Understanding Caretakers' Dilemma in Deciding Whether or Not to Adhere with Referral Advice after Pre-Referral Treatment with Rectal Artesunate

Background: Malaria kills. A single rectal dose of artesunate before referral can reduce mortality and prevent permanent disability. However, the success of this intervention depends on caretakers' adherence to referral advice for follow-up care. This paper explores the dilemma facing caretaker...

Full description

Bibliographic Details
Main Authors:	Simba, D. O., Kakoko, D. C., Warsame, M., Premji, Z., Gomes, M. F., Tomson, G., Johansson, E.
Format:	Journal Article
Language:	EN
Published:	2012
Online Access:	http://hdl.handle.net/10986/5346

id	okr-10986-5346
recordtype	oai_dc
spelling	okr-10986-53462021-04-23T14:02:21Z Understanding Caretakers' Dilemma in Deciding Whether or Not to Adhere with Referral Advice after Pre-Referral Treatment with Rectal Artesunate Simba, D. O. Kakoko, D. C. Warsame, M. Premji, Z. Gomes, M. F. Tomson, G. Johansson, E. Background: Malaria kills. A single rectal dose of artesunate before referral can reduce mortality and prevent permanent disability. However, the success of this intervention depends on caretakers' adherence to referral advice for follow-up care. This paper explores the dilemma facing caretakers when they are in the process of deciding whether or not to transit their child to a health facility after pre-referral treatment with rectal artesunate. Methods: Four focus group discussions were held in each of three purposively selected villages in Mtwara rural district of Tanzania. Data were analysed manually using latent qualitative content analysis. Results: The theme "Caretakers dilemma in deciding whether or not to adhere with referral advice after pre-referral treatment with rectal artesunate" depicts the challenge they face. Caretakers' understanding of the rationale for going to hospital after treatment - when and why they should adhere - influenced adherence. Caretakers, whose children did not improve, usually adhered to referral advice. If a child had noticeably improved with pre-referral treatment however, caretakers weighed whether they should proceed to the facility, balancing the child's improved condition against other competing priorities, difficulties in reaching the health facilities, and the perceived quality of care at the health facility. Some misinterpretation were found regarding the urgency and rationale for adherence among some caretakers of children who improved which were attributed to be possibly due to their prior understanding. Conclusion: Some caretakers did not adhere when their children improved and some who adhered did so without understanding why they should proceed to the facility. Successful implementation of the rectal artesunate strategy depends upon effective communication regarding referral to clinic. 2012-03-30T07:32:24Z 2012-03-30T07:32:24Z 2010 Journal Article Malaria Journal 1475-2875 http://hdl.handle.net/10986/5346 EN http://creativecommons.org/licenses/by-nc-nd/3.0/igo World Bank Journal Article Tanzania
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	EN
geographic_facet	Tanzania
relation	http://creativecommons.org/licenses/by-nc-nd/3.0/igo
description	Background: Malaria kills. A single rectal dose of artesunate before referral can reduce mortality and prevent permanent disability. However, the success of this intervention depends on caretakers' adherence to referral advice for follow-up care. This paper explores the dilemma facing caretakers when they are in the process of deciding whether or not to transit their child to a health facility after pre-referral treatment with rectal artesunate. Methods: Four focus group discussions were held in each of three purposively selected villages in Mtwara rural district of Tanzania. Data were analysed manually using latent qualitative content analysis. Results: The theme "Caretakers dilemma in deciding whether or not to adhere with referral advice after pre-referral treatment with rectal artesunate" depicts the challenge they face. Caretakers' understanding of the rationale for going to hospital after treatment - when and why they should adhere - influenced adherence. Caretakers, whose children did not improve, usually adhered to referral advice. If a child had noticeably improved with pre-referral treatment however, caretakers weighed whether they should proceed to the facility, balancing the child's improved condition against other competing priorities, difficulties in reaching the health facilities, and the perceived quality of care at the health facility. Some misinterpretation were found regarding the urgency and rationale for adherence among some caretakers of children who improved which were attributed to be possibly due to their prior understanding. Conclusion: Some caretakers did not adhere when their children improved and some who adhered did so without understanding why they should proceed to the facility. Successful implementation of the rectal artesunate strategy depends upon effective communication regarding referral to clinic.
format	Journal Article
author	Simba, D. O. Kakoko, D. C. Warsame, M. Premji, Z. Gomes, M. F. Tomson, G. Johansson, E.
spellingShingle	Simba, D. O. Kakoko, D. C. Warsame, M. Premji, Z. Gomes, M. F. Tomson, G. Johansson, E. Understanding Caretakers' Dilemma in Deciding Whether or Not to Adhere with Referral Advice after Pre-Referral Treatment with Rectal Artesunate
author_facet	Simba, D. O. Kakoko, D. C. Warsame, M. Premji, Z. Gomes, M. F. Tomson, G. Johansson, E.
author_sort	Simba, D. O.
title	Understanding Caretakers' Dilemma in Deciding Whether or Not to Adhere with Referral Advice after Pre-Referral Treatment with Rectal Artesunate
title_short	Understanding Caretakers' Dilemma in Deciding Whether or Not to Adhere with Referral Advice after Pre-Referral Treatment with Rectal Artesunate
title_full	Understanding Caretakers' Dilemma in Deciding Whether or Not to Adhere with Referral Advice after Pre-Referral Treatment with Rectal Artesunate
title_fullStr	Understanding Caretakers' Dilemma in Deciding Whether or Not to Adhere with Referral Advice after Pre-Referral Treatment with Rectal Artesunate
title_full_unstemmed	Understanding Caretakers' Dilemma in Deciding Whether or Not to Adhere with Referral Advice after Pre-Referral Treatment with Rectal Artesunate
title_sort	understanding caretakers' dilemma in deciding whether or not to adhere with referral advice after pre-referral treatment with rectal artesunate
publishDate	2012
url	http://hdl.handle.net/10986/5346
_version_	1764394713622773760

Understanding Caretakers' Dilemma in Deciding Whether or Not to Adhere with Referral Advice after Pre-Referral Treatment with Rectal Artesunate

Similar Items