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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Understanding caretakers' dilemma in deciding whether or not to adhere with referral advice after pre-referral treatment with rectal artesunate
Malaria Journal, Volume 9, No. 1, Article 123, Year 2010
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Description
Abstract. Background: Malaria kills. A single rectal dose of artesunate before referral can reduce mortality and prevent permanent disability. However, the success of this intervention depends on caretakers' adherence to referral advice for follow-up care. This paper explores the dilemma facing caretakers when they are in the process of deciding whether or not to transit their child to a health facility after pre-referral treatment with rectal artesunate. Methods. Four focus group discussions were held in each of three purposively selected villages in Mtwara rural district of Tanzania. Data were analysed manually using latent qualitative content analysis. Results: The theme «Caretakers dilemma in deciding whether or not to adhere with referral advice after pre-referral treatment with rectal artesunate» depicts the challenge they face. Caretakers' understanding of the rationale for going to hospital after treatment - when and why they should adhere - influenced adherence. Caretakers, whose children did not improve, usually adhered to referral advice. If a child had noticeably improved with pre-referral treatment however, caretakers weighed whether they should proceed to the facility, balancing the child's improved condition against other competing priorities, difficulties in reaching the health facilities, and the perceived quality of care at the health facility. Some misinterpretation were found regarding the urgency and rationale for adherence among some caretakers of children who improved which were attributed to be possibly due to their prior understanding. Conclusion: Some caretakers did not adhere when their children improved and some who adhered did so without understanding why they should proceed to the facility. Successful implementation of the rectal artesunate strategy depends upon effective communication regarding referral to clinic. © 2010 Simba et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Simba, Daudi O.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Sweden, Stockholm
Karolinska Institutet
Kakoko, Deodatus Conatus Vitalis
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Warsame, Marian Yusuf
Sweden, Stockholm
Karolinska Institutet
Premji, Zulfiqarali G.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Gomes, Melba F.
Switzerland, Geneva
Organisation Mondiale de la Santé
Tomson, Göran B.
Sweden, Stockholm
Karolinska Institutet
Johansson, Eva Elisabeth
Sweden, Stockholm
Karolinska Institutet
Sweden, Gothenburg
Nordiska Högskolan För Folkhälsovetenskap
Statistics
Citations: 41
Authors: 7
Affiliations: 4
Identifiers
Doi:
10.1186/1475-2875-9-123
e-ISSN:
14752875
Research Areas
Disability
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Randomised Control Trial
Cohort Study
Study Approach
Qualitative
Study Locations
Tanzania