Table 2. Summary of responses and trends from the 2014 and 2016 IHOPE surveys on indicators of sick-child care seeking behavior and care content (children <5 years old).
| Indicator | 2014 | 2016 | 2014–2016 Trend | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Study group | N | Percent (SE) | Difference (p-value) |
N | Percent (SE) | Difference (p-value) |
Percent relative change | Percent absolute change | DiD (p-value) |
|
| Summary statistics for all children with symptoms of diarrhea, fever, and/or coughing with difficulty breathing | ||||||||||
| Visit to a PHF or CHW | IG | 183 | 41.35 (5.33) | — | 98 | 62.50 (7.42) | — | 51.17 | 21.16 | — |
| NG | 474 | 30.02 (3.35) | 11.32 (0.07)+ | 313 | 27.88 (3.97) | 34.62 (0.00)*** | −7.13 | −2.14 | 23.29 (0.01)** | |
| Visit to a PHF | IG | 183 | 28.98 (5.43) | — | 98 | 49.66 (7.04) | — | 71.37 | 20.68 | — |
| NG | 474 | 22.23 (3.34) | 6.75 (0.28) | 313 | 22.10 (3.50) | 27.56 (0.00)*** | −0.56 | −0.12 | 20.81 (0.00)*** | |
| Visit to a CHW | IG | 183 | 12.85 (3.91) | — | 98 | 12.84 (5.06) | — | −0.09 | −0.01 | — |
| NG | 474 | 7.98 (1.95) | 4.87 (0.23) | 313 | 5.78 (2.52) | 7.06 (0.17) | −27.61 | −2.20 | 2.19 (0.74) | |
| Any treatment prescribed at a PHF or CHW |
IG | 183 | 40.14 (5.53) | — | 98 | 58.26 (7.73) | — | 45.16 | 18.12 | — |
| NG | 474 | 29.56 (3.31) | 10.58 (0.10)+ | 313 | 26.93 (3.95) | 31.33 (0.00)*** | −8.89 | −2.63 | 20.75 (0.02)* | |
| Care seeking for children with diarrhea | ||||||||||
| Visit to a PHF or CHW | IG | 56 | 43.28 (9.88) | — | 44 | 61.47 (8.41) | — | 42.03 | 18.19 | — |
| NG | 125 | 31.02 (5.90) | 12.26 (0.28) | 107 | 31.45 (5.30) | 30.02 (0.00)*** | 1.37 | 0.43 | 17.76 (0.16) | |
| Visit to a PHF | IG | 56 | 35.96 (10.01) | — | 44 | 45.29 (10.78) | — | 25.95 | 9.33 | — |
| NG | 125 | 21.95 (5.27) | 14.01 (0.19) | 107 | 26.97 (5.30) | 18.32 (0.12) | 22.87 | 5.02 | 4.31 (0.74) | |
| Visit to a CHW | IG | 56 | 7.32 (4.97) | — | 44 | 16.18 (9.15) | — | 120.98 | 8.86 | — |
| NG | 125 | 9.07 (3.37) | -1.75 (0.78) | 107 | 4.48 (1.86) | 11.70 (0.06)+ | −50.63 | −4.59 | 13.45 (0.21) | |
| Content of care for children with diarrhea | ||||||||||
| Any treatment prescribed at a PHF or CHW |
IG | 56 | 41.50 (10.04) | — | 44 | 58.30 (8.80) | — | 40.48 | 16.80 | — |
| NG | 125 | 27.69 (6.23) | 13.80 (0.23) | 107 | 22.42 (4.75) | 35.88 (0.00)*** | −19.05 | −5.28 | 22.07 (0.13) | |
| Oral rehydration therapy prescribed at a PHF or CHW |
IG | 56 | 29.64 (6.81) | — | 44 | 49.93 (10.52) | — | 68.48 | 20.30 | — |
