Care-seeking for diarrhoea in Southern Malawi: attitudes, practices and implications for diarrhoea control

Salule Masangwi, Neil Ferguson, Anthony Grimason, Tracy Morse, Lawrence Kazembe

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

This paper examined care-seeking behaviour and its associated risk factors when a family member had diarrhoea. Data was obtained from a survey conducted in Chikwawa, a district in Southern Malawi. Chikwawa is faced with a number of environmental and socioeconomic problems and currently diarrhoea morbidity in the district is estimated at 24.4% statistically higher than the national average at 17%. Using hierarchically built data from a survey of 1,403 households nested within 33 communities, a series of two level binary logistic regression models with Bayesian estimation were used to determine predictors of care-seeking behaviour. The results show that 68% of mothers used oral rehydration solutions (ORS) last time a child in their family had diarrhoea . However, when asked on the action they take when a member of their household has diarrhoea two thirds of the mothers said they visit a health facility. Most respondents (73%) mentioned distance and transport costs as the main obstacles to accessing their nearest health facility and the same proportion of respondents mentioned prolonged waiting time and absence of health workers as the main obstacles encountered at the health facilities. The main predictor variables when a member of the family had diarrhoea were maternal age, distance to the nearest health facility, school level, and relative wealth, household diarrhoea endemicity, and household size while the main predictor variables when a child had diarrhoea were existence of a village health committee (VHC), distance to the nearest health facility, and maternal age . Most households use ORS for the treatment of diarrhoea and village health committees and health surveillance assistants (HSAs) are important factors in this choice of treatment. Health education messages on the use and efficacy of ORS to ensure proper and prescribed handling are important. There is need for a comprehensive concept addressing several dimensions of management and proper coordination of delivery of resources and services; availability of adequate healthcare workers at all levels; affordability to accessibility of healthcare resources and services to all communities; acceptability and quality of care; intensification of health education messages on the use and management of ORS, and prompt and timely treatment of diarrhoeal illness.
LanguageEnglish
Article number1140
Number of pages14
JournalInternational Journal of Environmental Research and Public Health
Volume13
DOIs
Publication statusPublished - 15 Nov 2016

Fingerprint

Malawi
Diarrhea
Rehydration Solutions
Health Facilities
Fluid Therapy
Maternal Age
Health
Health Education
Logistic Models
Mothers
Delivery of Health Care
Quality of Health Care
Therapeutics
Morbidity
Costs and Cost Analysis
Surveys and Questionnaires

Keywords

  • care-seeking behaviour
  • diarrhoea
  • multilevel modelling
  • Southern Malawi
  • morbidity
  • oral rehydration solutions
  • healthcare workers
  • health education
  • healthcare resources

Cite this

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title = "Care-seeking for diarrhoea in Southern Malawi: attitudes, practices and implications for diarrhoea control",
abstract = "This paper examined care-seeking behaviour and its associated risk factors when a family member had diarrhoea. Data was obtained from a survey conducted in Chikwawa, a district in Southern Malawi. Chikwawa is faced with a number of environmental and socioeconomic problems and currently diarrhoea morbidity in the district is estimated at 24.4{\%} statistically higher than the national average at 17{\%}. Using hierarchically built data from a survey of 1,403 households nested within 33 communities, a series of two level binary logistic regression models with Bayesian estimation were used to determine predictors of care-seeking behaviour. The results show that 68{\%} of mothers used oral rehydration solutions (ORS) last time a child in their family had diarrhoea . However, when asked on the action they take when a member of their household has diarrhoea two thirds of the mothers said they visit a health facility. Most respondents (73{\%}) mentioned distance and transport costs as the main obstacles to accessing their nearest health facility and the same proportion of respondents mentioned prolonged waiting time and absence of health workers as the main obstacles encountered at the health facilities. The main predictor variables when a member of the family had diarrhoea were maternal age, distance to the nearest health facility, school level, and relative wealth, household diarrhoea endemicity, and household size while the main predictor variables when a child had diarrhoea were existence of a village health committee (VHC), distance to the nearest health facility, and maternal age . Most households use ORS for the treatment of diarrhoea and village health committees and health surveillance assistants (HSAs) are important factors in this choice of treatment. Health education messages on the use and efficacy of ORS to ensure proper and prescribed handling are important. There is need for a comprehensive concept addressing several dimensions of management and proper coordination of delivery of resources and services; availability of adequate healthcare workers at all levels; affordability to accessibility of healthcare resources and services to all communities; acceptability and quality of care; intensification of health education messages on the use and management of ORS, and prompt and timely treatment of diarrhoeal illness.",
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author = "Salule Masangwi and Neil Ferguson and Anthony Grimason and Tracy Morse and Lawrence Kazembe",
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Care-seeking for diarrhoea in Southern Malawi : attitudes, practices and implications for diarrhoea control. / Masangwi, Salule; Ferguson, Neil; Grimason, Anthony; Morse, Tracy; Kazembe, Lawrence.

