Malaria-related perceptions and practices of women with children under the age of five years in rural Ethiopia

Background: Malaria remains to be the major cause of morbidity and mortality among pregnant women and children in Ethiopia. The aim of this study was to investigate the local perceptions, practices and treatment seeking behaviour for malaria among women with children under the age of five years. Methods: This community-based study was conducted in 2003 in an area of seasonal malaria transmission in Adami Tulu District, south-central Ethiopia. Total samples of 2087 rural women with children less than five years of age from 18 rural kebeles (the smallest administrative units) were interviewed about their perceptions and practices regarding malaria. In addition, focus group discussions and in-depth interviews were conducted on similar issues to complement the quantitative data. Results: Malaria, locally known as busaa, is perceived as the main health problem in the study area. Mosquitoes are perceived to be the main cause of the disease, and other misperceptions were also widespread. The use of prevention measures was very low. Most mothers were familiar with the main signs and symptoms of mild malaria, and some of them indicated high grade fever, convulsions and mental confusion as a manifestation of severe malaria. Very few households (5.6%) possessed one or two nets. More than 60% of the mothers with recent episodes of malaria received initial treatment from non-public health facilities such as community health workers (CHWs) (40%) and private care providers (21%). Less than 40% of the reported malaria cases among women were treated by public health facilities. Conclusion: Malaria was perceived as the main health problem among women and children. The use of malaria preventive measures was low. A significant proportion of the respondents received initial malaria treatments from CHWs, private care providers and public health facilities. Concerted effort is needed to scale-up the distribution of insecticide-treated nets and improve the knowledge of the community about the link between malaria and mosquitoes. Effective antimalarial drugs should also be available at the grassroots level where the problem of malaria is rampant.