Skip to main content
Top
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Community perceptions and practices of treatment seeking for childhood pneumonia: a mixed methods study in a rural district, Ghana

Authors: Mercy Abbey, Margaret A. Chinbuah, Margaret Gyapong, L. Kay Bartholomew, Bart van den Borne

Published in: BMC Public Health | Issue 1/2016

Login to get access

Abstract

Background

The World Health Organization recommends community case management of malaria and pneumonia for reduction of under-five mortality in developing countries. Caregivers’ perception and understanding of the illness influences the care a sick child receives. Studies in Ghana and elsewhere have routinely shown adequate recognition of malaria by caregivers. Similarly, evidence from Asia and some African countries have shown adequate knowledge on pneumonia. However, in Ghana, little has been documented about community awareness, knowledge, perceptions and management of childhood pneumonia particularly in the Dangme West district. Therefore this formative study was conducted to determine community perceptions of pneumonia for the purpose of informing the design and implementation of context specific health communication strategies to promote early and appropriate care seeking behaviour for childhood pneumonia.

Methods

A mixed method approach was adopted. Data were obtained from structured interviews (N = 501) and eight focus group discussions made up of 56 caregivers of under-fives and eight community Key Informants. Descriptive and inference statistics were used for the quantitative data and grounded theory to guide the analysis of the qualitative data.

Results

Two-thirds of the respondents had never heard the name pneumonia. Most respondents did not know about the signs and symptoms of pneumonia. For the few who have heard about pneumonia, causes were largely attributed to coming into contact with cold temperature in various forms. Management practices mostly were self-treatment with home remedies and allopathic care.

