Sociocultural and structural factors contributing to delays in treatment for children with severe malaria: a qualitative study in southwestern Uganda. Academic Article uri icon

Overview

abstract

  • Malaria is a leading cause of pediatric mortality, and Uganda has among the highest incidences in the world. Increased morbidity and mortality are associated with delays to care. This qualitative study sought to characterize barriers to prompt allopathic care for children hospitalized with severe malaria in the endemic region of southwestern Uganda. Minimally structured, qualitative interviews were conducted with guardians of children admitted to a regional hospital with severe malaria. Using an inductive and content analytic approach, transcripts were analyzed to identify and define categories that explain delayed care. These categories represented two broad themes: sociocultural and structural factors. Sociocultural factors were 1) interviewee's distinctions of "traditional" versus "hospital" illnesses, which were mutually exclusive and 2) generational conflict, where deference to one's elders, who recommended traditional medicine, was expected. Structural factors were 1) inadequate distribution of health-care resources, 2) impoverishment limiting escalation of care, and 3) financial impact of illness on household economies. These factors perpetuate a cycle of illness, debt, and poverty consistent with a model of structural violence. Our findings inform a number of potential interventions that could alleviate the burden of this preventable, but often fatal, illness. Such interventions could be beneficial in similarly endemic, low-resource settings.

authors

  • Sundararajan, Radhika
  • Mwanga-Amumpaire, Juliet
  • Adrama, Harriet
  • Tumuhairwe, Jackline
  • Mbabazi, Sheilla
  • Mworozi, Kenneth
  • Carroll, Ryan
  • Bangsberg, David
  • Boum, Yap
  • Ware, Norma C

publication date

  • March 23, 2015

Research

keywords

  • Antimalarials
  • Health Services Accessibility
  • Malaria
  • Patient Acceptance of Health Care

Identity

PubMed Central ID

  • PMC4426580

Scopus Document Identifier

  • 84929095468

Digital Object Identifier (DOI)

  • 10.4269/ajtmh.14-0784

PubMed ID

  • 25802438

Additional Document Info

volume

  • 92

issue

  • 5