Sociocultural and Structural Factors Contributing to Delays in Treatment for Children with Severe Malaria: A Qualitative Study in Southwestern Uganda

Hdl Handle:
http://hdl.handle.net/10144/550560
Title:
Sociocultural and Structural Factors Contributing to Delays in Treatment for Children with Severe Malaria: A Qualitative Study in Southwestern Uganda
Authors:
Sundararajan, Radhika; Mwanga-Amumpaire, Juliet; Adrama, Harriet; Tumuhairwe, Jackline; Mbabazi, Sheilla; Mworozi, Kenneth; Carroll, Ryan; Bangsberg, David; Boum, Yap; Ware, Norma C
Journal:
The American Journal of Tropical Medicine and Hygiene
Abstract:
Malaria is a leading cause of pediatric mortality, and Uganda has 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.
Publisher:
American Society of Tropical Medicine and Hygiene
Issue Date:
23-Mar-2015
URI:
http://hdl.handle.net/10144/550560
DOI:
10.4269/ajtmh.14-0784
PubMed ID:
25802438
Additional Links:
http://www.ajtmh.org
Language:
en
ISSN:
1476-1645
Appears in Collections:
Malaria

Full metadata record

DC FieldValue Language
dc.contributor.authorSundararajan, Radhikaen_GB
dc.contributor.authorMwanga-Amumpaire, Julieten_GB
dc.contributor.authorAdrama, Harrieten_GB
dc.contributor.authorTumuhairwe, Jacklineen_GB
dc.contributor.authorMbabazi, Sheillaen_GB
dc.contributor.authorMworozi, Kennethen_GB
dc.contributor.authorCarroll, Ryanen_GB
dc.contributor.authorBangsberg, Daviden_GB
dc.contributor.authorBoum, Yapen_GB
dc.contributor.authorWare, Norma Cen_GB
dc.date.accessioned2015-04-23T23:03:36Z-
dc.date.available2015-04-23T23:03:36Z-
dc.date.issued2015-03-23-
dc.identifier.citationSociocultural and Structural Factors Contributing to Delays in Treatment for Children with Severe Malaria: A Qualitative Study in Southwestern Uganda. 2015: Am. J. Trop. Med. Hyg.en_GB
dc.identifier.issn1476-1645-
dc.identifier.pmid25802438-
dc.identifier.doi10.4269/ajtmh.14-0784-
dc.identifier.urihttp://hdl.handle.net/10144/550560-
dc.description.abstractMalaria is a leading cause of pediatric mortality, and Uganda has 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.en_GB
dc.languageENG-
dc.language.isoenen
dc.publisherAmerican Society of Tropical Medicine and Hygieneen_GB
dc.relation.urlhttp://www.ajtmh.orgen_GB
dc.rightsArchived with thanks to The American Journal of Tropical Medicine and Hygieneen_GB
dc.titleSociocultural and Structural Factors Contributing to Delays in Treatment for Children with Severe Malaria: A Qualitative Study in Southwestern Ugandaen
dc.identifier.journalThe American Journal of Tropical Medicine and Hygieneen_GB
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