Barriers to care for children diagnosed with malaria at José Macamo Hospital in Maputo, Mozambique

Degree Project Thesis, Programme in Medicine. TITLE: Barriers to care for children diagnosed with malaria at José Macamo Hospital in Maputo, Mozambique. Abstract Background: Malaria is a life threatening but treatable disease, affecting millions of people annually. In Mozambique, malaria is a major cause of morbidity and mortality, foremost among children. People suffering from malaria should have access to diagnosis and treatment within 24 hours from onset of symptoms according to a target set by the Roll Back Malaria Partnership. Yet, people in low-income countries often encounter barriers to care, hindering them from prompt treatment. Objective: Determine socio-cultural, economical, geographical and health care related factors that have impeded access to malaria care for children diagnosed with malaria at a public hospital in Maputo and evaluate the general knowledge about malaria among caregivers of the children diagnosed with malaria. Methods: Semi-structured, questionnaire based interviews with questions covering possible barriers to malaria care and knowledge of malaria were held with caregivers to children under the age of 15 diagnosed with malaria. Results: 28 caregivers were interviewed. The majority of caregivers sought care with their ill child after 24 hours from onset of symptoms. We could not show that having received information about malaria prior to hospital visit, ability to associate correct symptoms to malaria, suspicions of malaria or previous episodes of malaria resulted in prompt care seeking. Main reason for waiting was thinking the disease would pass by itself. Most commonly experienced and perceived barriers to care were health care related factors. Few caregivers had been given information about malaria prior to coming to hospital or in connection with the hospital visit, and there is a lack of knowledge about malaria symptoms. Conclusion: Incorrect perceptions of malaria, its symptoms and its potential risks seem to cause delay in seeking prompt diagnosis and treatment. More information about malaria symptoms, and foremost information about the importance of seeking prompt care, even with a child with vague or mild symptoms, needs to be provided. Keywords: Malaria, treatment seeking behaviour, accessibility, knowledge, children, Mozambique, attitud