| dc.description.abstract | This study was designed to investigate lay people's malaria lived experiences
in Rigoma division, Nyamira district. Rigoma is situated in a malaria epidemic-prone
region in the southwestern highlands of Kenya. It is inhabited by the agricultural
Gusii community. The objectives of the study are; (1) to describe the factors that
determine the health seeking behaviour of malaria patients, (ii) to investigate the lay
peoples perceptions on malaria signs and symptoms, (iii) to establish the health care
options available to malaria patients, and (iv) the patient's response time in seeking
health care.
Fieldwork was carried out during the months of January to March 2001. Data
was mainly collected through case histories from 55 purposely selected respondents.
The selected respondents must have suffered a bout of malaria within the last three
weeks prior to the study. Additional data was obtained through direct observation and
four Focus Group Discussions (FGDs) from the four locations in the division. This
yielded qualitative and quantitative data. Qualitative data were thematically analysed,
while quantitative data were summarised into frequencies and percentages. Further systematic data was collected (22 respondents) using free listing method and analysed
using ANTHROPIC. Results are interpreted using Explanatory Models. Explanatory
models were considered suitable for this study, as they are concerned with people's
lived experiences with illness.
The study results reveal that various factors influenced lay people's health
seeking behaviour. Cost of treatment, distance from health facility, disease severity,
patient's social networks and service delivery emerged as the common factors that
influenced patients' health care choices. It is also clear from the 55 case histories that
the respondents are fairly knowledgeable on malaria aetiology, its signs and
symptoms and treatment. However this level of understanding did not seem to
translate into proper control and preventive measures, as there existed some
knowledge gaps. For instance. about 26 % of the respondents reported multiple
causality for malaria, while the 12 respondents who provided health care to children
in the study sample, found it difficult to diagnose malaria in children. This has greatly
affected the lay people's coping strategies against malaria infection. The study further
reveals that there are several treatment options available for malaria patients in the
area. The options available to the people include; self-medication, local private and
public health facilities. Indeed 87.3 % of the respondents began treatment at home and
reported using formal health facilities as subsequent options. Generally, most
respondents (81.8 %) took 1-3 days to seek medical care upon realization that they
had malaria. Specifically, 43.6 % took one day, 21.8 % took two days and 16.4 %
took three days. Only 18.2 % took over three days.
To help bridge the existing knowledge gaps about malaria aetiology and its
control and prevention measures, it is recommended that a public health education
program be initiated in the area. There is also a-need for the health authorities to establish a monitoring and surveillance system, which will provide for proper
forecasting of malaria epidemics in the area. Thus helping to mobilize resources for
effective management of the epidemics. This will greatly help to check the high
transmission rates associated with malaria epidemics. The scientific testing of the
efficacy levels of the reported traditional remedies and the promotion of bed net use in
the area are also recommended to be given due attention. | en |