In: International Journal of Environmental Research and Public Health, Vol. 13, 1140, 15.11.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Care-seeking for diarrhoea in Southern Malawi

T2 - International Journal of Environmental Research and Public Health

AU - Masangwi, Salule

AU - Ferguson, Neil

AU - Grimason, Anthony

AU - Morse, Tracy

AU - Kazembe, Lawrence

PY - 2016/11/15

Y1 - 2016/11/15

N2 - This paper examined care-seeking behaviour and its associated risk factors when a family member had diarrhoea. Data was obtained from a survey conducted in Chikwawa, a district in Southern Malawi. Chikwawa is faced with a number of environmental and socioeconomic problems and currently diarrhoea morbidity in the district is estimated at 24.4% statistically higher than the national average at 17%. Using hierarchically built data from a survey of 1,403 households nested within 33 communities, a series of two level binary logistic regression models with Bayesian estimation were used to determine predictors of care-seeking behaviour. The results show that 68% of mothers used oral rehydration solutions (ORS) last time a child in their family had diarrhoea . However, when asked on the action they take when a member of their household has diarrhoea two thirds of the mothers said they visit a health facility. Most respondents (73%) mentioned distance and transport costs as the main obstacles to accessing their nearest health facility and the same proportion of respondents mentioned prolonged waiting time and absence of health workers as the main obstacles encountered at the health facilities. The main predictor variables when a member of the family had diarrhoea were maternal age, distance to the nearest health facility, school level, and relative wealth, household diarrhoea endemicity, and household size while the main predictor variables when a child had diarrhoea were existence of a village health committee (VHC), distance to the nearest health facility, and maternal age . Most households use ORS for the treatment of diarrhoea and village health committees and health surveillance assistants (HSAs) are important factors in this choice of treatment. Health education messages on the use and efficacy of ORS to ensure proper and prescribed handling are important. There is need for a comprehensive concept addressing several dimensions of management and proper coordination of delivery of resources and services; availability of adequate healthcare workers at all levels; affordability to accessibility of healthcare resources and services to all communities; acceptability and quality of care; intensification of health education messages on the use and management of ORS, and prompt and timely treatment of diarrhoeal illness.

AB - This paper examined care-seeking behaviour and its associated risk factors when a family member had diarrhoea. Data was obtained from a survey conducted in Chikwawa, a district in Southern Malawi. Chikwawa is faced with a number of environmental and socioeconomic problems and currently diarrhoea morbidity in the district is estimated at 24.4% statistically higher than the national average at 17%. Using hierarchically built data from a survey of 1,403 households nested within 33 communities, a series of two level binary logistic regression models with Bayesian estimation were used to determine predictors of care-seeking behaviour. The results show that 68% of mothers used oral rehydration solutions (ORS) last time a child in their family had diarrhoea . However, when asked on the action they take when a member of their household has diarrhoea two thirds of the mothers said they visit a health facility. Most respondents (73%) mentioned distance and transport costs as the main obstacles to accessing their nearest health facility and the same proportion of respondents mentioned prolonged waiting time and absence of health workers as the main obstacles encountered at the health facilities. The main predictor variables when a member of the family had diarrhoea were maternal age, distance to the nearest health facility, school level, and relative wealth, household diarrhoea endemicity, and household size while the main predictor variables when a child had diarrhoea were existence of a village health committee (VHC), distance to the nearest health facility, and maternal age . Most households use ORS for the treatment of diarrhoea and village health committees and health surveillance assistants (HSAs) are important factors in this choice of treatment. Health education messages on the use and efficacy of ORS to ensure proper and prescribed handling are important. There is need for a comprehensive concept addressing several dimensions of management and proper coordination of delivery of resources and services; availability of adequate healthcare workers at all levels; affordability to accessibility of healthcare resources and services to all communities; acceptability and quality of care; intensification of health education messages on the use and management of ORS, and prompt and timely treatment of diarrhoeal illness.

KW - care-seeking behaviour

KW - diarrhoea

KW - multilevel modelling

KW - Southern Malawi

KW - morbidity

KW - oral rehydration solutions

KW - healthcare workers

KW - health education

KW - healthcare resources

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SN - 1660-4601

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