title: Health care switching behaviour of malaria patients in a Kenyan rural community.
abstract: Patients ordinarily use multiple sources of health care. This study reveals the transitions patients in a rural region of Gusii, Kenya are likely to make beyond the homestead in their search for alternatives to combat malaria. Malaria is a very common health problem in the region resulting in enormous human and economic losses. Data on health care seeking behaviour were collected over a 10-month period. The primary data for this paper is from malaria-focused ethnographic interviews with 35 adults (18 women and 17 men). Results show that patients are more likely to start with self-treatment at home as they wait for a time during which they observe their progress. This allows them to minimise expenditure incurred as a result of the sickness. They are more likely to choose treatments available outside the home during subsequent decisions. The decisions include visiting a private health care practitioner, a government health centre or going to a hospital when the situation gets desperate. Knowledge and duration of sickness, the anticipated cost of treatment. and a patient's judgement of the intensity of sickness determine their choice of treatment.
authors.affiliation: Institute of African Studies, University of Nairobi, Kenya. nama@insightkenya.com
authors.forename: I K
authors.initials: IK
authors.lastname: Nyamongo
mesh_terms: D000328:Adult; D003151:Community Health Centers / Q000706:statistics & numerical data; D017281:Cost of Illness; D003657:Decision Making; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D007630:Kenya; D008288:Malaria / Q000208:ethnology*; D008297:Male; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011331:Private Practice / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D012648:Self Care