Health-seeking practices of caregivers and determinants in responding to acute respiratory infection episodes in Biliran Island, Philippines

# Background Despite the substantial programs addressing childhood illnesses, pneumonia still ranks as the leading cause of childhood mortality in the Philippines. Hence, this study was designed to determine the current health seeking behavior and its determinants among caregivers of children under five years old. # Methods A prospective cohort study of 3,056 children under five years old was undertaken in selected barangays in two municipalities of Biliran Island, Philippines. These children were visited every two weeks from February 2014 to June 2015 to find out if they had any respiratory infections. Mothers documented signs and symptoms of respiratory infections and actions taken in response to the observed signs and symptoms in a disease calendar. Research staff confirmed calendar entries and accuracy of the data and encoded it into a database. The most severe Integrated Management of Childhood Illnesses (IMCI) category was selected to represent an illness period. A new episode was counted when there was >7 days interval of no clinical signs from a previous episode. # Results Results revealed that mothers may appear to recognize critical signs of illness but are not appropriately responding to them. Of the 191 pneumonia cases, 53.4% sought health care facilities, while 47.6% either took no action or resorted to self-medication. Overall rate of self-medication was highest among pneumonia cases and lowest among the Very Severe Pneumonia group. On average, 38.0% of acute respiratory infection (ARI) episodes self-medicated with antipyretics and antibiotics (33.0%). The number of children under five years old in the household and age of child at the time of the episode were identified as determinants for self-medication. # Conclusions The findings suggest that there was inappropriateness and delay in seeking care for childhood pneumonia in rural areas.