Malaria in Under Five Children and Help Seeking Behavior of Mothers in Calabar, Nigeria

Abstract

Malaria is a serious public health problem worldwide, yet preventable and treatable. However, in 2010 the disease killed an estimated 660, 000 people largely children under five years in sub-Saharan Africa; the Republic of Congo and Nigeria account for more than 40% of estimated global malaria deaths (WHO, 2013).  Federal Ministry of Health (FMOH) reports Nigeria accounts for one quarter of all malaria cases in Africa, one of the world’s highest rates of all cause -mortality for children under five, and about one in six children die before their fifth birthday (FMOH, 2012).  In Cross River State  under five mortality of 176 per 1000 births and infant mortality of 120 per 1000 births, placing Cross River among those with the highest child deaths in the country( State Ministry of Health, 2010), and  malaria prevalence of 19.8% (National Population Commission, 2009). Hence, the malaria control targets include 100% children under five years and pregnant women to use mosquito nets by 2015 (Community Health Department, 2013). Objective of the study was to determine help seeking behavior of mothers with children less than five years, and factors that influenced behavior. We randomly selected six primary health facilities out of 41, and administered a structured questionnaire to four hundred (400) women who brought their sick children to outpatient department of selected health facilities, and gave oral informed consent.  State Ministry of Health gave ethical clearance for access to community and health facilities. Most, 370 (93%) respondents completed the questionnaire, 37% were married, 50% had primary education, 26% secondary, and 10% tertiary,  42% were homemakers, 31% 19 -23 years, and 54% of children were within one year.   Many respondents 46% brought babies to health facility due to fever, and 32.4% said child had fever for over a week, yet 39.0% gave fever as symptom of malaria and 39.4% mosquito bite. Most 96% had heard of malaria largely from electronic media 40.5% and parents 32.4%.  However, despite knowledge about malaria, 35% gave tepid sponging, 31% herbal enema, 27% gave baby left over drugs; 40% said treatment  at home lasted 4 to 6 days and 12% more than a week. Home intervention led to child’s illness worsening 40%, and improved 38%. Respondents delayed taking children to hospital because they had no time 35.1%, husband was not at home 30%, had no money 22.7%, had no transport 6.2% and customary to first treat at home 6.0%. Furthermore, 52.4% said hospital was too far from residence and 14.0% no hospital in locality, 64.5% said father was responsible for child’s treatment. Cost of care 47.5%, transportation 32.7%, waiting time 10.0% and lack of time 9.2% were major factors affecting help seeking. This study shows that significant relationship exists between mother’s health seeking behavior and outcome of child’s illness. Further, suggests as global and national efforts continue, the role of fathers in reducing morbidity and mortality among infants requires considerable attention, particularly in patriarchal traditional societies, where mothers depend on decisions of husbands to seek help for the child.

Key words: Malaria, Children and Malaria, Help Seeking Behavior of Mothers.