| NG | 125 | 17.78 (5.47) | 11.86 (0.18) | 107 | 13.65 (3.37) | 36.28 (0.00)*** | −23.22 | −4.13 | 24.43 (0.05)* | |
| Antibiotics prescribed at a PHF or CHW |
IG | 56 | 24.19 (7.08) | — | 44 | 15.88 (7.09) | — | −34.34 | −8.31 | — |
| NG | 125 | 14.71 (3.89) | 9.48 (0.21) | 107 | 10.71 (3.08) | 5.17 (0.46) | −27.18 | −4.00 | −4.31 (0.67) | |
| Zinc supplements prescribed at a PHF or CHW |
IG | 56 | 15.81 (4.66) | — | 44 | 18.59 (11.47) | — | 17.61 | 2.78 | — |
| NG | 125 | 6.78 (2.80) | 9.03 (0.09)+ | 107 | 3.19 (1.79) | 15.40 (0.03)* | −52.97 | −3.59 | 6.38 (0.65) | |
| Antidiarrheal medication prescribed at a PHF or CHW |
IG | 56 | 8.32 (6.66) | — | 44 | 0.00 (0.00) | — | −100.00 | −8.32 | — |
| NG | 125 | 1.52 (1.08) | 6.80 (0.08)+ | 107 | 0.00 (0.00) | — | −100.00 | −1.52 | −6.80 (0.32) | |
| Homemade remedy prescribed at a PHF or CHW |
IG | 56 | 0.00 (0.00) | — | 44 | 0.00 (0.00) | — | 0.00 | 0.00 | — |
| NG | 125 | 2.97 (2.09) | −2.97 (0.34) | 107 | 0.53 (0.53) | −0.53 (0.54) | −82.33 | −2.45 | 2.45 (0.26) | |
| Care seeking for children with persistent cough and difficulty breathing | ||||||||||
| Visit to a PHF or CHW | IG | 110 | 38.46 (5.32) | — | 44 | 58.97 (11.24) | — | 53.31 | 20.50 | — |
| NG | 251 | 27.85 (4.05) | 10.61 (0.11) | 156 | 28.29 (4.54) | 30.67 (0.01)** | 1.58 | 0.44 | 20.06 (0.08)+ | |
| Visit to a PHF | IG | 110 | 28.83 (5.63) | — | 44 | 49.28 (10.48) | — | 70.97 | 20.46 | — |
| NG | 251 | 22.77 (3.67) | 6.06 (0.36) | 156 | 21.90 (3.96) | 27.38 (0.01)** | −3.80 | −0.87 | 21.32 (0.03)* | |
| Visit to a CHW | IG | 110 | 9.64 (3.15) | — | 44 | 9.68 (5.21) | — | 0.48 | 0.05 | — |
| NG | 251 | 5.08 (1.86) | 4.55 (0.19) | 156 | 6.39 (3.13) | 3.29 (0.57) | 25.71 | 1.31 | −1.26 (0.84) | |
| Content of care for children with persistent cough and difficulty breathing | ||||||||||
| Any treatment prescribed at a PHF or CHW |
IG | 110 | 37.35 (5.81) | — | 44 | 47.85 (10.38) | — | 28.10 | 10.50 | — |
| NG | 251 | 27.54 (4.05) | 9.81 (0.16) | 156 | 28.29 (4.54) | 19.56 (0.07)+ | 2.73 | 0.75 | 9.74 (0.40) | |
| Antibiotics prescribed at a PHF or CHW |
IG | 110 | 26.32 (4.83) | — | 44 | 45.12 (10.43) | — | 71.43 | 18.80 | — |
| NG | 251 | 16.95 (3.65) | 9.37 (0.12) | 156 | 17.47 (3.48) | 27.65 (0.00)*** | 3.08 | 0.52 | 18.28 (0.13) | |
| NSAIDs/paracetamol prescribed at a PHF or CHW |
IG | 110 | 29.59 (4.69) | — | 44 | 23.40 (6.85) | — | −20.92 | −6.19 | — |
| NG | 251 | 21.03 (3.81) | 8.56 (0.16) | 156 | 20.30 (4.02) | 3.10 (0.69) | −3.48 | −0.73 | −5.46 (0.48) | |
