Treatment-seeking behaviour for febrile illnesses and its implications for malaria control and elimination in Savannakhet Province, Lao PDR (Laos): a mixed method study
Abstract Background How people respond to febrile illness is critical to malaria prevention, control, and ultimately elimination. This article explores factors affecting treatment-seeking behaviour for febrile illnesses in a remote area of Lao PDR. Methods Household heads or their representatives (n...
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2019-04-01
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Online Access: | http://link.springer.com/article/10.1186/s12913-019-4070-9 |
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DOAJ |
language |
English |
format |
Article |
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DOAJ |
author |
Bipin Adhikari Koukeo Phommasone Tiengkham Pongvongsa Palingnaphone Koummarasy Xayaphone Soundala Gisela Henriques Pasathorn Sirithiranont Daniel M. Parker Lorenz von Seidlein Nicholas J. White Nicholas P. J. Day Arjen M. Dondorp Paul N. Newton Phaik Yeong Cheah Christopher Pell Mayfong Mayxay |
spellingShingle |
Bipin Adhikari Koukeo Phommasone Tiengkham Pongvongsa Palingnaphone Koummarasy Xayaphone Soundala Gisela Henriques Pasathorn Sirithiranont Daniel M. Parker Lorenz von Seidlein Nicholas J. White Nicholas P. J. Day Arjen M. Dondorp Paul N. Newton Phaik Yeong Cheah Christopher Pell Mayfong Mayxay Treatment-seeking behaviour for febrile illnesses and its implications for malaria control and elimination in Savannakhet Province, Lao PDR (Laos): a mixed method study BMC Health Services Research Health seeking Malaria Febrile illness On the counter Resistance Elimination |
author_facet |
Bipin Adhikari Koukeo Phommasone Tiengkham Pongvongsa Palingnaphone Koummarasy Xayaphone Soundala Gisela Henriques Pasathorn Sirithiranont Daniel M. Parker Lorenz von Seidlein Nicholas J. White Nicholas P. J. Day Arjen M. Dondorp Paul N. Newton Phaik Yeong Cheah Christopher Pell Mayfong Mayxay |
author_sort |
Bipin Adhikari |
title |
Treatment-seeking behaviour for febrile illnesses and its implications for malaria control and elimination in Savannakhet Province, Lao PDR (Laos): a mixed method study |
title_short |
Treatment-seeking behaviour for febrile illnesses and its implications for malaria control and elimination in Savannakhet Province, Lao PDR (Laos): a mixed method study |
title_full |
Treatment-seeking behaviour for febrile illnesses and its implications for malaria control and elimination in Savannakhet Province, Lao PDR (Laos): a mixed method study |
title_fullStr |
Treatment-seeking behaviour for febrile illnesses and its implications for malaria control and elimination in Savannakhet Province, Lao PDR (Laos): a mixed method study |
title_full_unstemmed |
Treatment-seeking behaviour for febrile illnesses and its implications for malaria control and elimination in Savannakhet Province, Lao PDR (Laos): a mixed method study |
title_sort |
treatment-seeking behaviour for febrile illnesses and its implications for malaria control and elimination in savannakhet province, lao pdr (laos): a mixed method study |
publisher |
BMC |
series |
BMC Health Services Research |
issn |
1472-6963 |
publishDate |
2019-04-01 |
description |
Abstract Background How people respond to febrile illness is critical to malaria prevention, control, and ultimately elimination. This article explores factors affecting treatment-seeking behaviour for febrile illnesses in a remote area of Lao PDR. Methods Household heads or their representatives (n = 281) were interviewed using a structured questionnaire. A total of twelve focus group discussions (FGDs) each with eight to ten participants were conducted in four villages. In addition, observations were recorded as field notes (n = 130) and were used to collect information on the local context, including the treatment seeking behaviour and the health services. Results Almost three-quarters (201/281) of respondents reported fever in past two months. Most (92%, 185/201) sought treatment of which 80% (149/185) sought treatment at a health centre. Geographic proximity to a health centre (AOR = 6.5; CI = 1.74–24.25; for those < 3.5 km versus those > 3.6 km) and previous experience of attending a health centre (AOR = 4.7; CI = 1.2–19.1) were strong predictors of visiting a health centre for febrile symptoms. During FGDs, respondents described seeking treatment from traditional healers and at health centre for mild to moderate illnesses. Respondents also explained how if symptoms, including fever, were severe or persisted after receiving treatment elsewhere, they sought assistance at health centres. Access to local health centres/hospitals was often constrained by a lack of transportation and an ability to meet the direct and indirect costs of a visit. Conclusion In Nong District, a rural area bordering Vietnam, people seek care from health centres offering allopathic medicine and from spiritual healers. Decisions about where and when to attend health care depended on their economic status, mobility (distance to the health centre, road conditions, availability of transport), symptoms severity and illness recognition. Current and future malaria control/elimination programmes could benefit from greater collaboration with the locally accessible sources of treatments, such as health volunteers and traditional healers. |
