Publication: Treatment-seeking behaviour for febrile illnesses and its implications for malaria control and elimination in Savannakhet Province, Lao PDR (Laos): A mixed method study
Issued Date
2019-04-24
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14726963
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2-s2.0-85065323204
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Mahidol University
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SCOPUS
Bibliographic Citation
BMC Health Services Research. Vol.19, No.1 (2019)
Suggested Citation
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. Vol.19, No.1 (2019). doi:10.1186/s12913-019-4070-9 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51716
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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
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London School of Hygiene & Tropical Medicine
University of Oxford
Mahidol University
Nuffield Department of Clinical Medicine
University of California, Irvine
Universiteit van Amsterdam
University of Health Sciences
Mahosot Hospital
Savannakhet Provincial Health Department
Amsterdam Institute for Global Health and Development
University of Oxford
Mahidol University
Nuffield Department of Clinical Medicine
University of California, Irvine
Universiteit van Amsterdam
University of Health Sciences
Mahosot Hospital
Savannakhet Provincial Health Department
Amsterdam Institute for Global Health and Development
Abstract
© 2019 The Author(s). 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.