| Antimalarial medication prescribed at a PHF or CHW |
IG | 110 | 8.61 (2.89) | — | 44 | 0.00 (0.00) | — | −100.00 | −8.61 | — |
| NG | 251 | 11.56 (2.43) | −2.95 (0.45) | 156 | 5.90 (2.53) | −5.90 (0.18) | −48.98 | −5.66 | −2.95 (0.46) | |
| Care seeking for children with fever | ||||||||||
| Visit to a PHF or CHW | IG | 91 | 50.26 (6.38) | — | 27 | 60.52 (12.36) | — | 20.41 | 10.26 | — |
| NG | 352 | 31.25 (3.87) | 19.00 (0.01)** | 137 | 33.48 (6.00) | 27.03 (0.05)* | 7.13 | 2.23 | 8.03 (0.57) | |
| Visit to a PHF | IG | 91 | 28.83 (7.31) | — | 27 | 51.15 (12.25) | — | 77.44 | 22.32 | — |
| NG | 352 | 24.37 (4.16) | 4.46 (0.59) | 137 | 29.29 (5.74) | 21.86 (0.10)+ | 20.18 | 4.92 | 17.41 (0.25) | |
| Visit to a CHW | IG | 91 | 21.43 (5.97) | — | 27 | 9.36 (5.83) | — | −56.30 | −12.07 | — |
| NG | 352 | 6.88 (1.77) | 14.55 (0.00)*** | 137 | 4.20 (2.17) | 5.17 (0.32) | −39.04 | −2.69 | −9.38 (0.30) | |
| Content of care for children with fever | ||||||||||
| Any treatment prescribed at a PHF or CHW |
IG | 91 | 50.26 (6.38) | — | 27 | 52.76 (12.59) | — | 4.99 | 2.51 | — |
| NG | 352 | 30.63 (3.79) | 19.63 (0.01)** | 137 | 31.37 (5.79) | 21.39 (0.12) | 2.43 | 0.74 | 1.76 (0.90) | |
| NSAIDs/paracetamol prescribed at a PHF or CHW |
IG | 91 | 39.63 (4.91) | — | 27 | 39.16 (10.50) | — | −1.18 | −0.47 | — |
| NG | 352 | 25.20 (3.83) | 14.43 (0.02)* | 137 | 25.60 (5.27) | 13.57 (0.23) | 1.57 | 0.40 | −0.87 (0.95) | |
| Antibiotics prescribed at a PHF or CHW |
IG | 91 | 23.49 (4.45) | — | 27 | 35.63 (11.75) | — | 51.67 | 12.14 | — |
| NG | 352 | 19.13 (3.10) | 4.36 (0.42) | 137 | 17.78 (5.12) | 17.85 (0.13) | −7.08 | −1.35 | 13.49 (0.31) | |
| Malarial rapid diagnostic test administered at a PHF or CHW |
IG | 91 | 39.26 (7.50) | — | 27 | 30.78 (9.97) | — | −21.60 | −8.48 | — |
| NG | 352 | 20.98 (4.00) | 18.28 (0.03)* | 137 | 20.28 (4.66) | 10.50 (0.31) | −3.30 | −0.69 | −7.79 (0.53) | |
| Antimalarial medication prescribed at a PHF or CHW |
IG | 91 | 22.99 (5.20) | — | 27 | 14.15 (7.10) | — | −38.45 | −8.84 | — |
| NG | 352 | 15.10 (2.60) | 7.89 (0.15) | 137 | 12.24 (4.15) | 1.91 (0.81) | −18.92 | −2.86 | −5.98 (0.50) | |
+p-value < 0.10.
*p-value < 0.05.
**p-value < 0.01.
***p-value < 0.001.
Abbreviations: CHW, community health worker site; DiD, difference-in-differences; IG, intervention group; IHOPE, The Ifanadiana Health Outcomes and Prosperity longitudinal Evaluation; NG, non-intervention group; NSAID, nonsteroidal anti-inflammatory drug; PHF, public health facility.