Determinants of inequality in health care seeking for childhood illnesses: insights from Nairobi informal settlements

Abstract

An in-depth understanding of patterns of inequities in healthcare seeking among the urban residents is critical in identifying appropriate interventions strategies. The study evaluates determinants of inequality in health care seeking for childhood illnesses among informal settlement residents in Nairobi, Kenya. Data from the second Nairobi Cross-Sectional Slum Survey (NCSS 2012) was examined. The inequality in seeking health care for childhood diarrhea as the prototype illness was assessed using concentration index (CI). The wealth index based on the household possessions and amenities was used as a measure for socioeconomic status. A total of 2 027 qualified women were included in this study. About 16.6% of children born of younger mothers aged < 20 years had diarrhea and a similar proportion of children (16.3%) was observed among mothers who were unemployed. The CI of −0.026 on health care seeking for diarrhea among children points to significant inequality among the urban poor (95% confidence interval: −0.028 to −0.023). Occupation of parents, age of mothers, ethnicity, marital status and children's age were major determinants with regard to disease outcome and to a broader extent inequality in health care seeking for childhood illnesses. Enhanced bottom top community health invigoration strategies in health information awareness and services access would be instrumental.