Young children with severe malaria in the Kapolowe health zone: an analysis of their parents’ health-seeking behaviors and the challenges they face

CONTEXT: In the remote areas of the Democratic Republic of Congo, particularly in the Kapolowe health zone, the healthcare-seeking behaviour of mothers with children suffering from severe malaria remains a major challenge. This is often a key factor in the deaths of many children because they do not receive effective treatment in a timely manner due to various factors, including socio-economic, geographical, cultural, and structural factors. At the community level, where the administration of medications via injection is not possible, a pre-referral community intervention has the potential to reduce morbidity and mortality. To successfully implement this in a community, it is essential to understand the healthcare-seeking behaviour of parents with severely ill children under five and the challenges they face. METHODS: Using a qualitative approach, 30 focus groups discussions were conducted in 30 villages within the Kapolowe health zone. Of these, 9 groups were selected based on pre-established criteria and were manually analysed in depth using the inductive method. The three delays model was adapted to guide the analysis. Data which were collected focused on participants' understanding of suspected malaria symptoms, actions taken when illness began, reasons behind these actions, and the difficulties encountered when seeking care. RESULTS: The findings indicate that mothers in Kapolowe often delay seeking care when their children become ill. When they do seek care, they frequently resort to self-medication with both modern medicines and traditional remedies. Barriers to access included geographical distance, impassable roads, lack of transportation and healthcare facilities, as well as financial difficulties related to both direct and indirect costs of care. Cultural factors also played a significant role in decision making, with mothers preferring to wait, rely on traditional practices, or turn to prayers. CONCLUSION: Healthcare-seeking behaviour in Kapolowe is shaped by structural, financial, and cultural barriers. This findings underscore the need to strengthen the health system in Kapolowe by developing strategies that account for lived realities of the community.