Background
Methods
Study area
Data collection
Ethics
Data analysis
Results
The mothers’ perspectives
A case study: the daughter of Adrienne
Day 1 | Consultation at the local healthcare center, diagnosed with malaria and prescribed artemisinin |
Day 4 | Consultation at healthcare center in the neighboring village, 6 km away, diagnosed with anemia and referred to the Regional Hospital |
Day 5 | Hospitalized with severe malaria in the Regional Hospital, 30 km away, self-organized transportation, treated for malaria, anemia and bacterial infection |
Day 6 | Hospitalized at the Regional Hospital (with mother and siblings) |
Day 17 | Sleepless night with high fever |
Day 20 | Hospitalized at the healthcare center (with mother and baby sister) |
Day 21 | Hospitalized at the healthcare center (with mother and baby sister) |
Day 23 | Referred to the Regional Hospital, diagnosed with simple malaria |
Day 31 | Sleepless night with high fever. Home treatment with traditional medicines bought at the market |
Day 32 | Self-referral to Regional hospital, diagnosed with severe bronchitis and malaria |
Day 33 | Hospitalized |
Day 34 | Hospitalized |
Day 35 | Hospitalized |
Day 35 | Consultation with traditional healer who provided protective scarifications on chest and administered herbal medicine. |
Day 41 | Follow-up consultation at Regional Hospital. Sent home without consultation since the doctor is not available |
Day 71 | Consultation at the healthcare center in the neighboring village for malnourished children with siblings. Received portion of fortified food for 2 weeks |
Day 73 | Follow-up visit at healthcare center in neighboring village |
Day 84 | Consultation at the healthcare center in the neighboring village for malnourished children with siblings. Nurses leave before she is treated and mother is told to come back the following day |
Day 86 | Fever. Home-treatment with paracetamol. Consultation at the healthcare center in the neighboring village for malnourished children with siblings. Received portion of fortified food for 2 weeks |
Day 87 | Home-treatment with paracetamol |
Living with poverty – strategies to mobilize scarce resources
Your child may be sick, and you have nothing in your pocket in order to treat him. As your mother used to go and get plants to heal you, you will also go to find the same plants, boil them, and then wash your child. Meanwhile, you will continue to look for money, so that if the child does not get cured, you go to the clinic.
Coping strategies: seeking hopeful directions
Normally, if the child gets sick, I’ll start with traditional medicine, and I go to the pharmacy [at the dispensary] to buy paracetamol. If he is still sick after this, I'll go to the hospital (healthcare center) for help. If he is not cured after this, I now return to traditional medicine.
Here, when your child is sick you pray and ask God to give good health. You also find leaves, boil them, and wash the child with that. It may work, or it may not work. If it doesn’t, you will bring the child to the healthcare center. And if the child doesn’t get better, you will return to prayers.
Routinization of the clinical encounter
You decide to go to the hospital but if you don’t leave very early in the morning you will not get a consultation. So you might have left your home at five in the morning and you might need to wait until one o’clock, and even then no one has paid attention to you. And you just stand there, waiting.