Conclusion

The low awareness and inadequate recognition of pneumonia implies that affected children may not receive prompt and appropriate treatment as their caregivers may misdiagnose the illness. Adequate measures need to be taken to create the needed awareness to improve care seeking behaviour.
Appendix
Available only for authorised users
Literature
1.
go back to reference Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, Jha P, Campbell H, Walker CF, Cibulskis R. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010;375(9730):1969–87.CrossRefPubMed Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, Jha P, Campbell H, Walker CF, Cibulskis R. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010;375(9730):1969–87.CrossRefPubMed
2.
go back to reference Unicef, WHO: Pneumonia the forgotten killer of children. New York, Geneva: The United Nations Children’s Fund (UNICEF). World Health Organization (WHO) 2006. Unicef, WHO: Pneumonia the forgotten killer of children. New York, Geneva: The United Nations Children’s Fund (UNICEF). World Health Organization (WHO) 2006.
3.
go back to reference World Health Organization: WHO/UNICEF joint statement: management of pneumonia in community settings: UNICEF; 2004. World Health Organization: WHO/UNICEF joint statement: management of pneumonia in community settings: UNICEF; 2004.
4.
go back to reference Schellenberg J, Victora C, Mushi A, de Savigny D, Schellenberg D, Mshinda H, Bryce J. Tanzania Integrated Management of Childhood Illness MCE Baseline Household Survey Study Group. Inequities among the very poor: health care for children in rural southern Tanzania. Lancet. 2003;361(9357):561–6.CrossRefPubMed Schellenberg J, Victora C, Mushi A, de Savigny D, Schellenberg D, Mshinda H, Bryce J. Tanzania Integrated Management of Childhood Illness MCE Baseline Household Survey Study Group. Inequities among the very poor: health care for children in rural southern Tanzania. Lancet. 2003;361(9357):561–6.CrossRefPubMed
5.
go back to reference Winch PJ, Gilroy KE, Wolfheim C, Starbuck ES, Young MW, Walker LD, Black RE. Intervention models for the management of children with signs of pneumonia or malaria by community health workers. Health Policy Plan. 2005;20(4):199–212.CrossRefPubMed Winch PJ, Gilroy KE, Wolfheim C, Starbuck ES, Young MW, Walker LD, Black RE. Intervention models for the management of children with signs of pneumonia or malaria by community health workers. Health Policy Plan. 2005;20(4):199–212.CrossRefPubMed
6.
go back to reference Lehmann U, Sanders D. Community health workers: What do we know about them? The state of the evidence on programmes, activities, costs and impact on health outcomes of using community health workers. World Health Organization. 2007;1–42. Lehmann U, Sanders D. Community health workers: What do we know about them? The state of the evidence on programmes, activities, costs and impact on health outcomes of using community health workers. World Health Organization. 2007;1–42.
7.
go back to reference World Health Organization: The Roll Back Malaria strategy for improving access to treatment through home management of malaria: World Health Organization. 2005. World Health Organization: The Roll Back Malaria strategy for improving access to treatment through home management of malaria: World Health Organization. 2005.
8.
go back to reference Kallander K, Nsungwa-Sabiiti J, Peterson S. Symptom overlap for malaria and pneumonia policy implications for home management strategies. Acta Trop. 2004;90(2):211–4.CrossRefPubMed Kallander K, Nsungwa-Sabiiti J, Peterson S. Symptom overlap for malaria and pneumonia policy implications for home management strategies. Acta Trop. 2004;90(2):211–4.CrossRefPubMed
9.
go back to reference Brown ENL. Early appropriate home management of fevers in children aged 6 months to 6 years in Ghana. Geneva: WHO-TDR; 2001. Brown ENL. Early appropriate home management of fevers in children aged 6 months to 6 years in Ghana. Geneva: WHO-TDR; 2001.
10.
go back to reference Hausmann Muela S. Community understanding of malaria, and treatment-seeking behaviour, in a holoendemic area of southeastern Tanzania. University of Basel; 2000. Hausmann Muela S. Community understanding of malaria, and treatment-seeking behaviour, in a holoendemic area of southeastern Tanzania. University of Basel; 2000.
11.
go back to reference Ruebush TK, Kern MK, Campbell CC, Oloo AJ. Self-treatment of malaria in a rural area of western Kenya. Bull World Health Organ. 1995;73(2):229–36.PubMedPubMedCentral Ruebush TK, Kern MK, Campbell CC, Oloo AJ. Self-treatment of malaria in a rural area of western Kenya. Bull World Health Organ. 1995;73(2):229–36.PubMedPubMedCentral
12.
go back to reference Ahorlu CK, Dunyo SK, Afari EA, Koram KA, Nkrumah FK. Malaria-related beliefs and behaviour in Southern Ghana: implications for treatment, prevention and control. Trop Med Int Health. 1997;2(5):488–99.CrossRefPubMed Ahorlu CK, Dunyo SK, Afari EA, Koram KA, Nkrumah FK. Malaria-related beliefs and behaviour in Southern Ghana: implications for treatment, prevention and control. Trop Med Int Health. 1997;2(5):488–99.CrossRefPubMed
13.
go back to reference Obol J, David Lagoro K, Christopher Garimoi O. Knowledge and Misconceptions about Malaria among Pregnant Women in a Post-Conflict Internally Displaced Persons’ Camps in Gulu District, Northern Uganda. Malaria Research and Treatment. 2011;2011:7. http://dx.doi.org/10.4061/2011/107987. Obol J, David Lagoro K, Christopher Garimoi O. Knowledge and Misconceptions about Malaria among Pregnant Women in a Post-Conflict Internally Displaced Persons’ Camps in Gulu District, Northern Uganda. Malaria Research and Treatment. 2011;2011:7. http://​dx.​doi.​org/​10.​4061/​2011/​107987.
14.
