Treatment Actions in Home Management of Malaria in Children Under Five Years in Kashari County, Mbarara District South Western Uganda

Abstract

Purpose:  The purpose of this study was to describe treatment actions in home management of malaria in children under-five years in Kashari County, Mbarara District, Uganda.

Materials and Methods: This was a household survey employing quantitative methods of data collection. The study was conducted in Kashari County, Mbarara District, in Southwestern Uganda. Four hundred thirty two caretakers of children under five years who had a fever in the two (2) weeks preceding the survey were randomly selected from 23 villages (Lc1’s). Caretakers were interviewed on treatment actions during the most recent episode of fever, perceptions about malaria, socio-economic and socio-demographic characteristics.

Findings: The findings found out that, 66% of the caretakers had good knowledge of the cause of malaria and reported mosquitoes as the cause and knowledge of the danger signs was generally low. 58% of the caretakers did not know the cause of convulsions and more than 6 in 10 (68%) of caretakers whose children had ever had convulsions, treated the convulsing children with herbs. More than eight in ten (85%) respondents took the first treatment action within 24 hours of recognition of fever but only 57% of the caretakers took appropriate treatment action. More than five in ten caretakers first obtained treatment from private health care provider.  Less than three in ten (26%) obtained treatment from a government health unit. Only 22% of the caretakers took a second treatment action. Choice of first treatment was mainly based on severity of illness and availability of money. The reason for taking the second treatment action was mainly failure of the first treatment.  First treatment action was associated with perception of the of the child’s illness (OR=3.968, p=0.000) and age of the child (OR=2.353, p=0.020). Taking prompt and appropriate action was associated with distances to the nearest health facility (OR=4.167, p=0.000), household income (OR=3.800, p=0.000), politeness of health workers at the nearest health facility (OR=1.416, p=0.022) and perception of cause of malaria (OR=1.767, p=0.020).  Less than three in ten caretakers take their children with malaria to a government health facility as the first treatment action. Private health care providers play a major role in treatment of malaria in children in Kashari County and the perceived quality and accessibility of health services contribute to choice of treatment options and promptness.

Unique Contribution to Theory Practice and Policy:  It was therefore recommended that, the Ministry of Health should invest in more strategies that improve caretaker’s choice of government health units as first treatment option. The health workers should therefore tell, educate and sensitize the caretakers the names and dangers of giving the sick children the drugs they don’t know the names.  Government should make sure that anti-malarial drugs are availed in the government health units.