Evidence map›Paper›PMID 42208999›Full record

ArticleBMJ open2026

Three delays of malaria care-seeking in Malawi: a cross-sectional study.

Bolanle Olapeju, Michael Bride, Tyson Volkmann, Shelby Cash, Edson Dembo, Michael Kayange, Austin Gumbo, Taonga Mafuleka, Jennifer Boyle, Alfred Mang'ando and 2 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Bolanle OlapejuDepartment of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA bolanle.olapeju@usuhs.edu.ORCID http://orcid.org/0000-0002-2958-2708
Michael BrideJohns Hopkins University Center for Communication Programs, Baltimore, Maryland, USA.
Tyson VolkmannU.S. President's Malaria Initiative, US Centers for Disease Control and Prevention Research Centers, Lilongwe, Malawi.
Shelby CashU.S. President's Malaria Initiative, Malaria Branch, US Centers for Disease Control and Prevention Research Centers, Atlanta, Georgia, USA.
Edson DemboU.S. President's Malaria Initiative, USAID, Lilongwe, Malawi.
Michael KayangeNational Malaria Control Program, Government of Malawi Ministry of Health, Lilongwe, Central Region, Malawi.
Austin GumboNational Malaria Control Program, Government of Malawi Ministry of Health, Lilongwe, Central Region, Malawi.
Taonga MafulekaNational Malaria Control Program, Government of Malawi Ministry of Health, Lilongwe, Central Region, Malawi.
Jennifer BoyleJohns Hopkins University Center for Communication Programs, Baltimore, Maryland, USA.
Alfred Mang'andoJohns Hopkins University Center for Communication Programs, Baltimore, Maryland, USA.
Nyanyiwe Masingi MbeyeEvidence Informed Decision Making Centre, Department of Epidemiology and Biostatistics, Kamuzu University of Health Sciences School Global and Public Health, Blantyre, Southern Region, Malawi.
Chime MukwakwaJohns Hopkins University Center for Communication Programs, Baltimore, Maryland, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo identify psychosocial and structural barriers to prompt malaria care-seeking in Malawi by applying the Three Delays Model (delay 1: deciding to seek care; delay 2: reaching a facility; delay 3: receiving quality care).

designcross-sectional study.

settingNationally representative data collected from Malawi communities between 25 May 2021 and 1 July 2021.

participants913 female caregivers who reported a child with fever in the past 2 weeks. PRIMARY OUTCOME MEASURES: Prompt care-seeking for fever (same or next day) from a qualified health provider.

resultsPrompt care-seeking was primarily associated with delay 1 (adjusted OR (aOR) 0.58, 95% CI 0.43 to 0.78) and psychosocial (aOR 0.59; 95% CI 0.44 to 0.79) factors. Significant factors included incorrect knowledge of malaria symptoms, cause and diagnosis (aOR 0.71: 95% CI 0.53 to 0.97), negative attitudes towards care-seeking (aOR 0.58; 95% CI 0.41 to 0.82), incorrect knowledge of when and where to seek care (aOR 0.19: 95% CI 0.07 to 0.50) and far distance from a health facility (aOR 0.67, 95% CI 0.49 to 0.93).

conclusionDespite the availability of free malaria services, significant bottlenecks remain in the initial decision-making phase. To reduce malaria mortality, national programmes should prioritise social and behaviour change interventions that move beyond general awareness to target specific care-seeking attitudes and intra-household decision-making dynamics.

Indexed as

Health Knowledge, Attitudes, PracticeHealth Services AccessibilityMalariaPatient Acceptance of Health CareAdolescentAdultCaregiversChild, PreschoolCross-Sectional StudiesFemaleHumansInfantMalawiMiddle AgedTreatment DelayYoung AdultAfrica South of the SaharaBehaviorMalaria

Identifiers

PMID42208999
PMCPMC13223671

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LicenceCC BY-NC
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.