In Tanzania, parents seeking treatment for children with severe, often malaria-related, fever vary in their choice of care. Their choice is influenced by a range of social and cultural factors that need to be better understood if children are to be successfully treated.

In urban and peri-urban areas of Tanzania, many parents believe their children suffer from 'degedege' - a local term for malaria-related childhood febrile (fever) illnesses. Parents and carers would prefer, in the first instance, to take their children to a biomedical facility. However, opening and closing times are not always convenient. Consequently, parents often have no choice but to seek out a traditional healer who can provide treatment and comfort at more convenient hours.

Many parents or carers of children with severe fevers do not necessarily follow one single approach to seeking treatment. Despite shared cultural knowledge concerning the causes of degedege, for example, parents deal with their children's illnesses in a variety of different ways.

It is the less obvious social and cultural dynamics of treatment management in households that influence how people seek health care in a crisis situation. These also interact with structural constraints and circumstances that influence how an illness is managed. Such constraints include:

• Physical, social and communication barriers at health care facilities, such as poor doctor-to-patient communication.
• A limited ability to use resources, including biomedical health facilities and social networks, due to poverty and social status.
• Little or no previous experience with the illness - especially young mothers.
• Bad timing of the illness, such as when health services are closed during a public holiday.
• the lack of social support and appropriate advice from members of ones social networks.

If malaria treatment strategies are to be successfully implemented, policymakers need to pay attention to:

• the subtleties of how poor households' make health care decisions
• how uncertainties of life and every day contingencies influence poor people's health care decisions
• social change in poor communities, such as when new health care interventions like insecticide treated nets are introduced
• the politics of communication at public health facilities, such as when social status affects communication between health workers and mothers of sick children
• issues that go beyond the study of beliefs about the causes and origins of the illness like the politics of health care
• cultural models about the appropriateness of certain treatment seeking behaviours and practices.

Source(s):
'"I thought it was only ordinary fever!" Cultural knowledge and the micropolitics of therapy seeking for childhood febrile illness in Tanzania', Social Science & Medicine 62(12), pages 2945-2959, by Vinay R. Kamat, 2006

id21 Research Highlight: 18 July 2006

Further Information:
Vinay R. Kamat
Department of Anthropology
University of British Columbia
2119 - 6303 N.W. Marine Drive
Vancouver
British Columbia
V6T 1Z1
Canada

Tel: +1 604 822 4802
Fax: +1 604 822 6161
Contact the contributor: kamatvin@interchange.ubc.ca

Department of Anthropology, University of British Columbia, Vancouver, Canada

Other related links:
'Hitting malaria where it hurts: household and community responses in Africa'

'Buying the best? Household malaria prevention in the Gambia'

'To buy or not to buy? Communities and bed nets in rural Ghana'

'Forgotten people: malaria control in refugee camps'

'Mosquito nets challenge tradition in Tanzania'

'Malaria: the acceptable disease in Tanzania'

'Kenyan communities fight back against malaria'