“It is good to take her early to the doctor” – mothers’ understanding of childhood pneumonia symptoms and health care seeking in Kilimanjaro region, Tanzania

BMC International Health and Human Rights

Research Article

Helena Hildenwall¹  Judith Meta²  Hilda Mbakilwa²  Hugh Reyburn³  Raimos Olomi⁴  Florida Muro⁴  Jenny Renju⁵  Adiel Mushi⁶ 

[1] Department of Public Health Sciences, Global Health – Health System and Policy Research Group, Karolinska Institutet, SE-171 77, Stockholm, Sweden;Joint Malaria Programme – Kilimanjaro Christian Medical Centre, P.O.Box 2228, Moshi, Tanzania;Joint Malaria Programme – Kilimanjaro Christian Medical Centre, P.O.Box 2228, Moshi, Tanzania;London School of Hygiene and Tropical Medicine (LSHTM), Keppel St, WICE7HT, London, UK;Kilimanjaro Christian Medical University College, P.O.Box 2240, Moshi, Tanzania;Kilimanjaro Christian Medical Centre, P.O.Box 3010, Moshi, Tanzania;Kilimanjaro Christian Medical University College, P.O.Box 2240, Moshi, Tanzania;London School of Hygiene and Tropical Medicine (LSHTM), Keppel St, WICE7HT, London, UK;The National Institute for Medical Research (NIMR), P. O. Box 9653, 3 Barack Obama Drive, 11101, Dar es Salaam, Tanzania;

关键词: Acute respiratory illness (ARI);    Care-seeking;    Children;    Fever;    Illness concepts;    Pneumonia;   

DOI  :  10.1186/s12914-017-0135-1

 received in 2016-08-24, accepted in 2017-09-17,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundPneumonia is among the leading causes of avoidable deaths for young children globally. The main burden of mortality falls on children from poor and rural families who are less likely to obtain the treatment they need, highlighting inequities in access to effective care and treatment. Caretakers’ illness perceptions and care-seeking practices are of major importance for children with pneumonia to receive adequate care. This study qualitatively explores the caretaker concepts of childhood pneumonia in relation to treatment seeking behaviour and health worker management in Moshi urban district, Tanzania.MethodsIn May - July 2013 data was gathered through different qualitative data collection techniques including five focus group discussions (FGDs) with mothers of children under-five years of age. The FGDs involved free listing of pneumonia symptoms and video presentations of children with respiratory symptoms done, these were triangulated with ten case narratives with mothers of children admitted with pneumonia and eleven in-depth interviews with hospital health workers. Transcripts were coded and analysed using qualitative content analysis.ResultsMothers demonstrated good awareness of common childhood illnesses including pneumonia, which was often associated with symptoms such as cough, flu, chest tightness, fever, and difficulty in breathing. Mothers had mixed views on causative factors and treatments options but generally preferred modern medicine for persisting and severe symptoms. However, all respondent reported access to health facilities as a barrier to care, associated with transport, personal safety and economic constraints.ConclusionLocal illness concepts and traditional treatment options did not constitute barriers to care for pneumonia symptoms. Poor access to health facilities was the main barrier. Decentralisation of care through community health workers may improve access to care but needs to be combined with strengthened referral systems and accessible hospital care for those in need.

【 授权许可】

CC BY   
© The Author(s). 2017