‘This diarrhoea is not a disease …’ local illness concepts and their effects on mothers’ health seeking behaviour: a qualitative study, Shuhair, Yemen

Webair, Hana Hasan; Ghouth, Abdulla Salim Bin

doi:10.1186/1471-2458-14-581

Cited by 19 publications

(15 citation statements)

References 24 publications

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“…Many studies have found that biomedical drugs, and particularly injections, are perceived as the most powerful form of medicine [13, 30, 31]. However, this study adds nuance to these findings, indicating that it does not necessarily follow that they are most appropriate, while herbal medicines also had gradients of power and appropriateness.…”

Section: Discussionmentioning

confidence: 66%

A qualitative exploration of care-seeking pathways for sick children in the rural Oromia region of Ethiopia

Shaw

Amouzou

Miller

et al. 2017

BMC Health Serv Res

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BackgroundEthiopia has experienced rapid improvements in its healthcare infrastructure, such as through the recent scale up of integrated community case management (iCCM) delivered by community-based health extension workers (HEWs) targeting children under the age of five. Despite notable improvements in child outcomes, the use of HEWs delivering iCCM remains very low. The aim of our study was to explain this phenomenon by examining care-seeking practices and treatment for sick children in two rural districts in the Oromia Region of Ethiopia.MethodsUsing qualitative methods, we explored perceptions of child illness, influences on decision-making processes occurring over the course of a child’s illness and caregiver perceptions of available community-based sources of child illness care. Sixteen focus group discussions (FGDs) and 40 in-depth interviews (IDIs) were held with mothers of children under age five. For additional perspective, 16 IDIs were conducted fathers and 22 IDIs with health extension workers and community health volunteers.ResultsCaregivers often described the act of care-seeking for a sick child as a time of considerable uncertainty. In particular, mothers of sick children described the cultural, social and community-based resources available to minimize this uncertainty as well as constraints and strategies for accessing these resources in order to receive treatment for a sick child. The level of trust and familiarity were the most common dynamics noted as influencing care-seeking strategies; trust in biomedical and government providers was often low.ConclusionsOverall, our research highlights the multiple and dynamic influences on care-seeking for sick children in rural Ethiopia. An understanding of these influences is critical for the success of existing and future health interventions and continued improvement of child health in Ethiopia.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2123-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 66%

A qualitative exploration of care-seeking pathways for sick children in the rural Oromia region of Ethiopia

Shaw

Amouzou

Miller

et al. 2017

BMC Health Serv Res

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“…Not only was the use of formal healthcare for illness with a cough low, but this decreased over time. Children's cough symptoms can be easily overlooked unless production of thick sputum or persistent over a long time ( 20 , 21 ). Such misconceptions can put children at risk because mothers often think that formal treatment is not necessary.…”

Section: Discussionmentioning

confidence: 99%

Determinants of early childhood morbidity and proper treatment responses in Vietnam: results from the Multiple Indicator Cluster Surveys, 2000–2011

