Barriers to prompt and effective malaria treatment among children under five years of age in Mpika District

Abstract

Prompt and effective malaria treatment is a key malaria control strategy in Zambia, which has helped to reduce the incidence of malaria and consequently, reduce the infant mortality rate. However, studies done in Zambia show that as low as 19 percent of children under five years of age are accessing prompt and effective malaria treatment at health facilities in the rural settings. The barriers to this important malaria control strategy need to be established. Therefore, this study aimed at determining barriers to prompt and effective malaria treatment among under five children in Mpika district. This was mixed method study design combining both quantitative and qualitative methodology; analytical cross-sectional study and focus group discussions respectively. The quantitative sample size of 380 caretakers of under five children and eight health workers were considered. For qualitative method, eight focus group discussions (FGDs) involving caretakers of children under five years of age were held comprising a total of 78 participants. The study found that out of the total sample size of 380 participants, only 14 percent of children diagnosed with malaria received prompt and effective malaria treatment. The following were barriers to prompt and effective malaria treatment: caregivers residing at a distance of more than five kilometres to the health facility (OR 2.09 95%CI: 1.03 – 4.22 P = 0.041, inadequate household income (OR 2.89 95%CI: 1.18 – 4.39 P = 0.001), self-treatment of children at home with antipyretics prior to seeking care (OR 1.83 95%CI: 1.28 – 3.26 P = 0.018 and lack of community health education (IEC) (OR 2.14 95%CI: 1.10 – 4.13 P = 0.024). Moreover, non-availability of antimalarial drugs at health facilities and the use of herbal medicines were reported in FGDs to be associated with delays in seeking appropriate malaria treatment. The findings of this study highlight the factors that negatively influence access to prompt and effective malaria treatment in a rural setting of Zambia. It underscores the need to formulate and implement interventions aimed at fostering appropriate health seeking behaviours that are setting-specific among caretakers of under five children, through community health education. There is also a need to address the socioeconomic constraints, both at household and health facility level that hinder access to early and effective malaria treatment in children.