Acute Respiratory Infections in Under Fives: A Study of the Determinants of Care Seeking And Home Management Practice in Akatsi District

Abstract

Acute Respiratory Infections (ARIs) include infections in any part of the respiratory system lasting less than 3 days. They are a major cause of childhood deaths worldwide. Though the vast majority of ARIs are harmless, there are a few severe ones, which usually cause death within a short time and must therefore be recognised early. Available evidence shows that in Akatsi District about half of ARIs are managed at home. Since this care may be inappropriate there is the need for further investigation into what is actually being done and what determines this action. This work is a descriptive study, conducted in July 20000, to assess the determinants of care seeking and home management practices of ARIs in under fives in Akatsi District. Perceptions of importance, cause, prevention and treatment of ARIs, knowledge of severity, home management practices, the time and sequence of care seeking and socioeconomic factors influencing these were studied, in order to make recommendations for development of appropriate health intervention programmes. Qualitative and quantitative methods were used through FGDs with community members and administration of semi-structured questionnaire to 210 caretakers selected through cluster sampling. The study showed that ARIs are perceived to be important for such reasons as cost of ewe and inconvenience to caretaker and child and not because of their associated mortality. Knowlegde of modes of prevention was high. Severity was related to duration of episode and not signs and symptoms, implying that a severe ARI could be identified rather late. Food is not completely withheld from a child with an ARI, however certain foods may be withheld on grounds that they worsen the condition. Though most people would attempt to seek some form of care quite early, self-medication with herbal preparations and drugs from chemical shops is common. There is also a sequential resort, which can lead to delays in receiving appropriate care. The main constraint to care seeking is financial. The study therefore recommends Health Education by health staff on recognition of signs of severe ARIs for early care seeking and a reinforcement of the positive practices identified. The District Health Administration should also collaborate with the alternative health providers in the communities and explore alternative methods of health care financing.