The use of traditional medicine practitioners for childhood illness among childbearing women: a multi-level Analysis of Demographic and Health Surveys in 32 sub-Saharan African countries

Abstract Background: Understanding traditional medicine practitioners (TMP)-seeking behaviour for childhood diseases may be important to reducing child mortality. However, a comprehensive picture of TMP utilisation and its associated factors for childhood illness in sub-Saharan Africa (SSA) is lacking. This study aimed to estimate the prevalence of women with children under five years old who sought the service of a traditional medicine practitioner to treat their children’s illness and identify individual and community-level factors associated with such a pattern of use. Methods We utilised extracted Demographic and Health Surveys (DHS) data collected between 2010 and 2021 among 353,463 under-fives children from 32 SSA countries. Our outcome variable was the use of TMP for childhood illness (diarrhoea or fever/cough or both). We used STATA v14 to conduct descriptive, bivariate, and two-level multivariable multi-level modelling. Results Approximately [2.80% (95%CI: 1.88-3.90)] women who sought healthcare for childhood illnesses utilised the service of a TMP with the highest in Ivory coast [16.3% (95%CI: 13.87-19.06)] followed by Guinea (13.80% (95%CI: 10.74-17.57)] to the lowest in Sierra Leone [0.10%(95%CI:0.01-1.61)]. Specifically, approximately [1.95% (95%CI: 1.33-2.68)] and [1.09% (95%CI: 0.67-1.60)] women sought the service of a TMP for childhood diarrhea and fever/cough, respectively. Women with no formal education [AOR=1.62;95%CI:1.23-2.12], no media access [AOR=1.19;95%CI:1.02-1.39), who lived in a household headed by a man [AOR=1.64;95%CI:1.27-2.11],without health insurance [AOR=2.37;95%CI: 1.53-3.66], who considered it a problem getting permission to visit a health facility [AOR=1.23;95%CI:1.03-1.47] and perceived the size of their children at birth to be above average[AOR=1.20;95%CI:1.03-1.41] had higher odds of using TMP for childhood illness. Conclusion Despite the low usage of TMP for childhood illness, our findings highlight that TMPs continue to have a role in managing childhood illness in SSA. It is essential that policymakers and service providers consider the potential role of TMPs in designing, reviewing and implementing child health policies and interventions in SSA. Also, child health policies and interventions should be focused on the characteristics of women who use TMPs for childhood diseases identified in our study.