Health seeking behaviour of caregivers of children under five and its determinants in Ho West and Adaklu districts, Volta Region, Ghana: a community-based cross-sectional study

Background Despite gains made in child survival, morbidity and mortality remain high in sub-Saharan Africa. Seeking healthcare at health facilities for sick children under-five within 24 h of onset of symptoms is key to mitigating severe morbidity and mortality. However, literature on this outcome is limited and poses challenges for monitoring caregivers' adherence to prompt health seeking behaviour. This study assessed the prevalence and determinants of prompt caregiver health seeking behaviour (HSB) for sick under-fives in two districts in the Volta Region of Ghana. Methods The study was conducted among 770 caregivers/children in the Ho West and Adaklu districts of the Volta Region. Data on caregiver and child characteristics and knowledge of childhood illness symptoms/ signs among others were obtained. Summary statistics were presented as frequencies and percentages. Logistic regression was used to assess for association between prompt HSB and independent variables including caregiver and child socio-demographics. Odds ratios were presented with 95% confidence intervals at a statistical significance of p < 0.05 in the final model. Results Almost 93% (714/770) of the caregivers were females while about three-quarters (559/767) were aged 20-39 years. The mean age of the study children was 24.1 months. Of caregivers who sought formal health care the last time their children fell ill, only about 59% (337/573) did so within 24 h of symptoms onset. Less than 10% (52/770) of caregivers had adequate knowledge of childhood danger signs while about 64% (492/770) had decision-making capacity regarding sending a sick child to a health facility. Male children had twice the odds of caregivers' prompt HSB compared to females [AOR 2.02 95% CI: 1.24, 3.27; p = 0.004]. Fourth-born or higher birth order children had 56% reduced odds of prompt HSB [AOR 0.44 95% CI: 0.26, 0.75; p = 0.003]. Conclusion About 60% of those who sought formal care for their sick children did so promptly and this was influenced by the sex and birth order of the child. Public health managers in the study area must promote interventions to improve prompt caregiver HSB, especially for children of higher birth orders. Community education is needed to minimize 'discrimination' against the girl child as far as prompt HSB is concerned.