6807 Exploring health seeking behavior among caregivers in an urban informal settlement in Kenya

Objectives In Kenya, under-5 mortality and neonatal mortality rates in 2019 were 4.3% and 2.1%, respectively.1 This study describes health-seeking behavior, including the barriers among parents and guardians of children under 12, in an urban informal settlement in Kenya. This was done to explore the value of a digital symptom checker as a tool for decision-making among caregivers. Methods A cross-sectional observational study was conducted between July 15th and September 15th, 2023. The area of study targeted 6 wards within the peri-urban informal settlements of Kenya. Data was collected through consented recorded interviews and electronic questionnaires. These were given to caregivers in households with sick children identified by the Community Health Promoters (CHPS).2 The study focused on whether the caregiver sought help, the challenges faced, and their access to a digital device. Additionally, a research doctor present at each interview, triaged every recruited child into 3 categories: stay at home, seek medical advice, seek urgent medical advice. Results A total of 346 questionnaires were completed for caregivers of children under 12 years of age, including neonates. Figure 1 shows the actions taken by caregivers for their unwell children. A qualitative review of audio recordings shows the following barriers to accessing healthcare: Lack of knowledge of common childhood conditions, lack of finances, perceived limited resources at the facility, cultural beliefs, distance to the facility, and lack of trust in government health providers. It also showed in 62%(96/158) of families who did not seek intervention, the research doctor had triaged the child as requiring medical review. Of note, 54%(187/346) of caregivers had access to a digital device. Conclusion The study showed that 27.7% (96/346) of caregivers had not yet sought help for an unwell child and this had been recommended by the research doctor. It was noted that over half of the caregivers owned a smartphone. A digital tool may help to address the health-seeking of caregivers with the potential to improve child health outcomes in urban informal settlements. References https://data.worldbank.org/indicator/SH.DYN.MORT?locations=KE https://www.health.go.ke/kenyas-bold-step-towards-universal-health-coverage-unveiling-community-health-promoter-kits