Gender role and child health care utilization in Nepal

Objective: To study the gender role in child health care utilization in Nepal. Methods: We analysed 8112 individual observations of age ≤15 years from 2847 households in 274 communities, obtained from the 1996 Nepal Living Standard Survey. Four steps of a health seeking action, namely illness reporting, choosing an external care, choosing a specific health care provider, and spending money to treat the sick child, were examined using discrete/continuous choice models. Results: There was no statistically significant difference between boys and girls by demographic, socio-economic and geographical status in the sample. However, gender was associated with all four utilization decision steps. While the net effect of being a boy was modest in illness reporting (p < 0.10), it appeared stronger in the choice of external care, in the choice of public provider and in the choice of expenditure with the private provider (p < 0.05). Conclusion: Gender role not only affects illness reporting but also affects the decision to choose a health care provider and how much to spend on the sick child, i.e. it affects the entire steps of a health seeking action.