Lee

Huy

Choi

2016

Global Health Action

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BackgroundDespite significant achievements in health indicators during previous decades, Vietnam lags behind other developing countries in reducing common early childhood illnesses, such as diarrhea and respiratory infections. To date, there has been little research into factors that contribute to the prevalence and treatment of childhood morbidity in Vietnam.ObjectiveThis study examines the determinants of diarrhea and ‘illness with a cough’ and treatments for each of the conditions among young children in Vietnam, and describes trends over time.DesignData from the Vietnam Multiple Indicator Cluster Surveys in 2000, 2006, and 2011 were used. Multivariable logistic regressions were undertaken to investigate factors associated with these childhood illnesses and proper treatment patterns.ResultsBetween 2000 and 2011, the prevalence of diarrhea among children under the age of five declined from 11 to 7%, while having illness with a cough increased to 40% in 2011 after falling from 69 to 28% between 2000 and 2006. During the same period, the prevalence of oral rehydration therapy (ORT) for treating diarrhea increased from 13 to 46%, whereas the rate of seeking formal treatment for illnesses with a cough fell from 24 to 7%. Multivariable models indicated that children who were older than 2 years (odds ration [OR]: 0.44, 95% confidence interval [CI]: 0.37–0.53, p<0.001), male (OR: 1.21, 95% CI: 0.64–2.37, p<0.05), living in rural areas (OR: 1.28, 95% CI: 1.00–1.64, p<0.05), or of Kinh ethnicity (OR: 0.70, 95% CI: 0.56–0.87, p<0.01) were more likely to suffer from diarrhea. Ethnic differences and higher household wealth were factors significantly associated with having illness with a cough. In particular, the effect of level of wealth on illness with a cough varied in each wave. Mothers with higher levels of education had higher odds of seeking ORT compared with mothers with the lowest level of education. Seeking formal treatment for children who have illness with a cough was associated with being in a household in the richest wealth quintile (OR: 0.56, 95% CI: 0.34–0.91, p<0.05).ConclusionsThis study demonstrates the importance of identifying different risk factors for these two illnesses and also factors associated with healthcare-seeking behaviors in order to reduce the burden of childhood morbidity in Vietnam. Policies aimed at tackling childhood morbidities should include comprehensive strategies that impact on socioeconomic and environmental factors.

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“…The purpose of the FHC is to help families recognize danger signs and improve their treatment-seeking behavior in accordance with evidences that show correlation between treatment seeking and neonatal mortality. [11][12][13] In addition to recognition of danger signs, local interpretation of illnesses, 14,15 knowledge of causes, perception of severity of illnesses, and the helpfulness of treatment also affect treatment-seeking behavior. 15−19 Better information about the social processes, the timing and type of care-seeking actions, and treatments received before death are critical to identifying modifiable factors to prevent avoidable deaths.…”

Section: Introductionmentioning

confidence: 99%

Causal Beliefs Affect Treatment Practices and Preferences for Neonatal Danger Signs in Northwest Ethiopia: A Qualitative Study

Bogale

Worku

Yalew

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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This study was conducted to explore the experiences of community members, particularly mothers, concerning their beliefs about the causes, treatment practices, and preferences for World Health Organization-defined neonatal danger signs in northwest Ethiopia. A phenomenological qualitative study was conducted in three districts of north Gondar Zone, Amhara region, Ethiopia, from March 10 to 28, 2016. Twelve focus group discussions were conducted involving 98 individuals. In-depth interviews were conducted with six health extension workers and 30 women who were either pregnant or who delivered in the past 6 months. Six subthemes emerged explaining the causes of neonatal danger signs. The causes varied from danger sign to danger sign and from person to person. Most of the perceived causes of danger signs in neonates do not align with the current biomedical science. Causal assumptions and perceived seriousness of danger signs influenced treatment practices and preferences. Four subthemes also emerged for treatment practices and preferences. In some cases, respondents indicated that non-biomedical sources of treatment were superior in outcome compared with biomedical treatment options. Unsatisfactory outcomes were mentioned as major reasons to opt for treatments from non-biomedical sources. Religious and cultural reasons were reported to be major impediments for treatment seeking for newborn danger signs. There is an urgent need to introduce or expand locally modified program interventions, such as community-based newborn care, to educate the community on the causes of neonatal danger signs and the need for prompt care seeking from qualified providers.

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‘This diarrhoea is not a disease …’ local illness concepts and their effects on mothers’ health seeking behaviour: a qualitative study, Shuhair, Yemen

Cited by 19 publications

References 24 publications

A qualitative exploration of care-seeking pathways for sick children in the rural Oromia region of Ethiopia

A qualitative exploration of care-seeking pathways for sick children in the rural Oromia region of Ethiopia

Determinants of early childhood morbidity and proper treatment responses in Vietnam: results from the Multiple Indicator Cluster Surveys, 2000–2011

Causal Beliefs Affect Treatment Practices and Preferences for Neonatal Danger Signs in Northwest Ethiopia: A Qualitative Study

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