Malaria Treatment-Seeking Behaviour among Caregivers of Children Under Five Years in the Nkwanta District

Abstract

The malaria menace continues to claim the lives of children. More than a third of children under five die before the first month of life. In any malaria control programme, treatment seeking behaviour of caregivers acting in synergy with other factors such as socio-cultural factors, economic and health system factors has been identified as contributing significantly to the survival of children. They contribute directly or indirectly to the high morbidity and mortality rate in children under five years. This study is therefore aimed at determining the knowledge of caregivers on causes and symptoms of malaria, to identify the treatment options and factors influencing caregivers‟ treatment seeking behaviour in the Nkwanta district as well as their treatment practices. A multi-stage cluster sampling method was used in selecting caregivers. Three sub-districts were selected purposively taking their geographical locations into consideration. Four hundred caregivers from the three sub-districts were interviewed. Both quantitative and qualitative methods of data collection were used using structured questionnaires and focus group discussion guides. Data was analysed using SPSS version 11.5 and EpiInfo version 3.3.2 software for the quantitative data and the qualitative data was analysed manually after transcription. Results showed that caregivers‟ knowledge on malaria was low and was affected by their level of education. Caregivers used multiple methods of treatment for their children. Their first point of call for treatment was the hospital (71.4%) and pharmacy (26.9%). Delay at home, distance to and time spent at the treatment source (P<0.05) was seen to influence caregivers‟ treatment seeking behaviour. Caregivers use artesunate amodiaquine to treat their children. Others used chloroquine and artesunate monotherapy. Concoctions or herbal preparations were also used by a few caregivers. About 20% of the caregivers sought treatment within 24 hours of the onset of malaria. Educating caregivers on the importance of seeking early and appropriate treatment for their children is necessary. Intensifying the home-based care strategy by WHO to cover the whole district would also improve the treatment-seeking behaviour of caregivers in the district especially within 24 hours of the onset of illness. Chemical sellers should also be educated or occasionally trained on the use of ACT to treat uncomplicated malaria in children under five years. The continuous use of chloroquine and artesunate monotherapy can be detrimental to the success of Ghana‟s new drug policy to treat uncomplicated malaria. The National Malaria Control Program in collaboration with the MOH/GHS should put strategies in place to ensure that chloroquine is removed from all health centres and chemical stores/pharmacy within the country.