Patterns of Care Seeking During Episodes of Childhood Diarrhea and Its Relation to Preventive Care Patterns: National Integarated Monitorinh and Evaluation Survey (IMES) of Family Health Islamic Repob

Background: In Iran, diarrheal disease is the fourth cause of under five?year mortality. Proper care?seeking behavior and system?based disease management in the national field will have a great effect in reducing morbidity and mortality. Methods: This nationwide study was performed on a target population of rural and urban communities; in all 31 provinces of the Islamic Republic of Iran. One lakh three thousand three hundred and thirty one (103331) families were sampled by multi?stage stratified random sampling and were interviewed with a standard data collection form. The collected data was entered into the Stata 8.0 software and analyzed by the survey analysis method. Results: Of the 14625 (10.1%) children who were reported to have diarrheal diseases two weeks prior to the interview, 8.8% were cured and 1.5% were not. About 70% of them had at least one visit for health seeking the most of patients were seen by a rural health worker (Behvarz) in the rural and by a general pediatrician in the urban areas. About 62% of the patients in urban and 57% in the rural areas had been treated with antibiotics and these rates for ORS were 51% and 65%, respectively. The factors most related to a care?seeking pattern were the level of routine preventive well?child care, number of siblings, child age, and living area. Conclusion: According to this national survey, our health system needs to integrate all the levels of prevention, especially the Integrated Management of Child Illnesses (IMCI) programs with a family physician project. Futher more, there is a great need for empowering the referral system and gate keeping in all referral levels, to make efficient national integrated programs.