go back to reference Asante KP, Abokyi L, Zandoh C, Owusu R, Awini E, Sulemana A, Amenga-Etego S, Adda R, Boahen O, Segbaya S. Community perceptions of malaria and malaria treatment behaviour in a rural district of Ghana: implications for artemisinin combination therapy. BMC Public Health. 2010;10(1):409.CrossRefPubMedPubMedCentral Asante KP, Abokyi L, Zandoh C, Owusu R, Awini E, Sulemana A, Amenga-Etego S, Adda R, Boahen O, Segbaya S. Community perceptions of malaria and malaria treatment behaviour in a rural district of Ghana: implications for artemisinin combination therapy. BMC Public Health. 2010;10(1):409.CrossRefPubMedPubMedCentral
15.
go back to reference Hussain R, Lobo MA, Inam B, Khan A, Qureshi AF, Marsh D. Pneumonia perceptions and management: an ethnographic study in urban squatter settlements of Karachi, Pakistan. Soc Sci Med. 1997;45(7):991–1004.CrossRefPubMed Hussain R, Lobo MA, Inam B, Khan A, Qureshi AF, Marsh D. Pneumonia perceptions and management: an ethnographic study in urban squatter settlements of Karachi, Pakistan. Soc Sci Med. 1997;45(7):991–1004.CrossRefPubMed
16.
go back to reference Irimu G, Nduati R, Wafula E, Lenja J. Community understanding of pneumonia in Kenya. Afr Health Sci. 2008;8(2):103–7.PubMedPubMedCentral Irimu G, Nduati R, Wafula E, Lenja J. Community understanding of pneumonia in Kenya. Afr Health Sci. 2008;8(2):103–7.PubMedPubMedCentral
17.
go back to reference Gálvez CA, Modeste N, Lee JW, Betancourt H, Wilkins RL. Peruvian mothers’ knowledge and recognition of pneumonia in children under 5 years of age. Rev Panam Salud Publica. 2002;11(2):99–108.CrossRefPubMed Gálvez CA, Modeste N, Lee JW, Betancourt H, Wilkins RL. Peruvian mothers’ knowledge and recognition of pneumonia in children under 5 years of age. Rev Panam Salud Publica. 2002;11(2):99–108.CrossRefPubMed
18.
go back to reference Nonvignon J, Aikins MK, Chinbuah MA, Abbey M, Gyapong M, Garshong BNA, and SF, Gyapong JO. Treatment choices for fevers in children under-five years in a rural Ghanaian district. Malaria. 2010:9(1):1–8. Nonvignon J, Aikins MK, Chinbuah MA, Abbey M, Gyapong M, Garshong BNA, and SF, Gyapong JO. Treatment choices for fevers in children under-five years in a rural Ghanaian district. Malaria. 2010:9(1):1–8.
19.
go back to reference Hennink M, Hutter I, Bailey A. Qualitative Research Methods. London: Sage publishers; 2011. Hennink M, Hutter I, Bailey A. Qualitative Research Methods. London: Sage publishers; 2011.
20.
go back to reference Ryan GW, Martinez H, Pelto GH. Methodological issues for eliciting local signs/symptoms/illness terms associated with acute respiratory illnesses. Arch Med Res. 1995;27(3):359–65. Ryan GW, Martinez H, Pelto GH. Methodological issues for eliciting local signs/symptoms/illness terms associated with acute respiratory illnesses. Arch Med Res. 1995;27(3):359–65.
21.
go back to reference Asteriou D, Hall SG. Applied econometrics: Palgrave Macmillan. 2011. Asteriou D, Hall SG. Applied econometrics: Palgrave Macmillan. 2011.
22.
go back to reference Hildenwall H, Rutebemberwa E, Nsabagasani X, Pariyo G, Tomson G, Peterson S. Local illness concepts—implications for management of childhood pneumonia in eastern Uganda. Acta Trop. 2007;101(3):217–24.CrossRefPubMed Hildenwall H, Rutebemberwa E, Nsabagasani X, Pariyo G, Tomson G, Peterson S. Local illness concepts—implications for management of childhood pneumonia in eastern Uganda. Acta Trop. 2007;101(3):217–24.CrossRefPubMed
23.
go back to reference Källander K, Tomson G, Nsabagasani X, Sabiiti JN, Pariyo G, Peterson S. Can community health workers and caretakers recognise pneumonia in children? Experiences from western Uganda. Trans R Soc Trop Med Hyg. 2006;100(10):956–63.CrossRefPubMed Källander K, Tomson G, Nsabagasani X, Sabiiti JN, Pariyo G, Peterson S. Can community health workers and caretakers recognise pneumonia in children? Experiences from western Uganda. Trans R Soc Trop Med Hyg. 2006;100(10):956–63.CrossRefPubMed
24.
go back to reference Källander K, Nsungwa-Sabiiti J, Peterson S. Symptom overlap for malaria and pneumonia—policy implications for home management strategies. Acta Trop. 2004;90(2):211–4.CrossRefPubMed Källander K, Nsungwa-Sabiiti J, Peterson S. Symptom overlap for malaria and pneumonia—policy implications for home management strategies. Acta Trop. 2004;90(2):211–4.CrossRefPubMed
25.
go back to reference Agyepong IA. Malaria: Ethnomedical perceptions and practice in an Adangbe farming community and implications for control. Soc Sci Med. 1992;35(2):131–7.CrossRefPubMed Agyepong IA. Malaria: Ethnomedical perceptions and practice in an Adangbe farming community and implications for control. Soc Sci Med. 1992;35(2):131–7.CrossRefPubMed
26.
go back to reference Mukanga D, Tibenderana JK, Peterson S, Pariyo GW, Kiguli J, Waiswa P, Babirye R, Ojiambo G, Kasasa S, Pagnoni F. Access, acceptability and utilization of community health workers using diagnostics for case management of fever in Ugandan children: a cross-sectional study. Malar J. 2012;11:121.CrossRefPubMedPubMedCentral Mukanga D, Tibenderana JK, Peterson S, Pariyo GW, Kiguli J, Waiswa P, Babirye R, Ojiambo G, Kasasa S, Pagnoni F. Access, acceptability and utilization of community health workers using diagnostics for case management of fever in Ugandan children: a cross-sectional study. Malar J. 2012;11:121.CrossRefPubMedPubMedCentral
27.
go back to reference Abbey M, Bartholomew LK, Pappoe M, van den Borne B. Treating fever in children under five: caregiver perceptions of community health worker services in Dangme West district, Ghana. Int health. 2015;7(6):455–63. Abbey M, Bartholomew LK, Pappoe M, van den Borne B. Treating fever in children under five: caregiver perceptions of community health worker services in Dangme West district, Ghana. Int health. 2015;7(6):455–63.
28.
go back to reference Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.CrossRefPubMed Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.CrossRefPubMed
Metadata
Title
Community perceptions and practices of treatment seeking for childhood pneumonia: a mixed methods study in a rural district, Ghana
Authors
Mercy Abbey
Margaret A. Chinbuah
Margaret Gyapong
L. Kay Bartholomew
Bart van den Borne
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3513-z

Other articles of this Issue 1/2016

BMC Public Health 1/2016 Go to the issue