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 of 17%. Using hierarchically built data from a survey of 1403 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) the 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.

Mothers’ Healthcare Autonomy, Maternal-Health Utilization and Healthcare for Children under-3 Years: Analysis of the Nigeria DHS Data (2008–2018)

“…This could be explained by the fact that there are effective homemade treatments for diarrhoea such as ORS. The efficacy of this cost effective solution which only requires salt, sugar and clean water may have made it unnecessary to seek further medical care for this sickness, as was also observed in a study from southern Malawi [30]. Additionally, a study conducted in the northern part of Nigeria revealed that people who participated in an ORS knowledge programme demonstrated better skills for managing diarrhoea at home than people who did not participate [31].…”

Multilevel Analysis of Factors Associated with Treatment-Seeking Behaviors among Caregivers with Febrile Children in Malawi

“…54 A 2016 study in southern Malawi revealed that a higher proportion (68%) of women with children with diarrhea reported administering ORT at home, whereas 14% gave the children other fluids and only 13% visited a health facility. 55 In addition, women may regard diarrhea as a minor ailment 56 which can be easily managed at home without incurring further costs by visiting health facilities. Prior health service utilization was associated with increased odds of both treatment-seeking behaviors.…”

Knowledge, attitudes, and practices of mothers on the use of oral rehydration salts in children with diarrhoea: a cross‐sectional survey in Malaysia

“…23 These results indicate the importance of health education messages on the use and efficacy of ORS to ensure proper and prescribed handling in the management of diarrhoea. 24 Furthermore, it is important to follow the recommendations in the management of acute diarrhoea strictly, since indiscriminate usage of drugs results in the development of resistance if an antibiotic is added to the management regimen. The addition of so-called harmless but unnecessary drugs shifts the emphasis from the standard management of childhood diarrhoea, which includes ORS, feeding, and zinc supplementation.…”