17

In spite of preventive activities, malaria remains the most lethal tropical disease among children aged 5 or below in Benin. However, few mothers in rural areas use modern healthcare services when their child is feverish. This paper aims to identify risk factors associated with the under-utilization of healthcare services in child fever situations in Benin. We conducted a cross-sectional study of 360 mothers recruited randomly in villages. For 76% of feverish children surveyed during the two weeks preceding the survey, 6% used primary healthcare centers. For the rest, family members preferred self-medication (leaves infusions or medication bought without medical prescription) despite their perception of the severity of child malaria. A multivariate analysis selected: high cost of healthcare (OR = 1.47, IC = 0.95–2.25); mothers’ perceptions (OR= 1.22, IC = 0.72–2.07); husbands’ decisions (OR = 1.59, IC =1.36–1.91), inappropriateness of work schedules in healthcare centers (OR = 3.19, IC = 1.41–7.02), and traditional family practices (OR = 1.31, IC= 1.00–1.68). Following a discussion of methodological limitations, the authors suggest reinforcing awareness among family members of the advantages of modern early healthcare, appropriate work schedules for rural populations, and the promotion of insecticide-impregnated bed nets for children.