# Morbidity and health seeking behavior among children and adolescents (0–19 years): a household survey assessment in Northwestern Tanzania

## TL;DR

This study examines illness and health-seeking behavior in children and adolescents in Tanzania, showing that both decline with age and are influenced by factors like education and location.

## Contribution

The study introduces a method to estimate morbidity and health-seeking behavior in children aged 5–19 using household survey data, extending beyond the commonly studied under-five group.

## Key findings

- Morbidity prevalence decreased from 26.1% in children under five to 10.4% in adolescents aged 15–19.
- Health-seeking behavior dropped from 48.2% in under-fives to nearly 30% in adolescents.
- Fever/Malaria was the most commonly reported illness across all age groups.

## Abstract

Information on morbidity and health-seeking behavior beyond early childhood is crucial for planning evidence-based interventions. Currently, data is limited to children under five. This study introduces a method for estimating morbidity and health-seeking behavior in older children and adolescents (5–19 years) using women’s birth histories from a household survey in northwestern Tanzania, comparing it with data on children under five.

We conducted a household survey among women 15–49 years as part of the Magu Health and Demographic Surveillance from October 2020 to November 2021, including 16,896 children aged 0–19 living with their mothers. The study outcomes were the prevalence of reported illness in the last four weeks and health-seeking behavior, defined as visiting a health facility for recent illness. Modified Poisson regression analysis was performed, accounting for mothers as clusters and adjusting for child and mother characteristics. We compared the prevalence of recent illness and health-seeking behavior among older children and adolescents (5–19 years) with children under five within the same population.

Morbidity presented as the prevalence of any illness decreased with age, from 26.1% in children under-five to 10.4% among adolescents aged 15–19. Health seeking behavior also decreased with age, from 48.2% in children under-five to nearly 30% among adolescents aged 15–19. Types of illnesses reported were similar across age groups, with Fever/Malaria accounting more than two-thirds, followed by respiratory tract illnesses. Higher illness prevalence was noted in rural areas for both age groups. Health seeking behavior was higher among mothers with secondary education and above for both children under-fives (APR:1.22;95% CI: 1.02, 1.47) and 5–19-year-olds (APR: 1.31; 95% CI:1.01, 1.70). Additionally, those with health insurance also reported higher health seeking behavior (APR: 1.38; 95% CI:1.07, 1.78), while lower for children in rural households (APR: 0.72; 95% CI:0.61, 0.83), for 5–19-year-olds.

Our findings on morbidity and health-seeking behavior demonstrate the importance of extending health monitoring beyond early childhood. The inequalities identified point to gaps in programming and health service delivery that require attention.

The online version contains supplementary material available at 10.1186/s12913-025-13173-y.