Psychosocial factors associated with malaria care-seeking in rural Ethiopia.

Ethiopia's National Malaria Control and Elimination Program aims to diagnose all suspected malaria cases within 24 h of fever onset and provide prompt treatment for confirmed cases. This study explored psychosocial factors associated with no-, delayed- and prompt- care-seeking among female caregivers of children under five years with fever in rural Ethiopia. Household surveys were conducted from 2016-2019 among female caregivers (N = 479) of children under five years old with fever in Oromia; Amhara; Southern Nations, Nationalities, and Peoples Region (SNNPR); and Tigray. Prompt and delayed care-seeking were defined as seeking treatment within ≤ 24 h or > 24 h of symptom onset respectively. Contextual factors explored included sociodemographic factors, household supply of bed nets, exposure to health messages, and household vulnerability (a measure of financial access to food, shelter, schooling, and medical treatment). Ideational factors included psychosocial factors related to care-seeking (knowledge, self-efficacy, response efficacy, attitudes, involvement in decision-making, and household social support). The prevalence of fever among children under five years was 18% (ranging from 9% in Tigray to 34% in SNNPR. Overall, 45% of caregivers of children with fever sought care promptly, while 23% delayed care-seeking and 32% sought no care. Prompt care-seeking rates were higher among caregivers with positive attitudes toward prompt care-seeking (48%), involved in decision-making (48%) or perceived equitable gender norms in the community (65%). Caregivers with a high care-seeking ideation had increased odds of prompt care-seeking (aOR: 2.65; 95% CI: 1.74-4.02). Significant contextual factors included residence in the Oromia region (aOR: 2.99; 95% CI:1.40-6.41), caregivers age 35-49 years (aOR: 0.49; 95% CI: 0.26-0.95), residence in vulnerable households (aOR: 2.01; 95% CI: 1.28-3.18). Among this rural Ethiopian population, prompt care-seeking was low but positively influenced by both ideational and contextual psychosocial factors occurring at the caregiver level. Multi-sectoral interventions at the individual, community, and health facility levels are needed to improve prompt care-seeking. These include social behavior change interventions to improve ideation, complemented by health facility interventions to ensure provision of high-quality services and structural interventions to increase educational attainment in these rural settings.

Olapeju B ，Tamene H ，Ayele M ，Heliso S ，Berhanu T ，Alemayehu G ，Kapadia-Kundu N ... -  《BMC PUBLIC HEALTH》

Caregivers' perception of malaria and treatment-seeking behaviour for under five children in Mandura District, West Ethiopia: a cross-sectional study.

Mitiku I ，Assefa A 《MALARIA JOURNAL》

Malaria Related Perceptions, Care Seeking after Onset of Fever and Anti-Malarial Drug Use in Malaria Endemic Settings of Southwest Ethiopia.

Birhanu Z ，Abebe L ，Sudhakar M ，Dissanayake G ，Yihdego YY ，Alemayehu G ，Yewhalaw D ... -  《PLoS One》

Predictors of delayed health seeking for febrile children: multi-level analysis of cross-sectional study data from southern Ethiopia.

Febrile illnesses are commonly reported as a primary reason for seeking healthcare in sub-Saharan Africa. Timely diagnosis and getting prompt treatment within 24 h of fever onset is crucial to avert the risk of developing severe complications and death. Understanding factors contributing to delayed health seeking is important for public health interventions. Hence, this study aimed to assess individual- and contextual-level factors associated with the delay in seeking prompt treatment for children with fever. A community-based cross-sectional study was conducted from September 2022 to June 2023 in Gamo zone, southern Ethiopia. Three districts were chosen, and then, from each district, six clusters or kebeles were chosen by simple random sampling. A total of 820 caregivers were randomly selected. A two-level mixed-effects logistic regression model was employed to identify factors associated with the delay in seeking prompt treatment. The associations were measured by an adjusted odds ratio (AOR), and statistical significance was declared at a 5% level of significance. The prevalence of the delay in seeking prompt care was 47.8%. Factors contributing to the delay were caregivers who were aged 30 years and above [AOR 0.23, 95% confidence interval (CI): 0.10-0.52], caregivers who followed the Protestant religion (AOR 3.67, 95% CI: 2.08-6.48), caregivers unable to read and write (AOR 5.32, 95% CI: 6.80-11.70), merchant caregivers (AOR 6.63, 95% CI: 2.75-15.97), caregivers who were exposed to only one media source (AOR 9.3, 95% CI: 8.43-15.60), caregivers with the experience of child death (AOR 0.05, 95% CI: 0.01-0.22), and caregivers seeking permission from their partners to access healthcare (AOR 12.64, 95% CI: 6.98-22.89). There was a high level of delay in seeking healthcare. Targeted community education through mass media, healthcare facilities, and community-level awareness campaigns should be strengthened to improve early treatment seeking and lessen the consequences of delayed treatment seeking.

Chisha Y ，Feleke T ，Zeleke EA ，Aschalew Z ，Abate ZG ，Haile Y ，Dalbo M ，Endriyas M ... -  《Frontiers in Public Health》

Correlates of social behavior change communication on care-seeking behaviors for children with fever: an analysis of malaria household survey data from Liberia.

Awantang G ，Babalola S ，Koenker H ，Fox K ，Toso M ，Lewicky N ，Somah D ，Koko V ... -  《MALARIA JOURNAL》