malnutrition, air pollution, missing vaccinations, and environmental hazards like (indoor air pollution, overcrowding, and smoking) [1,2,3]. Although several microorganisms are the etiologic agents of pneumonia, Streptococcus pneumonia and H. influenzae are the most common bacteria that cause pneumonia . The respiratory syncytial virus is the most common type of virus that causes pneumonia in younger children .
Complications of pneumonia are categorized either as local (parapneumonic effusion, empyema, necrotizing pneumonia, and lung abscess) or as systemic (bacteremia, metastatic infection, multiorgan failure, acute respiratory distress syndrome, disseminated intravascular coagulation and, rarely, death) . However, children from pneumonia can be protected (through effective use of exclusive breastfeeding and complementary feeding), prevented (by vaccination, hand washing with soap, reducing household air pollution, and preventing infectious diseases), and treated by the appropriate therapies, including supplemented oxygen .
Globally, almost 1 million children under the age of five die from pneumonia every year, accounting for 15% of all child deaths, while South Asia and sub-Saharan Africa are predominantly affected by this infectious disease . Africa loses thousands of children due to pneumonia each year that causes around 750,000 child deaths per year in sub-Saharan African countries . In Ethiopia, pneumonia kills 15 people per 1000 live births, and the country ranks sixth among the top 15 countries in the world for pneumonia morbidity and mortality .
Primary caregivers’ timely recognition of the signs and symptoms, as well as subsequent care seeking for treatment, are poor, resulting in many under-five deaths in developing countries despite effective treatment for pneumonia exists . As a result, the World Health Organization (WHO) estimates that prompt medical attention can save 20% of children’s lives and dramatically reduce morbidity from acute respiratory infections, including pneumonia . Delaying seeking healthcare for pneumonia contributes to many deaths in developing countries . Around the world, 40% of kids put off getting the aid and care they need, but in sub-Saharan Africa, where pneumonia kills the most kids, that number rises to almost 60% . In our country, Ethiopia, health-seeking behavior is deficient in around 61.3% of caregivers .
According to a WHO report, more than half of childhood mortality is caused by a delay or insufficient response to medical care, which can be avoided by obtaining medical help sooner . Despite the fact that it is recommended that children seek immediate medical attention, approximately 40% of children worldwide do not receive the necessary aid and care, and approximately more than half of children in sub-Saharan Africa, where the majority of pneumonia deaths occur, are left at home or delay in seeking care .
According to a United Nations International Children Emergency Fund (UNICEF) report, just 3 out of every five children in Sub-Saharan Africa with pneumonia-specific symptoms are not early taken to an appropriate health facility for treatment; children from poorer and less educated families are less likely to seek care . Accordingly, in Chad (27.4%), Central African Republic 30.9%, Democratic Republic of Congo (44.2%), Nigeria (41.9%), Sierra Leone (73.2%) and Malawi (68.8%) seek health care on time respectively whereas the remained delayed to seek care from the health facility for their children . The Ethiopian Demographic Health Survey (EDHS) 2016 report showed that about 70% of mothers with less than 5 years old do not seek healthcare promptly without delay for pneumonia (acute respiratory infections) in Ethiopia .
According to earlier research [13, 14], mothers’ and caregivers’ health-seeking for pneumonia in children between the ages of 2-59 months is influenced by socio-demographic factors, such as parental socioeconomic status, health facility-related factors (such as distance from the health facility), and lack of awareness of pneumonia.
In agreement with the WHO, the Ethiopian government is implementing integrated community case management to reduce childhood-related mortality and morbidity due to pneumonia . The Ethiopian government is working to improve the survival of children under five . For example, training healthcare workers, formulating case management guidelines, strengthening communities with health insurance services and adequate health information, and extending healthcare facilities and infrastructures for implementing integrated community case management.
However, from our experience, caregivers’ practices like taking their baby to church, using traditional methods, and using types of syrup previously bought for unrelated cases are reported. A community uses different beliefs, cultures, and traditional ways of managing childhood illness. Some of them are toxic to child growth and development. The Ethiopian government’s commitment alone is not sufficient to reduce childhood mortality and morbidity due to pneumonia. There is limited research sought to identify the level and contributing factors related to delay in healthcare seeking for pneumonia in Ethiopia. Therefore, this study desired to assess the level of delay in healthcare seeking for pneumonia and associated factors among caregivers of U5C in public health facilities in Nekemte town, Ethiopia.