Title: Household decision-making on child health care in developing countries: the case of Nepal.

POPLINE Document Number: 194589

Author(s):

Pokhrel S
Sauerborn R

Source citation:

Health Policy and Planning, 2004 Jul;19(4):218-233.

Abstract:

Quantitative studies on health care utilization often overlook the importance of capturing the ‘pathway’ of household decision-making processes. This paper offers a four-step construct which maps out a hierarchical scale of household decision-making regarding child health care. The construct begins with the perception of illness, moves on to choice of care and provider, and finally ends with health care expenditure. The construct is substantiated by means of a descriptive analysis of nationally representative data from the 1996 round of the Nepal Living Standards Survey. About 10% of the total population reported illness, 69% of whom sought care, and depending upon the provider they chose, spent between 2.5 to 4.3% of their per capita household total annual expenditure on health care. Bivariate analysis detected age and gender biases in the perception of illness, but if a child was reported ill, all subsequent steps were found to be free from such differences. Further analysis, that took into account the changing effects of income and mother’s education, indicated that there may be conceptually different household dynamics that underlie boys’ and girls’ illness perception; this ultimately determines whether or not health care is sought. The authors put forward a hypothesis to be tested by future studies. They argue that gender role significantly affects the perception of illness, but not necessarily the subsequent care-seeking. The relevance of this hypothesis to explaining the typical South Asian characteristic of differential child mortality rates is discussed. (author's)

Keywords:

Nepal
Research Report
KAP Surveys
Demographic Surveys
Family and Household
Child
Decision Making
Utilization of Health Care
Child Care
Perception
Fees
Age Factors
Sex Factors
Sex Preference
Microeconomic Factors
Developing Countries
Asia, Southern
Asia
Surveys
Sampling Studies
Studies
Research Methodology
Population Dynamics
Demographic Factors
Population
Youth
Population Characteristics
Behavior
Health Services
Delivery of Health Care
Health
Child Rearing
Psychological Factors
Financial Activities
Economic Factors
Value Orientation