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dc.contributor.authorSundararajan, Radhika
dc.contributor.authorMwanga-Amumpaire, Juliet
dc.contributor.authorAdrama, Harriet
dc.contributor.authorTumuhairwe, Jackline
dc.contributor.authorMbabazi, Sheilla
dc.contributor.authorMworozi, Kenneth
dc.contributor.authorCarroll, Ryan
dc.contributor.authorBangsberg, David
dc.contributor.authorBoum, Yap
dc.contributor.authorWare, Norma C
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.
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
refterms.dateFOA2019-03-04T12:23:37Z
html.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.


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