Treatment-seeking behaviour for malaria in children under five years of age: implication for home management in rural areas with high seasonal transmission in Sudan.

Background: Effective management of malaria in children under the age of 5 requires mothers to seek, obtain, and use medication appropriately. This is linked to timely decision, accessibility, correct use of the drugs and follow-up. The aim of the study is to identify the basis on which fever was recognized and classified and exploring factors involved in selection of different treatment options.

Methods: Data was obtained by interviewing 96 mothers who had brought their febrile children to selected health facilities, conduction of 10 focus group discussions with mothers at village level as well as by observation.

Results: A high score of mothers' knowledge and recognition of fever/malaria was recorded. Mothers usually start care at home and, within an average of three days, they shift to health workers if there was no response. The main health-seeking behaviour is to consult the nearest health facility or health personnel together with using traditional medicine or herbs. There are also health workers who visit patients at home. The majority of mothers with febrile children reported taking drugs before visiting a health facility. The choice between the available options determined by the availability of health facilities, user fees, satisfaction with services, difficulty to reach the facilities and believe in traditional medicine.

Conclusion: Mothers usually go through different treatment option before consulting health facilities ending with obvious delay in seeking care. As early effective treatment is the main theme of the control programme, implementation of malaria home management strategy is urgently needed to improve the ongoing practice.