Households Entrapment in Vicious Cycle of Poverty and Ill-Health: An Analysis of Factors Influencing Health Seeking Behaviour towards Millenium Development Goals in Butere District, Kenya

Background: The survival of mothers and their babies has been intrinsically linked with poverty. Infant and child mortality is often higher in poorer households and poorer women face much higher risks in pregnancy and childbirth than their richer counterparts. This paper examines household poverty as an obstacle to reaching Millennium Development Goals (MDGs) 4 and 5 in a rural setting in Kenya.

Methods: The paper is based on analysis of data from a cross sectional survey of 3299 Under-five children from 2232 households in four sub-locations, registered for community based health care (CBHC) in Butere.  Logistic regression analysis is used to examine household socio-economic factors that influence maternal/child health seeking behavior. Indicators of maternal/child health seeking behaviour (dependent variables) are presence of a child vaccination card, at least 4 antenatal visits during pregnancy, health facility delivery and use of ITN, key explanatory variables include housing type, cereal availability, educational attainment of household head, and presence of a latrine in the household.

Results: Among the indicators of health seeking behavior included in the analysis, ITN use shows the strongest association with household socio-economic status. Availability of cereals in a household is associated with double the odds of ITN use among under fives (p=0.000) while permanent housing is associated with about 70 percent higher odds of ITN use than rudimentary (mud) housing (p=0.039). Health facility delivery shows some evidence of significant association with household socio-economic status. The odds of a health facility delivery are about 90 percent higher in households with permanent housing than rudimentary housing (p=0.005). There is little evidence of household socio-economic vulnerability in relation to child vaccination or antenatal care.

Conclusion: There is evidence that household poverty is a barrier to health seeking behavior in relation to ITN use and delivery care, but not child vaccination or antenatal care.