Table 2. Healthcare-seeking and characteristics reported by caregivers of children 1–4 years old and 5–14 years old.
Results presented are for univariable analysis, by district and age group, and multivariable analysis, by age group only. “Original” refers to the serosurvey carried out in April—June 2022 in Ndola and Choma districts, Zambia, using stratified multi-stage clustering design. “Missed” refers to the study sample from the follow-up missed population study, carried out in a subset of clusters of the original survey between July—August 2022. This study was carried out in a subsample of clusters from the original survey; in each selected cluster, a sample of households not available during listing of the original serosurvey, and hence excluded from its sampling frame, were randomly selected.
| Caregivers of children 1–4 years old | Caregivers of children 5–14 years old | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Ndola | Choma | Multivariable OR; p-value2 | Ndola | Choma | Multivariable OR; p-value2 | |||||
| Characteristic | Original (N = 101); Missed (N = 106) | p-value1 | Original (N = 198); Missed (N = 105) | p-value1 | Original (N = 208); Missed (N = 185) | p-value1 | Original (N = 371); Missed (N = 162) | p-value1 | ||
| District (Ref: Ndola) | 0.246; p = 0.001 | 0.104; p<0.001 | ||||||||
| Household-level characteristics | ||||||||||
| Male-headed household | 73%; 67% | 0.32 | 82%;58% | <0.001 | 0.513; p = 0.003 | 68%;32% | 0.027 | 70%;62% | 0.090 | 0.711; p = 0.030 |
| Wealth score3 | 1.74 (1.26);1.35 (1.13) | <0.001 | -1.36 (2.67);-2.00 (2.80) | <0.001 | 0.821; p = 0.014 | 1.96 (1.12)– 1.47 (1.09) | <0.001 | -1.31 (2.74); -1.59 (2.91) | 0.003 | 0.651; p<0.001 |
| Number of people in household3 | 6 (2); 6 (3) | 0.12 | 6 (3); 5 (2) | <0.001 | 0.919; p = 0.050 | 6 (3); 6 (2) | 0.016 | 6 (2); 5 (2) | 0.002 | 0.903; p = 0.002 |
| Male child | 41%;51% | 0.15 | 51%;58% | 0.24 | 1.458; p = 0.062 | 51%;46% | 0.30 | 48%;52% | 0.44 | 0.899; p = 0.477 |
| Health care seeking at Choma General Hospital or Arthur Davison Children’s Hospital | ||||||||||
| Would seek care at referral-level health facility4 | 0.032 | 0.004 | 0.032 | 0.004 | ||||||
| Don’t know | 0%;0% | 0.5%;0% | 0%;0% | 0.3%;0% | ||||||
| No | 7%;1% | 15%;3.8% | 5%;1% | 14%;5.6% | ||||||
| Yes | 93%;99% | 85%;96% | 95%;99% | 85%;94% | ||||||
| Way to travel to referral-level health facility | 0.43 | 0.86 | 0.073 | 0.20 | ||||||
| Private motorized transport (e.g., personal car or scooter) | 5.0%;2.8% | 2.5%;4.8% | 5.3%;8.1% | 5.4%;8.0% | ||||||
| Public motorized transport (e.g., bus, taxi) | 85%;83% | 72%;69% | 87%;82% | 68%;60% | ||||||
| Walk | 8.9%;14% | 21%;22% | 5.8%;9.7% | 22%;28% | ||||||
| Bicycle | 0%;0% | 3.5%;3.8% | 0%;0% | 3.5%;2.5% | ||||||
| Other | 1.0%;0% | 1.0%;1.0% | 1.9%;0% | 0.5%;1.2% | ||||||
| Travel time to referral-level health facility5 | 0.23 | 0.26 | 0.32 | 0.13 | ||||||
| Less than 30 mins | 17%;13% | 17%;25% | 16%;18% | 18%;19% | ||||||
| 30 mins—less than 1 hr | 35%;25% | 18%;18% | 36%;29% | 18%;26% | ||||||
| 1 hr—less than 2 hrs | 32%;39% | 22%;26% | 33%;33% | 22%;22% | ||||||
| 2 hrs—less than 3 hrs | 15%;23% | 17%;13% | 15%;20% | 22%;16% | ||||||
| 3 or more hours | 0%;0% | 26%;17% | 0%;0% | 21%;17% | ||||||
| General healthcare-seeking behavior | ||||||||||
| Money not a big barrier for health care seeking | 37%;47% | 0.12 | 24%;10% | 0.003 | 0.907; p = 0.684 | 33%;42% | 0.045 | 23%;10% | <0.001 | 0.995; p = 0.980 |
| Distance not a big problem for health care seeking | 71%;78% | 0.24 | 42%;51% | 0.11 | 75%;83% | 0.059 | 44%;47% | 0.56 | ||
| Where respondent would seek care for child’s severe fever first | 0.93 | 0.041 | 0.021 | 0.042 | ||||||
| Government clinic / health center | 94%;95% | 92%;98% | 92%;96% | 94%;96% | ||||||
| Government or mission hospital | 4.0%;3.8% | 3.0%;0% | 7.2%;2.2% | 1.6%;1.9% | ||||||
| Pharmacy or chemist | 1.0%;0% | 0%;0% | 0%;0% | 0%;0% | ||||||
| Private clinic or hospital | 1.0%;0.9% | 0.5%;0% | 0.5%;1.6% | 0%;0% | ||||||
| Community health worker | 0%;0% | 4.5%;1.0% | 0%;0% | 4.0%;0.6% | ||||||
| Traditional healer | 0%;0% | 0%;1.0% | 0%;0% | 0%;0.6% | ||||||
| Other facility | 0%;0% | 0%;0% | 0%;0.5% | 0%;0.6% | ||||||
| Don’t know | 0%;0% | 0%;0% | 0%;0% | 0.3%;0% | ||||||
| Has vaccination card6 | 0.82 | 0.084 | ||||||||
| No | 3.0%;1.9% | 5.6%;3.8% | ||||||||
| Yes, card not seen | 36%;39% | 33%;46% | Only applicable to children 1–4 years old. Caretakers of children 5–14 years old were not asked these questions. | |||||||
| Yes, card seen | 61%;59% | 62%;50% | ||||||||
| Regular vaccination location5,6 | 0.004 | 0.74 | ||||||||
| Community health worker | 2.0%;0% | 0%;0% | ||||||||
| Government clinic / health post | 80%;94% | 86%;83% | ||||||||
| Government or mission hospital | 4.0%;0.9% | 2.5%;1.9% | ||||||||
| Other facility or individual, specify | 0%;0.9% | 0%;0% | ||||||||
| Outreach posts | 14%;3.8% | 11%;15% | ||||||||
| Does not receive vaccines | 0%;0% | 0.5%;0% | ||||||||
1Fisher’s exact test; Pearson’s Chi-squared test.
2In multivariable model, the following covariates were included: District, male sex, male-headed household, wealth score, number of people in household, money not a big problem for seeking healthcare. For children 1–4 years old only, receipt of second dose of Pentavalent vaccine was also included. Full results are presented in S3 Appendix.
3Mean (SD).
4Choma General Hospital for respondents in Choma District or Arthur Davison Children’s Hospital for respondents in Ndola District.
5Excludes “Don’t know” responses.
6Only applicable to children 1–4 years old. Caretakers of children 5–14 years old were not asked these questions.