International Journal of Preventive Medicine (Int J Prev Med)2008-780231201108286067ENAssociate professor, Department of Pediatrics, Faculty of Medicine, Ahwaz University of Medical Sciences, Ahwaz, Iran.Associate Professor, Department of Community Medicine, Faculty of Medicine, Guilan University, Rasht, Iran.Assistant Professor of Pediatrics Department, Guilan University of Medical Sciences, Rasht, Iran.Department of Community Medicine, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.2011082620110826<p>Background: In Iran, diarrheal disease is the fourth cause of &nbsp;<br />under five‑year mortality. Proper care‑seeking behavior and <br />system‑based disease management in the national field will have a great effect in reducing morbidity and mortality.<br />Methods: This nationwide study was performed on a target <br />population of&nbsp; rural and urban communities; in all 31 provinces of the Islamic Republic of&nbsp; Iran. One lakh three thousand three hundred and thirty one (103331) families were sampled by multi‑stage stratifed random sampling and were interviewed with a standard data collection form. The collected data was entered into the Stata&nbsp; 8.0 software and analyzed by the survey analysis method.<br />Results: Of&nbsp; the 14625&nbsp; (10.1%) children who were reported to <br />have diarrheal diseases two weeks prior to the interview, 8.8% <br />were cured and 1.5% were not. About 70% of&nbsp; them had at least <br />one visit for health seeking the most of&nbsp; patients were seen by <br />a rural health worker (Behvarz) in the rural and by a general <br />pediatrician in the urban areas. About 62% of&nbsp; the patients in <br />urban and 57% in the rural areas had been treated with antibiotics and these rates for ORS were 51% and 65%, respectively. The factors most related to a care‑seeking pattern were the level of routine preventive well‑child care, number of&nbsp; siblings, child age, and living area.<br />Conclusion: According to this national survey, our health system <br />needs to integrate all the levels of&nbsp; prevention, especially the <br />Integrated Management of&nbsp; Child Illnesses (IMCI) programs with a family physician project. Futher more, there is a great need for empowering the referral system and gate keeping in all referral levels, to make efficient national integrated programs.<br />Keywords: Diarrhea, antibiotic, health service, national survey, <br />preventive child care, referral system, Iran</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/329http://ijpm.mui.ac.ir/index.php/ijpm/article/download/329/383