topic |
Health seeking Malaria Febrile illness On the counter Resistance Elimination |
url |
http://link.springer.com/article/10.1186/s12913-019-4070-9 |
work_keys_str_mv |
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doaj-0dcadf8659db4d89ac33ac9280ce2c072020-11-25T02:15:40ZengBMCBMC Health Services Research1472-69632019-04-0119111610.1186/s12913-019-4070-9Treatment-seeking behaviour for febrile illnesses and its implications for malaria control and elimination in Savannakhet Province, Lao PDR (Laos): a mixed method studyBipin Adhikari0Koukeo Phommasone1Tiengkham Pongvongsa2Palingnaphone Koummarasy3Xayaphone Soundala4Gisela Henriques5Pasathorn Sirithiranont6Daniel M. Parker7Lorenz von Seidlein8Nicholas J. White9Nicholas P. J. Day10Arjen M. Dondorp11Paul N. Newton12Phaik Yeong Cheah13Christopher Pell14Mayfong Mayxay15Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical MedicineLao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot HospitalSavannakhet Provincial Health DepartmentLao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot HospitalLao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot HospitalMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical MedicineMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical MedicineDepartment of Population Health and Disease Prevention, University of CaliforniaMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical MedicineMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical MedicineMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical MedicineMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical MedicineCentre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of OxfordMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical MedicineCentre for Social Science and Global Health, University of AmsterdamCentre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of OxfordAbstract Background How people respond to febrile illness is critical to malaria prevention, control, and ultimately elimination. This article explores factors affecting treatment-seeking behaviour for febrile illnesses in a remote area of Lao PDR. Methods Household heads or their representatives (n = 281) were interviewed using a structured questionnaire. A total of twelve focus group discussions (FGDs) each with eight to ten participants were conducted in four villages. In addition, observations were recorded as field notes (n = 130) and were used to collect information on the local context, including the treatment seeking behaviour and the health services. Results Almost three-quarters (201/281) of respondents reported fever in past two months. Most (92%, 185/201) sought treatment of which 80% (149/185) sought treatment at a health centre. Geographic proximity to a health centre (AOR = 6.5; CI = 1.74–24.25; for those < 3.5 km versus those > 3.6 km) and previous experience of attending a health centre (AOR = 4.7; CI = 1.2–19.1) were strong predictors of visiting a health centre for febrile symptoms. During FGDs, respondents described seeking treatment from traditional healers and at health centre for mild to moderate illnesses. Respondents also explained how if symptoms, including fever, were severe or persisted after receiving treatment elsewhere, they sought assistance at health centres. Access to local health centres/hospitals was often constrained by a lack of transportation and an ability to meet the direct and indirect costs of a visit. Conclusion In Nong District, a rural area bordering Vietnam, people seek care from health centres offering allopathic medicine and from spiritual healers. Decisions about where and when to attend health care depended on their economic status, mobility (distance to the health centre, road conditions, availability of transport), symptoms severity and illness recognition. Current and future malaria control/elimination programmes could benefit from greater collaboration with the locally accessible sources of treatments, such as health volunteers and traditional healers.http://link.springer.com/article/10.1186/s12913-019-4070-9Health seekingMalariaFebrile illnessOn the counterResistanceElimination |