Care-seeking behaviour and implications for malaria control in Southern Malawi

Salule Joseph Masangwi, Neil Ferguson, Anthony Grimason, L.N. Kazembe, T.D. Morse

Research output: Contribution to journalArticle

Abstract

Although malaria is a controllable and preventable disease, it remains among the leading causes of mortality and morbidity in southern Malawi. The importance of early diagnosis and prompt treatment with hospital prescribed drugs and effective home management to control malaria is well established; however, these in part depend on how households make their decisions when family members have suffered from malaria. This study examines the behaviour of households with regard to decisions they make in managing malaria illness. Using hierarchically built data from a survey of 1,400 mothers nested within 33 communities, a series of two-level logistic regression models with Bayesian estimation was used to determine predictors of care-seeking behaviour towards malaria when a family member or a child was perceived to have malaria. The results show that most families normally visit or use medication prescribed at health facilities for both adult (80%) and child (86%) members when they are perceived to have malaria. The main obstacle to accessing the nearest health facility was distance and transport costs (73%) and the main problems encountered at health facilities were long waiting time or absence of health workers (73%) and shortage of drugs (35%). Among the main predictor variables for choices of treatment for childhood malaria was the absence of a health surveillance assistant for those that visited hospitals [β=0.56; 95% CI:-0.86,-0.26]; bought medication from open markets [β=0.51; 95% CI:0.20,0.82]; and those that used other traditional methods or did nothing [β=0.70; 95% CI:-0.04,1.44; p=0.06].. The results have an important role to play in the control and prevention of malaria in Malawi. The results reveal the need for increased awareness about the dangers of purchasing drugs from non-medical and/or uncertified private institutions and sources such as those found in open markets. They also show the important role of community health workers in the delivery of health systems. The study recommends empowerment of community health workers through rigorous and relevant health promotion programmes to update both their knowledge and their skills in communication and counselling.
LanguageEnglish
Pages22-26
JournalSouthern African Journal of Epidemiology and Infection
Volume25
Issue number4
Publication statusPublished - 2010

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Malawi
Malaria
Health Facilities
Health
Logistic Models
Pharmaceutical Preparations
Health Promotion
Counseling
Early Diagnosis
Communication
Mothers
Morbidity
Costs and Cost Analysis

Keywords

  • southern malawi
  • malaria control

Cite this

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title = "Care-seeking behaviour and implications for malaria control in Southern Malawi",
abstract = "Although malaria is a controllable and preventable disease, it remains among the leading causes of mortality and morbidity in southern Malawi. The importance of early diagnosis and prompt treatment with hospital prescribed drugs and effective home management to control malaria is well established; however, these in part depend on how households make their decisions when family members have suffered from malaria. This study examines the behaviour of households with regard to decisions they make in managing malaria illness. Using hierarchically built data from a survey of 1,400 mothers nested within 33 communities, a series of two-level logistic regression models with Bayesian estimation was used to determine predictors of care-seeking behaviour towards malaria when a family member or a child was perceived to have malaria. The results show that most families normally visit or use medication prescribed at health facilities for both adult (80{\%}) and child (86{\%}) members when they are perceived to have malaria. The main obstacle to accessing the nearest health facility was distance and transport costs (73{\%}) and the main problems encountered at health facilities were long waiting time or absence of health workers (73{\%}) and shortage of drugs (35{\%}). Among the main predictor variables for choices of treatment for childhood malaria was the absence of a health surveillance assistant for those that visited hospitals [β=0.56; 95{\%} CI:-0.86,-0.26]; bought medication from open markets [β=0.51; 95{\%} CI:0.20,0.82]; and those that used other traditional methods or did nothing [β=0.70; 95{\%} CI:-0.04,1.44; p=0.06].. The results have an important role to play in the control and prevention of malaria in Malawi. The results reveal the need for increased awareness about the dangers of purchasing drugs from non-medical and/or uncertified private institutions and sources such as those found in open markets. They also show the important role of community health workers in the delivery of health systems. The study recommends empowerment of community health workers through rigorous and relevant health promotion programmes to update both their knowledge and their skills in communication and counselling.",
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Care-seeking behaviour and implications for malaria control in Southern Malawi. / Masangwi, Salule Joseph; Ferguson, Neil; Grimason, Anthony; Kazembe, L.N.; Morse, T.D.

In: Southern African Journal of Epidemiology and Infection, Vol. 25, No. 4, 2010, p. 22-26.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Care-seeking behaviour and implications for malaria control in Southern Malawi

AU - Masangwi, Salule Joseph

AU - Ferguson, Neil

AU - Grimason, Anthony

AU - Kazembe, L.N.

AU - Morse, T.D.

PY - 2010

Y1 - 2010

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AB - Although malaria is a controllable and preventable disease, it remains among the leading causes of mortality and morbidity in southern Malawi. The importance of early diagnosis and prompt treatment with hospital prescribed drugs and effective home management to control malaria is well established; however, these in part depend on how households make their decisions when family members have suffered from malaria. This study examines the behaviour of households with regard to decisions they make in managing malaria illness. Using hierarchically built data from a survey of 1,400 mothers nested within 33 communities, a series of two-level logistic regression models with Bayesian estimation was used to determine predictors of care-seeking behaviour towards malaria when a family member or a child was perceived to have malaria. The results show that most families normally visit or use medication prescribed at health facilities for both adult (80%) and child (86%) members when they are perceived to have malaria. The main obstacle to accessing the nearest health facility was distance and transport costs (73%) and the main problems encountered at health facilities were long waiting time or absence of health workers (73%) and shortage of drugs (35%). Among the main predictor variables for choices of treatment for childhood malaria was the absence of a health surveillance assistant for those that visited hospitals [β=0.56; 95% CI:-0.86,-0.26]; bought medication from open markets [β=0.51; 95% CI:0.20,0.82]; and those that used other traditional methods or did nothing [β=0.70; 95% CI:-0.04,1.44; p=0.06].. The results have an important role to play in the control and prevention of malaria in Malawi. The results reveal the need for increased awareness about the dangers of purchasing drugs from non-medical and/or uncertified private institutions and sources such as those found in open markets. They also show the important role of community health workers in the delivery of health systems. The study recommends empowerment of community health workers through rigorous and relevant health promotion programmes to update both their knowledge and their skills in communication and counselling.

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