Associations between parental socioeconomic position and health-seeking behaviour for diarrhoea and acute respiratory infection among under-5 children in Myanmar: a cross-sectional study

Objectives: To examine the associations of parental socialand economic position with health-seeking behaviourfor diarrhoea and acute respiratory infection (ARI) amongunder-5 children in Myanmar and explore potentialunderlying mechanisms.

Design: A cross-sectional study.

Setting: A secondary dataset from the nationwide 2015–2016 Myanmar Demographic and Health Survey (MDHS).

Participants: All under-5 children in the sampledhouseholds with reported symptoms of diarrhoea and ARIduring the 2-week period preceding the MDHS surveyinterview.

Primary and secondary outcome measures: Fourparental health-seeking behaviours: ‘seeking treatment’,‘formal health provider’, ‘public provider’ and ‘privateprovider’ were considered. Social and economic positionswere determined by confirmatory factor analysis.Multilevel logistic regressions were employed to examinethe associations of social and economic positionswith health-seeking behaviours for diarrhoea and ARI.Mediation analyses were conducted to explore potentialunderlying mechanisms in these associations.

Results: Of the 4099 under-5 children from the sampledhouseholds in MDHS, 427 (10.4%) with diarrhoea and131 (3.2%) with ARI were considered for the analyses.For diarrhoea, social position was positively associatedwith seeking treatment and private provider use (adjustedOR: 1.60 (95% CIs: 1.07 to 2.38) and 1.83 (1.00 to 3.34),respectively). Economic position was positively associatedwith private provider use for diarrhoea (1.57 (1.07 to2.30)). Negative associations were observed betweensocial and economic positions with public provider usefor diarrhoea (0.55 (0.30 to 0.99) and 0.64 (0.43 to 0.94),respectively). Social position had more influence thaneconomic position on parental health-seeking behaviourfor children with diarrhoea. No evidence for a significantassociation of social and economic position with healthseeking for ARI was observed.

Conclusions: Social and economic positions were possibledeterminants of health-seeking behaviour for diarrhoeaamong children; and social position had more influencethan economic position. The results of this study maycontribute to improve relevant interventions for diarrhoeaand ARI among children in Myanmar.