Care-seeking for fatal illnesses in young children in Indramayu, West Java, Indonesia

To examine patterns of seeking care for gravely ill infants and children, we studied all deaths in children under 5 in 10 000 households in Indramayu, West Java, Indonesia, between July 1, 1991, and Dec 31, 1992. 141 deaths were identified (mortality rate 80·7 per 1000), of which 139 were due to causes other than trauma. No treatment of any kind was sought outside the home for 30 (22%) of the children who died from natural causes, and for 59 (42%) others only a traditional healer or other source of non-western medical advice was consulted. Whether or not a mother sought western medical care was strongly associated with the age of the child, the duration of the terminal illness, the previous attendance of the mother at a community-based maternal-and-child-health facility, and the mother's response to a prospectively asked question about what care should be sought for a hypothetical 1-month-old baby with signs of severe pneumonia. Household income, maternal age, and education, and distance between home and government health post were not associated with whether or not western medical care was sought.