Spatial analysis of determinants of choice of treatment provider for fever in under-five children in Iganga, Uganda

Although health facilities and drug shops are the main alternatives to home management of fever in children in Uganda, the influence of distance on the choice of treatment provider by caretakers is still unclear. We examined the spatial distribution of choice of treatment provider for fever in under-five children and the influence of household and geographical factors. Spatial and regression analysis of choices of treatment provider was done using data from a 2-week recall survey conducted in the Iganga-Mayuge Health and Demographic Surveillance Site. Of 3483 households with febrile children, 45% of caretakers treated the child at home, 33% took the child to a health facility, and 22% obtained treatment at drug shops. The distance to access care outside the home was crucial as seen in the greater preference for treatment at home or at drug shops among caretakers living more than 3 km from health facilities. The influence of proximity to health facilities in the choice of treatment provider highlights the need for greater access to health care services. The current Uganda Ministry of Health threshold of 5 km for access to health facilities needs to be reviewed for rural areas. (C) 2010 Elsevier Ltd. All rights reserved.