Determinants influencing caregiver use of healthcare service utilisation for children under five in rural Budaka District, Uganda

Background Healthcare utilisation among caregivers of children under five remains a critical challenge in rural Uganda. This study investigated the determinants influencing caregiver use of healthcare service utilisation for children under five in rural Budaka District, Uganda, using the Andersen Behavioural Model to understand how child-related, enabling, and need factors influence caregivers’ decisions when seeking healthcare. Methods A cross-sectional study was conducted among 369 caregivers in rural Budaka. Data were collected in March 2026 using structured questionnaires and key informant interviews. Quantitative data were analysed using descriptive statistics and logistic regression to determine factors associated with utilisation. Results The study found that 97% of caregivers sought care from formal facilities, primarily government health centres (78%). Malaria/fever (90.2%) was the most reported illness. In multivariate analysis, the strongest predictors of seeking care were fever (aOR = 30.47; p = 0.003), rejection of cultural myths (aOR = 17.29; p = 0.045), persistent vomiting (aOR = 9.496; p = 0.016), and advice from family or friends (aOR = 7.29; p = 0.023). Conclusions While utilisation is relatively high, it is heavily driven by the perceived severity of symptoms. Strengthening caregiver education on danger signs and addressing cultural beliefs are critical for improving timely care-seeking in rural communities.