Socio-economic determinants in selecting childhood diarrhoea treatment options in Sub-Saharan Africa: A multilevel model

Multilevel multinomial logistic regression analysis was applied to Demographic and Health Survey data conducted in 11 countries in sub-Saharan Africa. The unit of analysis were the 12,988 caregivers of children who were reported to have had diarrhoea two weeks prior to the survey period.There were variability in selecting treatment options based on several socioeconomic characteristics. Multilevel-multinomial regression analysis indicated that higher level of education of both the caregiver and that of the partner, as well as caregivers occupation were associated with selection of medical centre, pharmacies and home care as compared to no treatment. In contrast, caregiver's partners' occupation was negatively associated with selection medical centre and home care for managing diarrhoea. In addition, a low-level of neighbourhood socio-economic disadvantage was significantly associated with selection of both medical centre and pharmacy stores and medicine vendors.In the light of the findings from this study, intervention aimed at improving on care seeking for managing diarrhoea episode and other childhood infectious disease should jointly consider the influence of both individual SEP and the level of economic development of the communities in which caregivers of these children resides.Diarrhoea remains an important cause of morbidity and mortality among children aged five and below in most developing regions of the world. According to an estimate, diarrhoea is reported to be responsible for close to 2 million deaths annually in this age-group[1]. In sub-Saharan Africa (SSA), the occurrence of diarrhoea like other infectious disease has been associated with poverty [2-4]. Timely administration of oral rehydration salt (ORS), and more recently Zinc tablets have proved to be both more cost effective and efficacious as primary interventions for preventing diarrhoea morbidity [5-11]. Despite the availability of these interventions; there have been no decline to diarrhoea i