ArticleMalaria journal2010
Understanding caretakers' dilemma in deciding whether or not to adhere with referral advice after pre-referral treatment with rectal artesunate.
Article in Malaria journal, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 51 citations in OpenAlex.
- Pre-referral Rectal Artesunate Treatment by Community-Based Treatment Providers in Ghana, Guinea-Bissau, Tanzania, and Uganda (Study 18): A Cluster-Randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Trial
- Article
- Article
- Starting at the community: Treatment-seeking pathways of children with suspected severe malaria in Uganda.PLOS global public health · 2023Article
- Effectiveness of rectal artesunate as pre-referral treatment for severe malaria in children under 5 years of age: a multi-country observational study.BMC medicine · 2022Observational
- Key factors predicting suspected severe malaria case management and health outcomes: an operational study in the Democratic Republic of the Congo.Malaria journal · 2022Observational
- The building blocks of community health systems: a systems framework for the design, implementation and evaluation of iCCM programs and community-based interventions.BMJ global health · 2022Review
- Prereferral rectal artesunate and referral completion among children with suspected severe malaria in the Democratic Republic of the Congo, Nigeria and Uganda.BMJ global health · 2022Observational
- Twenty years of integrated disease surveillance and response in Sub-Saharan Africa: challenges and opportunities for effective management of infectious disease epidemics.One health outlook · 2021Review
- A mixed-methods study exploring adherence to the referral of severely sick children in primary health care in Southern Ethiopia.Archives of public health = Archives belges de sante publique · 2021Article
- Referral of sick children and levels of adherence by carers: implications on quality health care in the middle belt of Ghana.Ghana medical journal · 2021Article
- Article
- Community understanding of the concept of pre-referral treatment and how this impacts on referral related decision-making following the provision of rectal artesunate: a qualitative study in western Uganda.BMC health services research · 2018Article
- Monitoring iCCM referral systems: Bugoye Integrated Community Case Management Initiative (BIMI) in Uganda.Malaria journal · 2016Article
- Estimating the cost of referral and willingness to pay for referral to higher-level health facilities: a case series study from an integrated community case management programme in Uganda.BMC health services research · 2015Article
- Occurrence of pfatpase6 Single Nucleotide Polymorphisms Associated with Artemisinin Resistance among Field Isolates of Plasmodium falciparum in North-Eastern Tanzania.Malaria research and treatment · 2015Article
- Special issue: newborn health in Uganda.Global health action · 2015Article
- 'As soon as the umbilical cord gets off, the child ceases to be called a newborn': sociocultural beliefs and newborn referral in rural Uganda.Global health action · 2015Article
- Public policy, health system, and community actions against illness as platforms for response to NCDs in Tanzania: a narrative review.Global health action · 2014Review
- High compliance with newborn community-to-facility referral in eastern Uganda:.an opportunity to improve newborn survival.PloS one · 2013Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMalaria 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.
methodsFour 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.
resultsThe 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.
conclusionSome 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.
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Registered trials
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