Levels and determinants of healthcare-seeking delay for pediatric pneumonia: a mixed-methods study

Early diagnosis and prompt treatment of childhood pneumonia are crucial. However, evidence on the extent and determinants of healthcare-seeking delays is limited. Therefore, this study aimed to assess delays in healthcare-seeking for childhood pneumonia and to explore barriers to prompt care in northwest Ethiopia in 2023. A concurrent mixed-methods study was conducted in Northwest Ethiopia, surveying 938 caregivers and conducting 15 in-depth interviews. Healthcare-seeking delay was defined as waiting more than 24 h after symptom recognition to reach a facility. Descriptive statistics, logistic regression, and thematic analyses were performed. The delay in healthcare-seeking for childhood pneumonia was 84.5%. The first delay, delay in deciding to seek healthcare, accounted for the largest share of the overall delay. Rural residents, low women’s autonomy, high perceived barriers, and low cues to action were positively associated with delayed healthcare seeking. The most commonly cited barriers to prompt care seeking for children with pneumonia were “illness leveling,” “presence of prioritized activities,” and “inaccessibility of the health facility.” Caregivers’ delay in care-seeking for childhood pneumonia remains very high. Given the high fatality rate of pneumonia among children and the serious consequences of delayed care, the health system needs to intensify efforts to improve caregivers’ prompt healthcare-seeking behavior.