Abstract:
This study examined the impact of culturally defined gender-equity on response to childhood fevers in Mbaise. A cross-sectional survey of two thousand, three hundred and eight (2308) fathers and care givers of children (5 5 years), who experienced fever not more than two weeks preceding the survey was conducted in two communities in Ezitlihitte LGA, Inlo State. The main instrument for data collection was a uniform set of structured interview schedule, administered by trained research assistants. This was supported by data from focus group discussion (FGD) with community members and in-depth interviews with community leaders and health workers. The analysis of the data showed that rights and responsibilities in childhood fevers were divided along gender lines. This division is culturally sanctioned in the communities studied. The Illen monopolized the right to make decision on the pattern of response to childhood fevers in the household as well as the allocation of l~ousehold~resou~fo~re sth' is purpose. On the other hand the women were saddled with the responsibility of ensuring the execution of the decisio~ls of the men with respect to seeking help in childhood fevers. The delay in response to childhood fever differed significantly between the boy-child and girl-child (ANOI'A = 16.04; P<0.0001). Response was faster when the sex of the sick child is male. There is a wider variation in health seeking for the girl child, however this is attributable to the delay in the health seeking for the girl child, which leads to complications requiring longer treatment and more cost. The results also slio\ved that the longer tlie delay the poorer the result of the first action taken in I-esponse to fever in children ( ~ ~ c / z t m= ~0.e0 11). The boys improved more after fir-st treatment than the girls (P<O.O001). Appropriateness of tlie first action taken in response to childhood fever was affected by the nature of decision making in the households (P<O.0001). The study also revealed that first actions were more appropriate in households where joint decisions were taken than in household where the father monopolized decision (P<0.03). The Regression ~riodel( ~ ~ c h t r t=i ~0 .eO l l ) revealed that a unit change in the process of decision making to involve mothers translates into 4-point increase in the appropriateness of the first action taken in response to childhood fevers. A number of socioeco~~o~nfaicc tors were also found to influence response to childliood fevers. For instance the elnploylnent status of the female respondent correlated positively with tlie appropriateness of the response to cliildhood fevers Female care givers who were in paid employlnent gave appropriate response faster than their counterparts in non-paid employment (2 = 13.333; P=O.OOl, ., ,, , . ,,t. 7,. 5 . , c=0. 101). The logistic multiple regression niodels identified gender difference as an explanatory variable of the speed and appropriateness of response to childhood \ I t - .L fevers in the household. However, the t-values for the multiple regression model revealed that gender difference was only the third most important factor that influence response to childhood Tevers. Religion and economic activities of the respondents were the first and second most important factors respectively. This shows that the impact of gender dityerence on response to childhood fevers is defined by other cultural factors These findings were equally supported by the qualitative data. FGD data show that a worrlarl woitld not take a child with fever to hospital without the father's approval because it is believed that the child is his, and if the outcoines were negative she would incur the wrath of the husband and his relatives. It was concluded that culturally defined gender equity influences response to cllildhood fevers in Mbaise households Consequently, it was recotnmended that the realities of the gender relations be factored into hture interventions on child health. The men should be targeted while the wotnen are empowered to enhance 111ei1- dispensing of the responsibilities of the prirnary health care providers in households
