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- Published: 28 July 2026
Scientific Reports (2026) Cite this article
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Abstract
Early diagnosis and prompt treatment of childhood pneumonia are crucial. However, evidence on the extent and determinants of healthcare-seeking delays is limited. Therefore, this study aimed to assess delays in healthcare-seeking for childhood pneumonia and to explore barriers to prompt care in northwest Ethiopia in 2023. A concurrent mixed-methods study was conducted in Northwest Ethiopia, surveying 938 caregivers and conducting 15 in-depth interviews. Healthcare-seeking delay was defined as waiting more than 24 h after symptom recognition to reach a facility. Descriptive statistics, logistic regression, and thematic analyses were performed. The delay in healthcare-seeking for childhood pneumonia was 84.5%. The first delay, delay in deciding to seek healthcare, accounted for the largest share of the overall delay. Rural residents, low women’s autonomy, high perceived barriers, and low cues to action were positively associated with delayed healthcare seeking. The most commonly cited barriers to prompt care seeking for children with pneumonia were “illness leveling,” “presence of prioritized activities,” and “inaccessibility of the health facility.” Caregivers’ delay in care-seeking for childhood pneumonia remains very high. Given the high fatality rate of pneumonia among children and the serious consequences of delayed care, the health system needs to intensify efforts to improve caregivers’ prompt healthcare-seeking behavior.
Abbreviations
AOR:
Adjusted Odds RatioCI:
Confidence IntervalI-CVI:
Item-level Content Validity IndexPCA:
Principal Component AnalysisS-CVI:
Scale-level Content Validity IndexUNICEF:
United Nations International Children’s Emergency FundWHO:
World Health Organization
Acknowledgements
The authors would like to acknowledge the University of Gondar for its financial support. We would like to forward our appreciation to data collectors, supervisors, and the study participants for their time.
Funding
The authors have received partial financial support for data collectors from the University of Gondar (ref. number: V/P/R/TT/05/248/2016). However, the funder had no role in the conceptualization, design, data collection, analysis, or preparation of the manuscript. The university encouraged the authors to publish the study in a reputable journal.
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Authors and Affiliations
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaAbebaw Addis Gelagay
- Department of Health Education and Behavioural Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaTelake Azale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaLemma Derseh Gezie & Kassahun Alemu
- Department of Pediatrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaZemene Tigabu
Corresponding author
Correspondence to Abebaw Addis Gelagay.
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Competing interests
The authors declare no competing interests.
Ethical approval and consent to participate
We obtained ethical approval from the Institutional Ethics Review Board (IRB) of the College of Medicine and Health Sciences, and Specialized Hospital, University of Gondar (reference number: R/T/T/C/Eng.75/08/2022). We approved that all methods were performed in accordance with the ethical guideline and regulations. This was an observational study, and the authors did not use any human biological samples. Support letters were obtained from administrative bodies in the health system. Permission was obtained from the head of each health facility. Informed consent was obtained from each caregiver prior to data collection. For severely ill children who required urgent referral, the interview was conducted at the referral hospital to avoid delay. This observational study did not involve the use of any human biological samples.
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Cite this article
Gelagay, A.A., Azale, T., Gezie, L.D. et al. Levels and determinants of healthcare-seeking delay for pediatric pneumonia: a mixed-methods study. Sci Rep (2026). https://doi.org/10.1038/s41598-026-63936-8
- Received04 February 2026
- Accepted22 July 2026
- Published28 July 2026
- DOIhttps://doi.org/10.1038/s41598-026-63936-8